3 top tips for coping with the sense of loss that goes with injury

This week we have a guest blog from a 15-year old hockey player who has spent almost three years with serious knee injuries, culminating in surgery in 2020. She shares her experience here, finishing with 3 top tips that you will definitely want to read!

Over to her:

“My injury came very out of the blue (like I’m sure most injuries do). One minute I’m saving a goal then, the next thing I know there’s this horrible clicking sound and I have collapsed to the floor my right knee in agony. After many X-rays, MRI’s and countless appointments they discovered that I had fractured my kneecap, ruptured the patella tendon, torn my Medial Patello-Femoral Ligament (MPFL) and to top it all off, my kneecap never went back into the right place.

“The first thing that I can remember thinking after hearing all of this is: How? How did I do so much damage to my knee whilst performing what I would call a reasonably easy save? Then the next thing I thought was: ‘I have county try-outs in two weeks I can’t miss them that’s what I have been working towards for the last year’. Well, I did miss those county try-outs. In fact, I missed the rest of the hockey season – only getting back on the field for a few weeks of the next season before dislocating my left knee and then tearing the MPFL in that knee!

“In total, I have been completely knocked out of any sport for almost two years.

“Since dislocating my right knee the first time in March 2018, I have dislocated my knees a total of 4 times and I have now had an operation on my right knee to hopefully prevent me from dislocating it again. But I think that it was the time that I dislocated my left knee that I found hardest to deal with. I had done all of the physio exercises, worked to gradually get back to the sport and I had finally got the all-clear from both my consultant and my physio to get back to goalkeeper training. Then, on my first goalkeeper training session back since I had dislocated my right knee almost exactly a year earlier, I saved a goal and felt my left knee go in almost the exact same way (I was even on the same pitch!) What made this time worse was the fact that my left knee was supposed to be my ‘good’ knee- it wasn’t meant to be the knee that I was worried about! Also, this time I knew how long the process of recovery would be and I knew that I would miss the rest of the hockey season and county try-outs for the second year in a row. This time the overriding feeling was annoyance: I was annoyed at myself for getting injured again, I was annoyed that no one knew why my knees kept on dislocating and, as selfish as it seems, I was annoyed that I was the one to get injured again- wasn’t it someone else’s turn?

“Every time I got injured, I really struggled with the feeling of loss. By hockey being torn away from me, it felt like I had not only lost connection with my teammates, but I had also lost my identity. Before all of this started, I was playing hockey competitively 5 times a week for 3 different teams (in 2 of which I was the captain) and so it did take up a huge part of my life and it always has. Ever since I was 3 and got my first hockey stick, I have been totally obsessed with hockey. I used to beg my Mum to let me go to her games to watch and as soon as I was old enough, I joined a team. So, by not being able to play hockey I felt like I didn’t know who I was anymore. Not to mention that some of my teammates are more like family to me, and so the fact that I wouldn’t be seeing them every week also had a major impact on me.

“Although I have spent a large amount of the last two years on crutches, I have tried my hardest to not let it hold me back. For example, the first time I was on crutches I went on a French Homestay with my school and I even got to go up the Eiffel Tower! And, only two weeks after I dislocated my right knee for the second time I climbed the stairs into the Batu Caves in Malaysia (granted very slowly) but I took it very literally one step at a time. I will never forget the feeling of dread that I had standing at the bottom of those stairs looking up, but I will also never forget the feeling of achievement I had standing at the top looking down!

“When I look back there are three things that I wish someone had told me at the beginning of this experience:

  1. Even if you can’t participate in the way you normally would you will not lose the sporting community. Over the last two years, I have really discovered how important the people in the sporting community are to me and, through injury, I have made new connections with some amazing people who have helped me through this process.
  2. There will be setbacks and it’s OK to be annoyed about them. Sometimes by trying so hard to stay positive about the situation, it made me feel worse and I wish that I had reminded myself that it is ok to not be ok because being injured and facing setbacks sucks and it is ok to be annoyed about it (as long as you don’t wallow in that annoyance for too long)
  3. It is OK to aim high but remember to celebrate the small achievements too. My long-term goal will always be to get back to hockey but along the way, I will make small achievements (such as being able to get upstairs to my bedroom for the first time in 8 weeks) in order to get there and by celebrating those it makes the journey to recovery feel just that little bit shorter.

“I am still on the long road to recovery and working on my goal of getting back to hockey but, at least now that I have had my operation, I know that I am on the right track and I can put even more effort into physio and trying to make small achievements every day.

I wish everyone luck for whatever stage of recovery you are in and I’m sending healing vibes your way.”

What I learned from two years of enforced social distancing & social isolation due to injury

I had an accident that led to two years of unbearable pain and repeated surgical interventions, interspersed with time in the house unable to do most things due to the pain of sitting, walking and standing. For many weeks and months I would barely leave the house, and when I did the physical cost would be having to return to lying on the floor or bed for a number of days to recover. Over time most of my social connections with the world disappeared and I became too depressed to interact with a world that I could not take part in, so I shut down all of my social media accounts. It was a very hard couple of years, but as the world enters social distancing and social isolation, I thought that I would share a few of the things that I learned.

Mental health is wrapped up with physical and emotional health

It is an obvious statement, but it takes time and effort to take care of these three interlinked aspects of health. I suddenly found myself at home with all of the time the usual rituals of meals totally disrupted. It was easy to let the nutrition and hydration slide. But actually, I found that meals can be moments of love and connection that have extra meaning. So I learned the importance of planning for them, looking forward to them and celebrating the flavour of the food and the life and energy that it was giving me.

Movement and fresh air is also really key. For me this was regulated by the physical rehabilitation exercises and targets set by the medical professionals. Many of them were complete agony, and walking to the corner of my road without overwhelming pain was beyond me for over 18 months. So I started to explore ideas like nature therapy and forest bathing. What could I do in my garden and in the local woodland to help my mental, physical and emotional health? I think that there are some deeply spiritual things that can be found, and I certainly explored much deeper parts of my mind and spirit in that time alone.

I had to really actively manage my anxiety. The pressures were overwhelming – lying on the floor unable to move and awake day and night with the pain, every worry in the world would crowd my mind – both about short-term and long-term survival. I could not resolve any of them and was totally in the power of the medical professionals and the wider universe. I developed a discipline of evaluating each one and deciding whether it was something that needed my attention today, or not today (ie later). Then I would write down the ones for today and work on how I could move those forward. All of the others I wrote on a separate page (to calm my mind by confirming that it would not be forgotten) and if there was a clear date, or a clear trigger for action, then I would write that down next to it. If others started worrying on my behalf about something that was not on today’s list, I would simply say to them, that is not today’s problem. These are today’s problems. Is there anything that you can do to help me with these?

I had to create a structure for the day, complete with little rewards and recovery moments!

In a topsy-turvy world, I came to realise the importance of ritual and routine for calming the mind. After a long period of everything being all over the place, I started to implement a timetable of when to eat (even if I had no appetite), bedtimes (even if I could not get into bed and could not sleep), getting up etc (even if I could not get up). In time the body started to respond to this routine and the Doctor helped to balance the drugs so that I did start to sleep.

I also started a timetable for each day – even if I never moved from one room. Rather than endless box-sets where the hours merged into each other and I was not sure if it was morning or afternoon, I started to make a plan for each day and break it into sections with rests and recovery in between. Given the levels of pain that I was in, days could be very different according to how my body was holding up. So I would start in the morning by getting a sense of how my body was and reviewing my list of what I had to try and solve today. Knowing that my energy would decline across the day, I would start with the hardest thing and promise myself a reward at a certain time, if I kept working at it until then.

Being a very goal-driven person, I had previously always set myself rewards based on completing the task and achieving the outcome. But I learned here that the challenges were too challenging, and so much like a running programme where the efforts are measured in time, not distance, I moved to a time-based approach. So for instance, if I could work on this until 11am, I would reward myself with a peppermint tea and a look out of the window to see what birds were in the garden.

I also kept a note of how my pain and energy levels varied with what I had done each day, and fine-tuned my timetabling to try to make days more manageable and find moments of joy, appreciation and laughter in each day. These were hard and took searching out, as life did seem very bleak.

Trying something new

With all of the things that I used to do as a triathlete beyond me due to my medical condition, I had to try new things. And some of them have been life-changing!

I always loved yoga, but now found the poses too aggressive for my body. But there are lots of free YouTube videos of Tai Chi and Qigong. These have been proven to have massive impact on all aspects of health and combine mental focus with physical and emotional wellbeing elements.

Just a short period in the morning can be a perfect way to get started, as these videos show:

Or for 20 minutes of Qigong: https://www.youtube.com/watch?v=cwlvTcWR3Gs

Taking longer-term distance learning course was fun and helped when the situation rolled on

One of the most challenging things was that I always thought that I would be better in 4-6 weeks, but the months rolled on and there could be a tendency to despair.

I was desperate to keep my mind active – both to ensure that I could get work again when I was better, and also for the joy of learning and challenging myself mentally. I loved the free distance learning via Future Learn (https://www.futurelearn.com/) where I studied for eight different courses, each of six to ten weeks long. These included online chat with other students, as well as paced weekly learning and the chance to then explore the subject more with further background reading.

The sense of something ongoing and paced in weekly does in a world where every day seemed unpredictable really helped me. Plus I learned a lot about things that really interested me!

Others helped me to be really inventive on the things that I could do!

Even when I was lying on my back on a thing memory foam mattress on the lounge floor, the ideas that others came up with to fill the time were really fun! Music playlists, adult colouring books, writing and blogging, even playing the guitar….

They say that necessity is the mother of invention, and once I started to push the anger, sadness and despair to one side then I could start to engage with creativity and invention.

Technology can be a great enabler to beat loneliness

Loneliness is deeply painful and a dangerous place to inhabit for long.

I was lucky to have a couple of key friends and my sister who would message, WhatsApp, phone and video chat on a regular basis. One used to call me every time that she was walking to the swimming pool and we would talk. These were lifelines in a world where I was sinking.

I learned the importance of keeping talking the hard way. It turned out that it is a mental and physical muscle that needs working and because it was under-used for so long, I can still find it really hard to find the right word or phrase, and am still conscious that I miscue in the usual social pacing of conversation. This adds stress and self-doubt in social interactions, which make it harder to re-engage with the world.

So how about:

  • setting up Skype or Facetime to chat for a wider family meal
  • having a book group via Zoom or Google hangouts
  • using your coffee break to message or call a friend and chat
  • have your pub night with friends virtually where you connect and chat with a drink in your hand, without leaving your own home

There are great books, podcasts, YouTube and video content

Finally, I would say that I found inspiration and insight in some amazing writing and content. This was a luxury that previously was confined to when I was on holiday, and it has been so exciting to read so many wonderful books.

In summary

Whilst this may seem like a terrible custodial sentence right now, I hope that you can and will find ways to make good things come out of it. I wanted to share my experiences of the last two years to try and help a little as we all step into a time when we need to reach out and support those around us. I know that things seem very frightening at the moment, but the human race has come through worse things than this, and with a little luck maybe it will help us to reassess some of our priorities so that we can make the world a better and kinder place.

I wish you every good wish, and if you want to chat with me – then tweet or DM me on Twitter @AthleteInjured

This is THE book!

This is the book and the community that I had been looking for. And I would recommend that if you know an injured athlete, then this book is probably the best gift that you could give them.

I came across it when I was listening to one of the podcast series that I often listen to and heard it mentioned: ‘Rebound: Train your Mind to Bounce Back Stronger from Sports Injuries’ by Carrie Jackson Cheadle and Cindy Kuzma.  As well as reading it cover to cover, and going back through it over and over, I also discovered the Podcast series and the Facebook page under the title of ‘The Injured Athletes Club’.

Practical support

The book has forty-nine mental drills that map against fifteen key mental skills that you can build to aid recovery from injury. It is built from real experience helping athletes through successful rehabilitation from injury – and the core belief that one can rebound from injury.

The book includes

  • narratives describing athletes’ journeys through injury, including the key inflection points
  • Scientific explanations of the underlying psychology
  • Key points to take away and work on
  • Specific mental drills that you can incorporate into your recovery

But perhaps the community is the most important part

The book opens with talking about the fact that you are not alone, and that with that pillar in place – there is a path forward.

The community allows for the stages of grieving – accepting and defusing the negative emotions, finding the clarity and support for the steps needed for your progress and then having a genuine cheerleading group to celebrate the simple, baby-steps steps of progress towards your bigger goals.

What I really like about the book

What I really like about the book is the fact that it is flexible and multi-faceted, so you can keep coming at things from different angles and building up even as your situation evolves and changes – whether that is progress or a slip backwards.

I hope that it brings you or your friends support and strength when this is most needed.

Recognising other bloggers who have cast helpful light and perspective on my own challenges

It has been quite some months since I last wrote a blog. The back end of last year was a hard road of trying to get the pain medications to the balance that made the basics of getting through the day possible, and working out how to shrink life to the things that I could get through. Then facing up to the surgeon’s persuasion that a tenth surgical procedure was the best way forward.

Through this time I struggled to find a way to share my experience in a way that I felt could help others.

Plus, I have to say that I found various bloggers and communities who are sharing their experiences and I felt were sharing a lot of the things that I had been searching for over the last two years.

So I wanted to blog to share links to some of them – in the hope that this is helpful for people reading it.

Joletta Belton – My Cuppa Jo (www.mycuppajo.com)

Jo shares her experience of over a decade of pain stopping her ability to work as a firefighter and to run and pursue the sport and life that she loved. She has gone on to do a huge amount of study about posture, musculoskeletal issues and pain, now sharing this with others in her beautiful and inspiring blog posts and also as a patient advocate at international conferences.

Tina – Living Well Pain (www.livingwellpain.net)

Just as Jo has pioneered the path in Canada, Tina has done the same in the UK. Tina’s accident was over two decades ago and she shares her experience of how to live well with persistent neuropathic and musculoskeletal pain with lots of practical tools and advice from her own experience. These come in the form of blog posts on specific topics and most recently as a patient advocate, she has written a guide for patients called ‘Making the most of Physiotherapy’.

Pete Moore – the Pain Toolkit (www.paintoolkit.org)

Pete attended a pain management programme in 1996 and since then has dedicated himself to sharing the best information and knowledge with both patients and clinicians across the globe dealing with persistent pain, especially back pain. He has a great website and has written a number of excellent guides on pain. Most recently he has set up a monthly Pain Toolkit Online Café on Zoom, where anyone is welcome to digitally ‘pop-in’ and chat or listen to others working with similar issues to their own.

Barbara Babcock – Return to Wellness (www.returntowellness.co.uk)

Barbara’s experience of her own neurological illness and also caring for her husband meant that she saw up-close-and-personally the life-changing impact that a serious health issue can have. This led her to use her coaching experience to restore emotional wellbeing and look positively towards the future. Her blogs and self-help tools help across: managing the health issue, reclaiming emotional health, reclaiming relationships, returning to work, reclaiming meaning & purpose in life, reclaiming hobbies & interests and support for carers and supporters.

Jo Moss – A Journey through the Fog (www.ajourneythroughthefog.co.uk)

Jo is bed-bound as a consequence of the health issues that she suffers from. She writes her blog to give other people in the same position a bit of hope. She says “My life isn’t easy, but it is worth living. I may cry a lot, but I also laugh a lot. I may get depressed, but I’m also optimistic. No matter how bad things seem right now, they will get better. You can take back control and give yourself hope for your future”. Her blog is frequent, searingly honest and brutally insightful on topics that others may shy away from.

Sheryl Chan – A Chronic Voice (www.achronicvoice.com)

Sheryl lives and blogs from Singapore, living with multiple lifelong illnesses. Her blog sets out to help other sufferers with a toolbox, but more widely to raise awareness of long-term illnesses from a number of perspectives and encourage empathy amongst all facets of society, and not just healthcare. Her blogs are frequently very practical, covering both the physical and the emotional challenges with equal frequency.

The Princess in the Tower (www.princessinthetower.org)

This site has a number of useful resources for learning about chronic pain and how to manage it and reduce it. The blogs focus a lot on the emotional impact, and ways to manage this.

Then, I also discovered some really useful communities:

HealthUnlocked (www.healthunlocked.com)

This is like a medical version of Facebook and there are different groups that you can sign up to. One of the groups is Pain Concern (a charity that also have a helpline that you can call and lots of other support tools that you can access at www.painconcern.org.uk)

Anyone can post a thread and expect to get genuine responses from others. The tone is universally helpful (in my experience) and can get some good insights. Obviously, this is not professional healthcare advice, so it needs to be seen in that context.

The Injured Athletes Club on Facebook

This community was set up by Carrie Jackson Cheadle and Cindy Kuzma to go with their book ‘Rebound: Train your mind to come back stronger from sports injuries’. They moderate and facilitate the group to get to a mix of being able to vent about challenging times, ask for advice/perspective and celebrate progress, with ‘Winning Wednesdays’, Monday Motivation and Friday Feeling themes running most weeks.

I hope that you find some of these inspiring and helpful, just as I did. If you have others that you think are excellent, then do share!

Learning to dance in the rain

One of my best friends, Liz, has a quote on her wall saying “Do not wait for the storm to pass, instead learn to dance in the rain”

It’s a concept that I love – and my husband and I have talked about it over and over across the last months. But I have been struggling with it too; constantly asking myself whether this level of acceptance is giving up on the goal of getting better. Like so many aspects of recovery, I have had lengthy internal debates about it and not reached any clear conclusion. Then this week I came across this very impactful TED talk from the amazing New York Times writer Suleika Jaouad; it has given me another perspective and perhaps helped me to slay a dragon and move forward some more.

It is a talk that applies to everyone – not just those struggling with injury or illness. Do watch it for yourself here (just 17 minutes of beautiful and impactful viewing): https://www.ted.com/talks/suleika_jaouad_what_almost_dying_taught_me_about_living

Living well ‘in the middle’

She challenges us to think again. Her premise that the separation between being sick and being well is not the simple, binary divide that we often paint it as. But that the border is porous. And that with the increased life expectancy of today, most of us will spend much of our lives travelling back and forth between the situations of being sick and being well, and living at least some of the time in the middle.

She finishes with the powerful thought that every single one of us will have our life interrupted… by something that brings us to the floor. We need to find ways to live in that in-between place managing whatever body and mind we currently have.

Powerful thoughts for ‘in-betweeners’

There were a number of themes that struck me as very powerful. But a few stuck out:

  1. The power of connection and shared experiences – her example of the prisoners in solitary confinement calling out their moves for the board games that they had made out of torn pieces of paper. It made me realise that the shame and inadequacy that we feel about not getting better and not keeping up is a dark shadow that we can (and need to) chase out with the bright light of friendships and fun.
  2. The importance of dreaming big on plans for the future – her example was the girl in Florida who plans someday to go camping in spite of her fear of bugs. When the whole world seems to be turned on its head, all dreams evaporate in the face of survival. But holding on to some things and keeping dreaming about them, and knowing that one day you will do them is a shining ever-present beacon of hope.
  3. The importance of taking the risk of opening up to new things – her example was the retired art history Professor in Ohio living through a lifetime of constant pain and disability, who in spite of all of the uncertainty of his health got married, had Grandchildren, taught, and danced with his wife every week. In spite of a situation that could have gripped him with constant fear and worry, he found meaning and built a beautiful life encapsulated in love.

Thank you Suleika for sharing your wisdom. And here is to learning to dance in the rain, through the different stages of the storm – in the eye of the storm, in the pouring rain and on the days where the thunder & lightening start to recede.

I hope that you find this as inspirational as I have – even if it took a few months for me to go the journey!

Affirmations and Mantras for healing

Self-talk is known to be one of the most important parts of mental strength. Athletes consistently use it (often together with visualisation) to help with performance under pressure. My suggestion is that it is just as important when you are injured and facing the challenges of recovery and rehabilitation.

Are you wondering what is self-talk? I define it as the voice in your head that chatters constantly, about all kinds of things and at times can escalate to a full-on internal debate. But there is good evidence that the mind takes these messages and images very seriously, driving changes in the hormonal system and the nervous system which in turn have very significant physical impacts (as well as changing your thought patterns going forward).

Affirmations or mantras are usually short, pithy phrases to insert positive messages into the mind. I would also be remiss not to mention that in the Hindu faith and yoga mantras are chanted, with specific mantras to generate powerful sound waves that promote healing, and the relaxation from the ancient practice of gong therapy or ‘sound bathing’.

This is something that many people write about. I especially enjoyed Carole’s blog from 2014 where she talked about Dr Coue’s mantra (or autosuggestion as he called it) where in conjunction with their medical treatment, they would say over and over to themselves 20 times in the morning and 20 times in the evening ‘Every day, in every way, I am getting better and better’. Read more on this inspiring story from over 100 years ago, plus some great tips and book recommendations in Carole’s blog:

What kind of mantras help?

When I was running ultramarathons and doing Ironman triathlons, I used mantras a lot and found:

  • It needs to be positive. I had a spin teacher who used ‘mine is the power and the glory’ as a mantra, and I know that many people find these universally positive exhortations very useful– hence the Ironman slogan of ‘Impossible is Nothing’.
  • It needs to be realistic at that moment! For instance, telling myself ‘I love to run’ is true, but in the final stages of ultra-marathons or long-distance triathlons the voice on my shoulder would scream back ‘I don’t right now – I want to stop!’ so I would use simple exhortations like ‘run for home’ or ‘nice and steady’.
  • It is better when it is process-based.  There are times in a long race where the final finish line seems too far away to engage with, and so process-based mantras worked better for me. This seems a strong parallel with the uncertainty on outcomes in recovery and rehabilitation. So just as I would focus on technique points in races like ‘keep my rhythm’, ‘nice and light’, which brings the benefits to keeping good technique at a time when tiredness can reduce form. In the same way in the tough part of recovery focus on the exercises, release work, nutrition, hydration and sleep patterns can reinforce the positive habits that will make a difference.
  • It is not helpful to set specific goals that you then miss. Whilst I have spent many races setting myself a challenge for the next split time, or the person that I would overtake, these are only useful when you hit the goal and then set the next goal. Missing them really can really drag you down, as it allows the internal critic to keep saying that today is not your day and you may as well just give up.

How do I apply that to my recovery?

It is really useful to reaffirm your strengths and the resilience that you bring to this situation: from the factual such as ‘we have a good plan and next steps with the medical team’ or ‘we are focused & determined and will get to the bottom of this’, ‘I have what I need to get through this’, ‘all of this strength and conditioning will make me a better athlete’ to the more aspirational ‘we will beat this’, ‘I’ll be back’, ‘my body is amazing’ and ‘I’ve come through tough times before and I will again’.

Also to recognise all of the people on your side and rooting for you: ‘I am in great hands’, ‘I am surrounded by love and support’, ‘I stand shoulder-to-shoulder with my team’, ‘I am enveloping my body in love and kindness’.

Reaffirming the sense of progress – even when it is too small to see: ‘every day of careful nutrition and good sleep helps my body to rebuild’, ‘little by little my body is healing itself’ and ‘every step towards recovery helps me’, ‘cell by cell my body is rebuilding itself’.

Some people find perspective very useful – for example: ‘whilst this is tough, people are facing much worse than this and getting through it’.

Some inspiring quotes

This link includes some inspiring quotes for injured athletes that could be used as mantras:

https://www.theodysseyonline.com/25-quotes-inspire-injured-athletes

So why not try it?

How about choosing a favourite mantra and use it every day for a week – repeat it under your breath over and over at key points in the day, write it on a post-it and put it on the bathroom mirror or under your pillow, close your eyes and smile gently as you visualise it… the mind is a powerful thing.

Your body and mind are amazing – ‘Every day, in every way, you are getting better and better’

“You just fight with your brain, to get the body ready to fight against the illness”

I am not a big Formula 1 fan, but I do listen to a lot of radio at the moment. And so I came to understand a little more of the amazing story of Niki Lauda, who passed away yesterday, aged 70.

Niki Lauda was Formula 1 world champion three times (1975, 1977 and 1984).

“My brain was the only thing that I could control”

But in 1976 he had a crash at 150mph on one of the bends at the German Grand Prix and suffered third-degree burns on the majority of his body. He was rushed to hospital, technically ‘died’ twice before being resuscitated each time and had a priest read him his last rites.

His mental toughness is credited for not only keeping him alive, but also getting him onto the start-line at the Italian Grand Prix at Monza just 40 days later (in incredible amounts of pain, but still contesting the world title race which he had been leading by some margin).

You can hear about it in his own words on this video:

https://www.theguardian.com/sport/video/2019/may/21/niki-lauda-looking-back-at-the-life-of-a-formula-one-legend-video-obituary

“The mind leads and when it can the body follows”

For an injured athlete who is having a hard time, this may sound corny – like one of those motivational posters hanging on the wall of the gym such as “your attitude defines your altitude” or the like. But there is not only Niki Lauda’s inspiring story, but the increasingly considered ‘BioPsychoSocial Model’ in medicine which shows how interlinked all of these aspects are.

So even if your body is not responding to therapy for you right now, keep working on your mind. Amazing things are possible. You could be back in the fast-lane sooner than you think!

Good luck to all, and of course RIP Niki Lauda

Why Injured Athletes need to actively manage the dangers of Social Media in their recovery

The power and privacy lapses of social media are big news at the moment, with regulators and Governments looking closely at issues such as Facebook’s deal with Cambridge Analytica. But leaving that bigger picture to them, how about the micro-picture of how social media fits into the lives of injured athletes, and how to manage the pressures and harness positives for recovery?

Most athletes will have Facebook, Instagram & Twitter friends and groups, Strava & Garmin groups and WhatsApp messenger groups that all rotate around the next training session and race. For some these will support the agreements with their sponsors. But for all they will be an important source of information and connection. The whole identity of athletes is often wrapped up in the exercise-driven world – this is their tribe. And every time they open any of these apps (which they probably did many times per day prior to their injury), it is a stark reminder of all that they have lost.

As I say on the opening page of this Injured Athlete website – this hits hard at the level of our human need of belonging, as well as our identity of who we perceive ourselves to be and how we achieve our physical and mental balance. Fighting all of those at once is pretty overwhelming, so you need some coping strategies!

Can you stay a part of your tribes?

Is there any way that you can stay a part of your tribe? Can coaching or supporting fill the gap for you? Can you be a social member? Is there anything behind-the-scenes that you can get involved in?

If not, then much like Jonathan Livingston-Seagull in the beautiful fiction book, you probably need to accept that you do not fit in the tribe any longer and find a new tribe… hopefully just for a little while, whilst you get better.

Form new groups

Can you make the walking group? Or the book group? Or the Friday or Saturday coffee group? Or even the injured athletes’ group!

Remember that the Facebook echo-chamber is not the real world

When it is very hard to get out and see people, social media can become the way that you keep in touch with what people are up to. But it gives a very fake view.

For most people, their Facebook status is an update more of the life that they would like to be living than the one that they are actually living. So you can get the impression that the world is having a brilliant time whilst you are not. And it can bring you all of the updates of where you want to be, but are not.

You need to decide what kind of content, on what kind of frequency is helpful to you. Then you can choose what platforms you want to visit, and via which devices.

Be careful about getting hooked on Social Media responses

Then there is the question of what you post yourself (or someone else on your behalf) and when.

I have seen some people who have gone beyond giving recovery updates on Facebook, into comments many times per day on their latest problem or mood. Maybe this works for them, but I sense their need to get even more comments and likes for each one of these comments, which I know don’t translate into real support or a good two-way conversation with someone who cares. And in order to keep getting comments and likes (which can become a focal point for people), there is often an escalation in the magnitude of the problem.

This addiction to likes and comments from others can happen to even the most unlikely of people when they are at the top of their game and do not look like they need the validation – so anyone can succumb to it when they are down and vulnerable!

It reminds me of the strategies that companies use when marketing a product – in order to be in the minds of the shopper the brand often increases the frequency and drama of their communications. This builds so-called top-of-mind awareness, even in ‘light buyers’ (infrequent purchasers of the product – or distant friends in the case of Facebook). But sustaining that level of exposure becomes a constant workload. I rebel against the thought that we have to keep marketing ourselves like this.

Maybe it is a reflection of my own vulnerability, but I would rather have many fewer friends and know that there was a meaningful bond in our friendship than measure myself in clicks, likes, and comments.

Finally – stating the obvious

To come full circle on the start, the reality of everything in the social media space is that whatever privacy you think that you have baked into your settings – this is not guaranteed.

Asking for the support that you need from your friends is so important, but this level of disclosure on a social platform with privacy lapses and making money from profiling you (including your vulnerabilities) may have consequences for you that are not easy to see right now. So I would suggest that the old-fashioned principle of ‘would you be comfortable with this being on the front page of the newspaper’ is a sensible one.

In summary

Overall, what I am trying to say is that I suggest that you approach social media to make it a tool in your recovery and rehabilitation. Unpick what it is about it that works for you and what does not.  Then put your plan into action and feel good about it.

#ItsOkNotToBeOk

The UK’s Mental Health Awareness Week 2019 started today.

At 11am almost all UK radio stations joined together to broadcast a minute of focus on mental health, with Stephen Fry and Prince William taking the microphone to ask “Are you listening? Are you really listening?”

Statistics from MIND show that 1 in 4 of all UK adults will be affected by a mental health challenge in any given year. And of course the battle when you are injured and in pain is more dramatic.

But it can be so difficult to talk about. Hence the importance of working out ways to talk about it and raising the thought in all of our minds with awareness weeks like this. Just being there and listening is really, really powerful and supportive. Overcoming our shame and embarrassment to have meaningful conversations really matters. And we do not have to have any answers or solutions – just listening really helps, plus there are a number of great charities to support any of us when we are in a difficult place.

The twitter feed is full of good advice from these brilliant charities and also experts in this area, and I have tried to retweet as many as possible (see the @AthleteInjured feed). I hope that you find support, kindness and love within them.

I have just tried to pick out some themes from my own experience of living with injury and pain, in case they are helpful:

  1. There are moments when you feel so alone, and possibly rebuffed by people who you hoped so much would help, but there is always someone or some people who will support you. Keep looking!
  2. There can be times in your treatment that make you feel ashamed or humiliated. Work actively on putting them out of your mind and focusing on something more positive.
  3. Even the most left-brained and analytical people in the medical profession are starting to talk about the BioPsychoSocial model –so what and how you think are a big part of your progress and recovery from any injury. Keep searching out and holding on to reasons to believe that you can recover.
  4. We are all conditioned to want to hear the simple redemption/resolution story with the linear beginning-middle-end narrative of (i) something happened, (ii) it was tough but I got treated and (iii) now I am stronger and wiser than ever before. Even people who write this story in their autobiographies are usually honest enough to admit that this not how it happened and that recovery was a messy path of a step forward and many back, having to knock on lots of doors and keep holding on to hope.
  5. Worrying is really toxic. Whenever you can, remove yourself from the source of worry and replace it with things, thoughts and places that make you feel good. And even when it takes a superhuman effort to do them, make yourself do one each day.
  6. Find the moments to cherish. Even in a terrible day, there is something that is worth cherishing, Write it down in a diary or a gratitude box and relive it when you feel low.
  7. Lots of people will ask you how you are (and actually when you are injured I found that many stop asking!) Find those who genuinely want to listen, and for the rest develop an honest one-sentence answer that lets them move onto the conversation that they want to have, without discomfort for either of you.
  8. Be kind to yourself. Pushing your body and mind beyond what it can do generally leads to a really unhealthy ‘boom and bust’ cycle that is physically and mentally damaging. Find things that are within your limits and spend time on them.
  9. Ask for help on the things that have to get done, but are currently beyond you. It is really hard for friends to be mind-readers, so ask for the help that you need. And if you cannot quite work out what the problem is, write it down on a piece of paper until you get to the bit that really has to be solved and then write down every possible solution that you can think of – even brainstorm it with a friend, and choose the best approaches.
  10. Loneliness is a real problem. Even if you can no longer keep up with your friends because they are all so into their sports, set yourself a goal of getting together for a nice chat with a friend at least once per week.

Good luck

#YouAreNotAlone #ItsOkNotToBeOk and #NothingIsForever

Brace! The one year anniversary is tough!

I’ve seen a few people go through the one year anniversary of their injury and have a really hard time. But why is the 365 days marker so significant? After all, there are about forty calendars in use around the globe – so it is a mental construct and based on the lines that our minds naturally travel down.

So this is where working on our mental strength and how we think about things can really help.

Humans constantly search for meaning

I was very struck by the parallels in the incredible books from Viktor Frankl ‘Man’s Search for Meaning’ and Jim & Sybil Stockdale’s book ‘In Love and War’. Both of them were clear that the people who died in the inhumane imprisonments were the optimists. Both suggest that the people who set timeframes that they could not control (‘we’ll be out by Christmas’), suffered from a broken heart when things did not turn out this way. This, combined with their physical frailty from their terrible treatment, meant that they succumbed quicker.

As well as being very humbled by the accounts, I was struck by the story of Jim Stockdale. His full name was James Bond Stockdale and he was a United States Navy vice admiral and aviator. Commander Stockdale was the senior naval officer held captive in Hanoi, North Vietnam for over seven years after being shot down in 1965. He personally suffered terrible torture, but led his men to ensure that as many as possible made it home. Meanwhile his wife actively and tirelessly campaigned through the international channels for their release.

What we as injured athletes can learn from the ‘Stockdale Paradox’

In the business book ‘Good to Great’ the author, Jim Collins, interviewed Commander Stockdale about his experiences in Vietnam and coined ‘the Stockdale Paradox’.  This is:

“Retain faith that you will prevail in the end, regardless of the difficulties AND at the same time, confront the most brutal facts of your current reality, whatever they might be.”

As athletes we are often good at each of these at different times, but combining them together and holding them side-by-side through the highs and lows is really hard. Yet important. And even more important when we are injured.

Back to setting deadlines

At one level setting deadlines for reviewing progress and rethinking is helpful. It can make us confront the brutal facts – that the current treatment or rehabilitation is not working as well expected and we need to explore and evaluate new approaches. But if the deadline leads us into a tailspin of losing hope in the eventual destination – a loss of faith that we can and will prevail – then it is not serving us well.

So we need to recognise the human tendency for each of us and our families and friends to think along the lines of anniversaries. But to use these as checkpoints on the journey, not destinations.

In summary

I have to leave the final words to Jim Stockdale and hope that his wisdom lifts and buoys you:

“I never lost faith in the end of the story, I never doubted not only that I would get out, but also that I would prevail in the end and turn the experience into the defining event of my life, which, in retrospect, I would not trade.

“This is a very important lesson. You must never confuse faith that you will prevail in the end—which you can never afford to lose—with the discipline to confront the most brutal facts of your current reality, whatever they might be”