It happened to me and I survived. It may even have made me stronger. I can say it now, years later, without cringing: I was injured.
Of course, it happened at the worst time, when I was deep into training for an Ironman triathlon. Most of my training partners had experienced some sort of snap, crackle or pop, so at first I thought I was simply “coming of age” as a triathlete. But there was no gain with this pain. My back seemed in a constant state of spasm and I could barely turn my head. Still, somehow I managed to swim, bike and run – despite the fact that nothing from my athletes’ first aid handbook (ibuprofen, ice, stretching, chiropractic, massage) brought relief.
When the doctor showed me the x-ray illuminating two bone spurs on my cervical spine, I felt a wave of relief at finally pinpointing the problem, followed by gut-wrenching panic at the thought of an injury compromising my quality of life as a triathlete. The big race was only nine months away.
Just a decade ago, my only recourse would have been to withdraw from the race and hope that I was guaranteed a starting spot the next year. But sports medicine has come a long way. It’s now understood that total rest can be as potentially devastating, physically and mentally, as injury itself. My doctor prescribed active recovery, in my case a combination of physical therapy, strength training and yoga.
These disciplines kept me active, reversed the pain and gave me tools to prevent a recurrence. In fact, my recovery set me up to be in better shape for my Ironman, which I finished pain-free and faster than my last.
How to Heal
Every athlete, from the first-time 5K jogger to the kings and queens of the adventure-race circuit, should know the components of active recovery. Understanding how to maintain fitness and even grow stronger while healing from an injury is as important as a good pair of shoes, a well-maintained bike and a decent ice pack.
Admitting you have a problem is always the first step. Every athlete has transient pain, such as stiffness and muscle soreness, that comes and goes. But if chronic pain develops, it’s time to seek medical attention. Swelling, pain that gets worse as you exercise or discomfort that affects your ability to move during an activity are each a sign that you should discontinue your activity and see a sports medicine doctor.
An important caveat here is to find a practitioner who will tell you what you want to hear. Namely, that after some initial rest, you can be active during your healing and recovery. I’m not being facetious or suggesting you continue training full force in the face of a potentially debilitating injury. But let’s face it, a doctor who tells you that you simply can’t _______ (fill in the blank with your athletic pursuit) likely won’t have a compliant patient.
Active recovery involves participating in an alternative fitness regimen that won’t exacerbate the injury, and may or may not include continuing your primary activity at a low level of intensity for short durations. This healing regimen is sound physically – it aids recovery by stepping up the blood oxidation process to the injured area – and also important psychologically. “Someone who is active and used to exercising can become very depressed if they’re suddenly forced to be sedentary,” says Joe Friel, triathlon coach and author of The Triathlete’s Training Bible (Velo Press, 2004). “Inactivity magnifies the emotional reaction to the injury.”
To keep active, injured runners may bike and swim or run in the deep end of the pool; cyclists, too, may swim. Swimmers on the mend might spend time on the treadmill or bike. Depending on the injury, all injured athletes will benefit from time in the weight room, on the yoga mat and in the physical therapy workout room.
Exercise for the Spirit
Physical workouts aren’t the only aspect of athletics that injured people miss. So often, a run, bike ride or swim is an integral part of an athlete’s social day as well. Build friends and motivational support into your recovery program, says USOC sports psychologist Kirsten Peterson, PhD, who completed her dissertation on how athletes cope with injury. “Social recovery involves spending time with people who love you,” says Peterson. “Mental recovery can involve relaxation techniques, listening to music or watching a motivational program.”
You can also take a total break, she says. Leave town, take a vacation or go visiting. It’s known as environmental recovery, Peterson says. That’s what Dallas runner Michele Allen did. When two stress fractures left Allen unable to run, she tried to fill in the gaps with other activities. “I started swimming and water running,” she says. Allen missed the intensity and the competition of her regular regimen, but one of her stress fractures was so severe it required surgery to implant a steel rod in her tibia. She would be able to run again, the doctors told her, but not in her near future.
Instead of sitting around at home, Allen coped by “running away.” She set off on trips that took her exploring museums in Europe, rafting in New Mexico and sightseeing in San Francisco. “It was easier not to run if I was away from my training partners,” she says. It worked out for Allen. After her out-of-town trips, she started swimming and cycling to keep fit and found herself in excellent shape for a triathlon. In her first attempt, she finished a half-Ironman triathlon as the 11th female overall. Not bad for someone who can set off airport security with her leg.
Even with complete physical recovery, there is one aspect of injury that can still hold back an athlete: fear of the injury recurring. “Athletes tend to have stable attributions about their ability – they know they [the athletes] are physically capable of coming back,” Peterson says. But it’s easy to become fixated on what could go wrong. “If someone has torn a ligament, they wonder, ‘How am I not going to do this again?’ or they may be afraid of any pain,” says Peterson. Injured athletes also tend to waste a lot of energy worrying about the time they’ve lost and feeling that they won’t catch up to the fitness level of their teammates or competitors. Peterson’s advice is to “start from now” and simply do what you can.
To strengthen your resolve and build courage during active recovery, engage in mental training. “Visualize yourself racing well,” Peterson advises. Keep your head in the game and you’ll return to your sport without feeling like you’re starting over. “This will help you stay oriented in what you do and stay confident,” she says. “If you do it vividly enough, and with all your senses, the part of your brain that receives images will fire as though you were really taking part in the activity.”
It’s trite but it’s true: That which doesn’t kill us often makes us stronger. An injury doesn’t have to be a setback; it can be a springboard to a stronger season – physically and mentally.
I know it was that way for me after recovering from my injury. And while the fear of the pain is always in the back of my mind (and moves to the front anytime I ride more than 30 miles), the thought of “rehab” no longer scares me.
On the Mend
Job one in the recovery process is knowing when to resume training. According to Joe Friel, triathlon coach and author of The Triathlete’s Training Bible (Velo Press, 2004), self-coached athletes often do too much too soon. Here’s how he tests athletes recovering from a foot or leg injury.
1. Jump up and down for a few minutes. If you can jump without a recurrence of pain or discomfort, go to step 2. If not, then resume active recovery.
2. Go for a 10-minute run or ride, preferably on a treadmill or stationary bike so that if you experience any discomfort you can stop immediately. If the activity results in no pain, go to step 3.
3. After the 10-minute test, take a day off, then move to step 4.
4. Ride or run for 20 minutes, followed by a day off. If pain-free, go to step 5.
5. Ride or run for 30 minutes, followed by a day off.
Gradually increase your distance or time, then the intensity of your workouts, until you are back on schedule. And what about that race you signed up for? According to Friel, “You shouldn’t race until you can do a workout that simulates the race.”