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!

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

Separating your identity from your sport

I read this blog and thought that it was just so relevant to injured athletes and the challenges of coping mentally.

It especially chimed to me when Steve Magness writes in this blog that identities are a tricky thing. They represent our inner narrative about our self. A convenient summary of ‘who we are’, where over time we often boil our identity down to a few words that can become a prison for us when circumstances change.

He goes on to give some reassuring advice: “Identities seem permanent, but they are in fact malleable. It may seem like we are stuck as who we are, but our stories can be altered.

“It took a long time for me to let go of the singular identity of ‘runner’ that I carried around for most of my life. I had to realize that I wasn’t defined by any one moment or any one activity, I had to actively rewrite my internal story, in essence convincing myself that I was complex. That I had a diverse range of abilities and skills– beyond running fast in circles around a track [Steve ran a mile in 4.01 in his early running career].

“When we are young, it’s easy to shed our identities. When I was 10, I identified as a baseball fanatic, when I was 13 soccer was my world. But as we grow older a process of identity cementing occurs. As we get ‘known’ for something in a circle wider than our family and friends, it becomes even more difficult. The tendency is to shift to who we perceive to be by the outside world, instead of who we truly are. That doesn’t mean we are stuck. It just means it takes more work. “

So well worth a read of the blog (link above) – and his book (just out yesterday) and full of very useful insights, theory and activities that you can put into action for yourself: