6 Ways to Mentally Recover from an Injury

In July, Maggie Vessey, an 800-meter specialist, lined up for her third and probably last Olympic Trials in track and field. Maggie unfortunately did not qualify for the Rio Olympics, which was not shocking given her shaky last few weeks of training prior to the event.

Like so many athletes, pro and amateur, Maggie struggled with injuries leading up to her race. After one particularly frustrating workout she experienced debilitating pain, leading to tears — tears emanating more from fear of her future as an elite athlete than the pain itself. Maggie explained, “I was in that moment and just terrified and crushed and felt like, ‘This is it. How am I going to come back from this?’ … I couldn’t believe it. It felt like a dream was slipping away in this moment… I worked so hard and this was what was going to take me down? It was so hard.”

Injuries are an athletic curse. So many questions swirl around, often without concrete answers: Will I overcome this injury? If I do overcome the injury, will it come back? Will I be able to climb back to the level I was at before my injury? Do people think I am a wimp because I am injured and cannot train or race? Why can’t I deal with pain, I must be weak. How do I resume activity after an injury?

‘Taking a step back to recover requires a placidity and intelligence that is difficult for me. But despite being forced to step back, I never considered stopping.’

The focus of this article is about the mental rehab necessary after an injury, and not about its physical rehabilitation which is also needed. Almost all physical injuries have their own specific physical rehab protocol. In contrast, the tenets of mental healing are rather consistent across injuries and sports.

The first thing to understand is that injuries are not discriminating; they do not care about who you are, how hard you train, how careful you are about rest and recovery, or how deserving you are of a good race or a period of good health. The word “injury” really should be a “four-letter word” (or at the very least, you should yell out some four-letter words when you get injured).

But when you get injured — and I do say when, because inevitably you will get injured — do not ever, ever, ever, utter these words: “It’s not fair.” As Grandpa in my favorite movie The Princess Bride said, “Who ever said life is fair? Where is that written?”

Once you recognize that fairness is not at play, you can eliminate a heavy burden and focus your energy elsewhere, such as healing, managing your emotions, and dealing with the pain from the injury.

Mary-Beth Ellis, a professional triathlete who has won numerous IRONMAN races and has also suffered abundant injuries and illnesses, succinctly stated, “Taking a step back to recover requires a placidity and intelligence that is difficult for me. But despite being forced to step back, I never considered stopping.” Before you consider terminating your athletic career due to an injury, here are my six ways to mentally deal with an injury.

1. Don’t isolate yourself

Injuries are scary and facing them alone is daunting. While nobody wants to hear incessantly about your injury and your inability to train, most people in your network are willing to be a support system and can often offer words of encouragement or a perspective you may not have thought about.

Mandy Johnston, an age group athlete who recently had hip surgery to repair a torn labrum reported, “The chronic discomfort, social isolation, and inability to have an outlet to reduce stress caused me to be irritable and tearful. Prior to surgery, my running friends would ask if we could walk, see a movie, or meet for lunch. This was really helpful in feeling supported and maintaining a connection with those that I loved seeing every week.”

The NCAA further explains, “Building a team to meet the challenges and demands of the new rehabilitation environment will help the athlete overcome feelings of isolation related to separation from the team, and build confidence in recovery and return to play.”

Many of you are single-sport athletes, in which case, you are not on a team per se. However, when I am healthy I usually run with a group, so when I am unable to due to injury, I tend to feel sequestered. I have to make a concerted effort to stay in touch with my training buddies and keep them up to date with my recovery. Support from friends and training partners is unquestionably morale boosting.

2. Visualize your recovery

Visualization is often spoken about in the context of creating a mental picture representing some kind of sporting success. Visualization is also an important component of mental healing during or after an injury. Indeed, as the NCAA explains, “Using mental rehearsal as a way of anticipating challenges and practicing coping skills help pave the way to recovery.” This means you should visualize yourself being healthy, going through motions of your rehab, and seeing yourself executing your sport with perfect form.

3. Maintain your self-esteem through other means

Often, an athlete’s self-esteem is tied very closely to their athletic performance; thus, dips in athletic performance due to a prolonged absence can leave an athlete floundering in a quagmire of low self-esteem. Self-esteem can be raised through other means though, such as learning a new skill, cross-training if possible, or through mental exercise (those crazy “brain games” are actually very useful during down time from training).

4. Educate yourself about the injury, and seek out the advice of others who have or have had a similar injury

Scientia potentia est. translates into “knowledge is power,” which sounds so much less kitschy in Latin. As overused as that aphorism is, it certainly is true, particularly when it comes to athletic injuries.

Seeking out the experiences of other athletes who have been through a similar injury can help you avoid some mistakes.

The Internet is rife with information just waiting for you to seek it out — just be sure to use reputable sites. You can even access PubMed or Google Scholar for the most reliable research and information. The first critical step is to diagnose the injury appropriately, and then to learn as much as possible about how it occurred and how to make it better. Some injuries require some concentrated physical therapy, while others need surgery. Learn which option is best suited to your injury. Understanding the natural history of an injury can ease some of the anxiety that comes with the unknown.

Additionally, seeking out the experiences of other athletes who have been through a similar injury can help you avoid some mistakes. Mandy told me that she was comforted by talking to others who attained a pain-free outcome from their surgical labrum repairs. 

5. Rebuild confidence

One of the main components of returning to activity is having confidence in your ability to do so. Some injuries allow for altered participation in your sport, while others require complete time off. If you can still train, spend time not only on your regular training, but also on drills and skills that will help prevent future injuries and can build strength and agility, both of which will help with fitness over time.

Should you be unable to train at all, confidence can be regained through mental imagery of sports participation. In addition, create a checklist of small steps that need to be achieved so that you can mark off your accomplishments as they occur. Use each feat as a means to rebuilding your confidence.

6. Do not compare your post-injury self to your pre-injury self…yet 

Emily Infeld suffered a stress fracture in her build-up to the 2016 Olympic Trials. She cross-trained, which helped her maintain fitness and the all-important aforementioned confidence.

When she finally was able to run again, she did have a moment of dread, however. She explained, “During that first run on land I felt so heavy and my breathing was out of control after only 20 minutes. I wasn’t running fast. I was trying so hard… I had my moments for sure — and a few freakouts and panics.”

Emily continued on her plan though, and maintained a conservative approach to her recovery. Over time she regained her regular speed, which was good enough to finish second in the Olympic trials and earn a berth to the Rio Olympics in the 10,000 meter.

Eventually, you will get back to your athletic pursuits, so do not be tempted to test your pace and fitness level by doing something that can set you back. Let your pace and fitness build organically as you continue to heal. As Mandy continues her long recovery she aptly said, “I try to tell myself to focus on the present and not worry about what may happen down the road.”

A final note

Injuries are brutal. They take away our endorphins. They take away our outlet from the real world. They make us doubt ourselves. My take home message, above and beyond everything else, is do not let an injury shake your resolve or make you doubt who you are or make you question your sanity because that’s when an injury has become more than just a bodily menace.

Joanna Zeiger, MS, PhD, raced as a professional triathlete from 1998-2010. She placed fourth in the triathlon at the 2000 Sydney Olympics and won the 2008 IRONMAN 70.3 World Championships. She is a seven-time Olympic trials qualifier in three sports — marathon, triathlon and swimming. Joanna still pursues her passion for sports as a top Masters runner. Through her company, Race Ready Coaching, Joanna trains endurance athletes to reach their personal best and instills in them the importance of having fun even when they are training hard. When she is not coaching or training for running events, Joanna works as a consultant in the field of biostatistics. Joanna’s book The Champion Mindset: An Athlete’s Guide to Mental Toughness will be published in February 2017 by St. Martin’s Press.