5 Inevitable Stages of Progress of Injury Recovery

The news at the evening trail workout was pretty grim — one of the regular runners had broken her ankle in a trail race over the weekend. Everyone winced. A friend relayed the doctor’s information about how much recovery time there’d be before she was back on the trail. Discussion ensued. I bit my tongue and silently offered up a prayer for that to be an accurate assessment.

You see, I broke my ankle on an icy trail run several years ago (read “Less than 10 Miles” for that story). As a result, I know the difference between what doctors say and what actually happens.

Just the other evening, I came home, beaming, after a run with friends and said to my husband, “Guess what? I rolled  the SHIT out of my ankle on the trail tonight.”

He looked at me with concern: “The bad one?” I smiled broadly, “YES! And I didn’t even know it until afterwards.”

For the first time since that February 2011 failed 100-miler, my left ankle wasn’t any different from my right. They were both just ankles, and due to that misstep, one of them — which just so happened to be the left one — hurt like hell.

I was happy because my delayed realization of just which ankle was involved revealed that, physically and psychologically, I was finally fully healed. Not that everything was roses; my ankle hurt all right, and there was some swelling the next day, but that’s normal stuff.

All injured runners are looking for is to get back to normal.

Sadly, getting back to normal after an injury can be a fairly elusive and somewhat lengthy and involved process. My journey took me almost five years.

I hope our runner has a better, shorter time of it. Every break is different, just as every body is unique (I also suspect she’s a few years younger than I was, which helps a lot). Regardless of the injury or person, there are some common feelings associated with dealing with the recovery process, which is why I wanted to share this article I wrote a few years back.

And, in light of my recent ankle-rolling experience, I’d add a 6th stage of injury:  FORGETFULNESS

(This essay originally appeared in the April 2012 issue of Austin Fit Magazine.)

5 Stages of Dealing With Injury

Just the other morning, I was having coffee with a friend, Shannon. We were discussing her recent injury, which had involved recovery time in a boot to heal a fracture sustained during a 100K. The two of us were commiserating, as I had recently spent some time in a boot myself, and Shannon laughingly related the story of how her doctor pointed out that her recovery time would be relatively short; when she reacted incredulously, he responded, “Well, it’s not like you are older and have 50-year-old bones, which take MUCH longer to heal.” The reason she was laughing? Shannon was just a few weeks shy of 50.

I just turned 50 myself. Running has kept me feeling young and it’s helped me to embrace new milestones (hey, a new age group! And I’m the YOUNG one in my new age group!). It’s so much fun to hang out with people of all ages, united simply by the fact that we all have a blast running on roads and trails. You concentrate on what you all have in common, not on what makes you different, so it doesn’t matter if the person running next to me is 20 or 70; we’re running the same pace. Everybody talks about the same stuff, especially the more specialized your running group becomes (GI issues, bad toe nails, chafing, favorite socks). Make the group a bunch of trail-loving ultra runners, and Shakespeare comes to mind: “we few, we happy few, we band of brothers.”

But my body has played some numbers on me past the age of 45. Have I treated it any differently? No, not really. Well…I did pile on all that long distance as I got ready for my ultra marathons…and I did do that Ironman…so I guess, yes, the truth is, I really have treated it differently. As I’ve gotten older, I’ve demanded more in endurance from myself as an athlete while I’ve cut back on intensity and speed. I’ve been slower but I’ve pushed myself to be stronger. And since I’ve demanded more, it seems I’ve paid more of a price. I’ve had a bout of some weird fatigue, a partially torn hamstring (my doctor said that it’s a very common injury for women over 40), Achilles inflammation and plantar fasciitis, and (here’s the big one) a broken ankle, all in the last three years.

Recovery from injuries has been an interesting process, one that I’ve seen mirrored in many of my friends. As I’ve talked to people, I’ve found that Kübler-Ross’s five stages of grief apply well to the process.

1. DENIAL

At first, you spend some time trying to convince yourself that it’s not “real” pain, it “only” hurts when you do such-and-such, and that it’s pretty much only an intermittent problem. I’ve noticed that the length of this stage is fairly proportionate to 1) how long the runner has been running, and 2) how big the upcoming goal event is. In the case of broken stuff, though, this may be skipped; it’s hard to argue with the sound of your fibula splintering.

2. ANGER

Woe to the spouses, significant others, friends, and children of the angry injured runner. Often, I found this anger to be directed at doctors who really didn’t “get” my aging athlete status. My own doctor asked me if I’d sustained my broken ankle in an equestrian event, since obviously I couldn’t have been running a 100-mile race. I got angry a lot, angry at people who minimized (“Oh, you’ll be back in NO time!”), babied (“No, no — you just sit there. Don’t you need some pain medication?”), or pushed (“Come on; you need to just get up and jump back in”). I was angry at myself — if I hadn’t been so greedy, I wouldn’t have tried that longer race and I could’ve ended 2011 satisfied with a season PR instead of a year-long DNF.

3. BARGAINING

This is the fun one to listen to once you realize what’s going on. We all do it; we make intricate plans for just how we’re going to come back. I’m going to trade off and only do short distance while I’m recuperating. I’m going to be so thankful when I can run without walk breaks. I will follow all my PT’s directions so that I will be the perfect patient, and then I’ll be well quicker. I will use compression socks, massage, Epsom salts, foam rollers, Bosu balls, acupuncture, physio tape, and any number of things if it will just get me back to running. If I do X, Y will happen and I’ll be well.

4. DEPRESSION

Except that bargaining invariably leads to disappointment; things never quite go how you think they will. Setbacks occur, and they hurt. This is the worst part, and I was embarrassed at how much I cried during the healing process: I cried when my PT told me my recovery schedule, when I had to scoot up the stairs on my rear because I couldn’t navigate our three-story house doped up and on crutches, as my husband helped me in and out of the shower, when I missed my son’s last-minutes-to-save-the-game-first-ever-high-school soccer goal, when I got on the scale. And then I tried not to act depressed. Which made me depressed. Which made me angry. Sigh.

5. ACCEPTANCE

I think being older helped me to finally reach the Zen state of acceptance. It’s easier to look at the big picture when you have a substantial past. You realize there will be other races if you take care of yourself. Your running friends are not going to go away and leave you, and even if they did, there are other running buddies yet to meet. You’re a little more philosophical about loss of skills (at some point, I’m REALLY going to be old, so things, they are a’changin’). My friends who are my age seem to be more open to rebuilding and taking a different tack; the younger ones are more bent on coming back to where they were as soon as possible. In all honesty, it’s a little bit fun starting over again. I’ve been reminded of just how hard it can be to run a half marathon, and I’ve been humbled by hills and the track. I’ve tried to forget what used to be and treat myself as a brand new runner. And that, actually, has made me feel young at heart.

Now, if I can only keep a sensible build, I’ll be back to that 100-miler in no time.