Round and round in circles

My experience of rehab is lots of circles!

Whilst finally being able to move a little can feel like a release from incarceration and make you want to re-explore the world that you once knew, the reality is that it probably needs to be much closer to home!

You need to be ready to stop and rest, or stop and return home at any stage – as pushing through pain can lead to a major set-back. So, I have built loops with benches, coffee stops and quick routes back to the car (in order to return home).

I think that I now know the distance to all of the benches within a half-mile radius of home! And even bought one of those walking sticks with a pop-up seat. It was surprisingly inexpensive, and actually comfortable enough for a little rest and recovery – although you would not want to sit on it for a long period!

Having a goal, but being flexible on the way of achieving it

Initially, I struggled because the goals seemed ridiculous – for instance 4 laps of 200m in a day and then a rest day seems petty when you have run marathons and ultra-marathons.

And then I struggled even more because I could not complete them without being doubled-over with the strobing pain – the other part of the goal was without any increase in pain level.

The goals are really important – as they help you to make and monitor progress over time, without over-extending yourself. And I learned to stop deriding how petty they were and to start to think of little rewards if I managed them, like a square of dark chocolate or a cup of coffee.

I also learned how to regress it when I could not achieve it – either by reducing the distance, or by increasing the rest interval. So I would walk to the bench with my book and if my body was not ready to walk back, I would either sit for a while or read for a while and then head back. And then do the same later in the day.

The psychological benefit of a change of scenery

I would also drive to wooded areas so that even very short loops looked and felt different as I walked them. And the opportunity for a nice cup of coffee as a reward sitting at a different café and taking in a different view!

Rule number 1 – leave the watch at home!

I have to admit that the only time I would do laps was as a part of training – whether a track, road or off-road loop – the goal would always be to look at the splits of each lap! This mentality of constantly pushing yourself is not at all the mode of gently listening to your body for the early cues of progress or issues – so it is important to leave the watch at home, and avoid cheeky glances at the lap times!

The hardest parts & my coping mechanisms

The parts that I struggled with were:

  • Stopping in time – since often the worst pain would be later in the day, I struggled to find the cues of when to stop if the session needed to be curtailed. The two insights that helped a little were: (i) spotting the very early signs of fatigue and stopping whilst there was at least one more lap in me and (ii) leaving enough time for my body to settle in between each one – so I would plan to sit for at least 10 minutes and at times 30-40 mins and even an hour to let the body settle and see how it felt.
  • Keeping the discipline and only doing the plan, even on days when I felt I could do more – because I couldn’t wait to be better and make faster progress, it was hard not to over-extend by adding an extra little walk to see something when I was feeling great. Especially when I was with friends, for whom so little activity was quite boring and their natural temptation was to tacitly or explicitly encourage you to go faster or do more. My two coping mechanisms were (i) for all that it was lovely to see people, doing these was better done alone and meeting them for a coffee later (ii) keeping a log of all of the exercises and what level and type of pain I had was a useful tracker for the programme and to talk with the medical experts.
  • Sometimes these leave me very inflamed and I then struggle to sleep – so I always do the sessions in the earlier part of the day in order to give the body more time to recover.

In summary – celebrating the circles!

As you probably gather, I found the process of going round and round in small circles rather hard to get my head around. So planning for it and finding ways to celebrate is key – every single one marks progress and is an opportunity for some fresh air and seeing different things. So well worth celebrating!

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

Should I be taking painkillers?

Pain is such a difficult topic and in all of the people that I have asked, no-one is really able to give any clear answers. I have written some other blogs on pain itself. In this blog, I wanted to explore the topic of when to take painkillers. It is the question that I have asked every single medical practitioner that I have come into contact with and not really got any consistent or clear answer.

So here is my summary.

Pain as the protector

Pain is there for a reason – it is there to protect our tissues from damaging actions. So taking painkillers in order to be able to ‘push through’ and walk/sit/stand or even do more energetic actions is likely to be a bad thing. The physiotherapists generally seem to sign-up to the ‘listen to your body’ school of understanding the pain signal.

When we are trying to release the tension in over-active, tight muscles with stretches/releases, there are some tricks like using the contract/relax form of stretching that uses the inverse stretch reflex, or activating the antagonist muscle during the stretch to use reciprocal inhibition to enable the muscle to ‘turn-off’ and stretch.  But if the releases and exercises (to activate the under-active muscles) hurt such that you have trouble adhering to the physiotherapy regime, then the GPs seem often to recommend taking enough painkillers to get through these in order to support recovery.

Pain as the problem

When pain stops you sleeping and leaves you in a permanent state of stress (racing heart-rate, perspiring etc), then this is clearly a problem for your body as well as coping with life. For the body to have any chance of healing, it needs the parasympathetic nervous system activated (the one that goes with calm and balance), not the sympathetic nervous system (the fight-or-flight system). Therefore, if you are not sleeping or not reaching a state of calm, then it would seem necessary to take enough painkillers to manage this situation. Certainly the osteopaths and chiropractors seem to subscribe to this view of management – ideally without synthetic drugs, but definitely calming the system and getting it out of the hyper-vigilant or over-alert state that it can get into. Homeopaths will also suggest treatments that can help here.

Which is fuzzier – pain or painkillers?

A lot of painkillers seem to leave you feeling mentally very fuzzy and unable to focus and concentrate, but pain can also leave you feeling like the world is a long way away down a dark tunnel. So you need to find the type and dosage of painkillers (or none) that give you the best effect physically and mentally. Obviously, painkillers are more effective if you take them over a period, so taking them as the pain comes on, rather than when it is totally unmanageable will help – which I know is sometimes easier said than done.

Drugs are not the only solution

Research that shows that pain is worse when we are low and lonely, less active or less busy and feeling less good about ourselves. For some great explanation of the science behind pain check out these brilliant and simple explanations of understanding and managing pain at  https://www.retrainpain.org/

There are also all sorts of mental and physical techniques that you can try and see what works for you and your situation. There is no simple solution that works for everyone.

But what about the question of if/when to take painkillers?

You need to find what works for you. But I think that the principle of listening to and understanding your pain, and then recognising what you need to give your body in order to manage the pain and the recovery is really important. Painkillers may have to be a part of this, especially in the early stages, but the quicker you can get to other, more sustainable, solutions the better it is likely to be for your body.

I hope that you get out of pain soon. I know just how exhausting and enervating it is.

Masters athletes: looking after ourselves to avoid injuries

With half of the adults in the UK now over fifty, looking after ourselves and avoiding injury is something that is on the minds of a lot of athletes. And so many training harder for longer, and turning out new age-group records every year, there can be pressure for age group athletes to push ever harder, and potentially into injury.

I was struck by an interview with James Cracknell OBE last week, in preparation for rowing in the Cambridge Blue Boat for the Boat Race this year, aged 46. He claimed that he can still put out close to the power (in endurance terms) that he did in his 20’s when he rowed to Gold medals in both the Sydney and Athens Olympics, but that the recovery is completely different; he talked about nurturing every aspect of his body to make the start-line in a couple of weeks’ time. And of course James Cracknell is an inspiration in terms of injured athletes, having suffered a brain injury after being hit by a petrol tanker whilst cycling across the USA in 2010.

The realities of the body with age

Medical studies show that from our 30’s onwards, there are changes in the body (which we intuitively play into by moving into longer distances and more endurance events, rather than the short, explosive power of our younger years):

  • Muscle loss due to fewer, smaller and weaker muscle fibres
  • Greater rigidity and brittleness of tissues such as tendon and ligaments, reducing flexibility
  • Reduction in bone density
  • Slower release of synovial fluid in the joints
  • Reduced power due to fewer fast twitch muscles
  • Reduction of sensory inputs and responses for good balance
  • The long-term impact of posture and lifestyle factors

The good news is that exercise can hold back these declines

Weight-bearing exercise is excellent for bone strength, and also maintaining power and muscle strength.  There is also clear evidence that sports and interests that develop flexibility and balance can maintain these too – so things like yoga and tai chi can be low intensity things on your rest day that really benefit your body too.

The challenge is injuries get more frequent and recovery takes longer

The part that older age groupers will all tell you is that the battle to avoid injuries is more challenging and recovery takes longer. This just means that you need to listen to your body and give it what it needs.

Some simple ways to avoid injuries

Proven approaches that are worth building into your training plan are:

  1. Warm up for longer and do a good selection of drills that raise your heart-rate to the target zone, as well as mobilising your joints and activating the key muscles
  2. Have a longer and more gradually tapered cool down after aerobic exercise
  3. Follow a good stretching and muscle release schedule – daily if possible
  4. Focus on correct technique and good posture, ahead of the length of the session
  5. Make sure that you follow the goal of each session – and therefore have the right mix of lower intensity and higher intensity, not just always doing the same sessions at the same intensity
  6. Give yourself the right amount of recovery time, taking more if needed. Within this, uninterrupted overnight sleep is really important.
  7. Do resistance training as well as cardiovascular exercise. Use cross-training to reach your goals when you are concerned that you can get overuse injuries, and think about reducing impact and moving in multiple planes and with movements in multiple parts of the body.
  8. Keep working on flexibility and balance
  9. Keep your training plan adaptable, so that you can listen to your body
  10. Keep a training logbook that includes aches and pains, so that you can spot warning signs for injury early and act on them
  11. Take injuries seriously – don’t try and push your way through them. And give your body the rest and recovery that it needs
  12. Go for the health checks that you are offered – especially the checks on blood pressure and cardiovascular health

And of course, above all, enjoy your training and racing.

We only have one body for life, so it is worth taking good care of it as it matures

The problem with life is that it is often no fairytale

From a young age, we love stories. And when life seems especially incomprehensible and unfair, we often look for the classic storylines to help us to make sense of it. Injury and illness is a classic example.

Friends and family want to hear that you have been the hero who has taken on the injury or disease, won over it and come back stronger and wiser from your trials.

Or that the medical professionals have the magic potion or magic hands that heal you, against the toughest odds.

And as the person who is injured or ill, we also want those comforting storylines to be true as well.

But the reality is so much tougher

The reality of recovery and rehabilitation is that lacks the instantaneous nature of stories, and brutishly ignores the linear nature of a classical storyline, with better days & worse days, progress & slip-backs and hope & despair. Part of the agony as the person with the injury or illness, is that time expands – filling 24 hours when you cannot sleep and cannot do anything or concentrate on anything can feel like forever. And when others want to hear the fairy-tale storyline as much as you, the loneliness of the reality of your situation can be overwhelming.

We all need a friend who is prepared to listen to the reality

In today’s fast-moving world, we all want injury and illness to be something that we bounce through within a week or two. But serious injury and illness is not like this. And as the person going through it, you do need to find someone who can let you talk about and let out some of the pain and frustration, as otherwise it eats you up from inside.

It’s not easy. It takes a lot of searching. And many people have told me that it was a surprise to them as to who stepped into the gap and supported them in this way. A truly vital friend, at a time of need.

But if you cannot find this person, then you need to find another outlet for your anger, grief and sense of loss. Some keep a journal and pour out their heart into the pages, or an audio diary. Some charities and support groups have people who will step into this role.

And hang in there

Whilst it may seem unbelievably tough right now, who knows what lies ahead? Just look after yourself through this hour and this day. The future will unfold. And who knows? Maybe in the end, you will be able to overlay one of the fairytale narratives onto your experiences – but for sure you will be glossing over the depth and darkness of some of the hardest times. Only you (and maybe that vital friend) will really know the reality.

Alex’s courage in talking about the loneliness of her head injury

If you have met Alex Danson MBE (gold medallist with the GB Hockey squad and since then the Captain of the England and GB Hockey teams), you will know her massive heart, her infectious smile and her complete passion for sport and team sport – and hockey especially.

It is so hard to see someone like Alex literally knocked out by the impact of concussion. But her courage in being searingly honest about how hard it is will be a lifeline to others who are injured. I also really hope that it will also be a lifeline to her with the massive outpouring of support for her on social media yesterday, and hopefully going forward in the coming weeks and months.

The most telling parts for me in her interview with The Times yesterday https://www.thetimes.co.uk/article/alex-danson-great-britain-hockey-captain-injury-post-0d09vm8bb were these lines:

“One of the hardest parts in all of this, aside from the physical trauma, has been losing my identity,” she wrote. “Going from leading my country, aspiring to qualify for the Tokyo Olympics to just trying to get through a day.

“Head injuries are serious, debilitating and lonely. When I have days when I feel well enough I will document some of my recovery. I’ve not been well enough to up to now and I’ve not been sure whether it’s something I wanted to do.”

They capture so brilliantly the complete stop that comes with an accident and injury, and the new mental framework that you have to build. And Alex’s commitment to make meaning out of this brutal, difficult and unfair injury by documenting her learnings and recovery to help others is totally inspirational.


Alex’s post on her Twitter feed @AlexDanson15 under the comment “It’s been a long 6 months….I’m thankful to say that I am on the road to recovery #mildtraumaticbraininjury”

Concussion is a very serious injury and many sports have now linked together to share the best knowledge. I am not an expert, but I would say that the Birmingham Sports Clinic is open to professional and amateur athletes over 16 years old, from all geographic areas. Instructions and how to get referred can be found here: https://www.uhb.nhs.uk/birmingham-sport-concussion-clinic.htm

Very best of luck for your recovery Alex. We are all rooting for you.

Imagining the Numskulls in the context of how bones heal

I don’t know whether you remember the Numskulls? This was a cartoon strip involving little people who lived inside the head of a person and did all of the hard work to make the person’s life function. 

I thought that they might be a helpful analogy for understanding why we really do need to give a broken bone the time to heal properly. So I created a couple of new characters:  

  • Mr(s) Preparation with a broom and all of the cleaning materials
  • Mr(s) Repair with a full tool-belt and DIY kit and team to help build the structure
  • Mr(s) Remodeller with the filler and sandpaper to make it fit in with the rest of the bone

Just like the healing of surgical cuts and tendons/ligaments/cartilage (covered in previous blogs) there are 3 phases, which I have added a little detail to below. Sadly all of this process goes a little slower when we are older (like most things!) – so worth adding a little extra time if you are older and ensuring that you pay even closer attention to the cues from your body.

  1. Reaction – with inflammation and initial tissue formation. The severed blood vessels in area of the break (or fracture – same thing) in the bone release blood into the area and this forms a clot very quickly (normally within a few hours). Then the first few days are characterised by a lot of inflammation as some of the body’s cells start to clear away the bone fragments and other damaged cells. In parallel, the new blood capillaries that have grown into the area bring the cells that start to build fibres to connect the bone and lay down the spongy bone structure.
  2. Repair – initially with a cartilage callus formation and then with bone: this stage starts after about 7-9 days and takes about 2 months to join the two ends together with a bony connection that has most of the bones original strength. During this time it hardens from being a fibrocartilaginous callus to a bony callus matrix, which evolves through two stages of bone hardening. This is often wider or thicker (so much so that you can feel this under the skin).
  3. Bone remodelling: The bony callus is remodelled over the next months (and often takes as long as 3-5 years) with the excess material on the outside and other locations being removed. There are also different layers of bone, so the remodelling gets back to the correct layering of these different types of bone – rather than the fast fix of the callus. Areas of well-healed breaks can remain uneven for years, but with 5-7% of bone mass being remodelled in the body each week, this will get fixed in time.

How is the fracture treated?

If you are lucky with your break, you have not got an infection in the fracture, and there is not the issue of the bone ends not coming together at all, or not coming together in the right way, or coming together too slowly.

These days it seems that many more people are having their fracture stabilised with surgical insertion of plates and screws (which generally stay in forever) and are being given a sling or protective boot, rather than the plaster-cast of old. The reasons for keeping away from the plaster-cast are often to maintain Range of Movement, but are not meant for you to keep doing your sport in the same way!

So what happens if you try to exercise with a broken bone?

Let’s go back to our friends the (new) Numskulls that I introduced at the start of this blog.

In those early days Mr(s) Preparation is out there working her socks off trying to clean everything up ready for Mr(s) Repair to get going. But if the area keeps getting moved, vibrated or jogged more bit of stuff keep falling off and Mr(s) Preparation keeps getting called back and getting in the way of Mr(s) Repair.

Likewise, Mr(s) Repair is trying to build out a new structure into the gap. This job takes weeks (like most building jobs!) and happens once the worst of the swelling and inflammation has passed. But if the area keeps getting moved, vibrated or jogged the bits fall off – meaning the work has to be done over and Mr(s) Preparation has to keep coming back and cleaning up again, rather than sitting down and having a cup of tea!

So activities like running and strong movement of the area lead to delay and having to repeat the healing

But there are a number of things that you can do to really help the healing:

  1. Good nutrition: the body needs a lot of nutrients to heal the bone, so ensuring that you have a good balanced diet with enough protein, and key vitamins (C and D) and minerals (Calcium, Iron, Magnesium and Phosphorus)
  2. Sleep well at night: a lot of healing happens in the deep sleep phases, so ensuring that you are getting your head down for a good uninterrupted 8 hours of sleep (or more if your body feels that it needs it) will be a big help.
  3. Avoid aspirin and ibuprofen, if you can: there can be a lot of pain, especially in the early inflammation stages, but the problem is that aspirin and ibuprofen delay the body’s natural healing process and therefore delay progress. So the sooner that you can stop taking them, the better. (There are some other medications that have impact – so worth checking with your Doctor, if you are taking any medication)
  4. Avoid smoking and limit alcohol intake
  5. Don’t feel tempted to test your broken bone whilst it is healing! Do keep it immobilised and work out how to take away risks in your day-to-day activities that could lead to a knock to the area. If you have been told that you must not be weight-bearing, then respect that and get shower chairs, scooting devices, crutches etc that enable you to do this all of the time (cycling gloves are brilliant for protecting your hands If you are on crutches).

So no sport at all?

You should review this with your medical team and coach. Depending on the fracture and the treatment, there may be some things that you can safely do that keep your strength and give you a cardiovascular workout whilst keeping the fracture immobilised. I have seen some really clever ideas that are safe and keep things going.

But if that is not possible? This is 6-8 weeks of your life. Add up how many weeks you have been alive (52 weeks per year!) – and this 6-8 weeks will be a very small percentage. Be kind to your body: let those Numskulls go their job without having to keep going back and repeating it, because you knocked down their hard work!

Good luck and keep smiling!

Jo Pavey’s ‘This Mum Runs’

One of the things about being injured and unable to move very much (without a lot of pain) is that I have read some great books. I wanted to share a few things that I took from reading Jo Pavey’s book that I think are really relevant for an injured athlete – but do buy the book, as it is a wonderful, human and inspiring read.

I remember really clearly the feeling of being in the crowd with my husband and two close friends and all screaming ourselves hoarse at Hampden Park stadium when Jo Pavey took bronze in the 2014 Commonwealth Games 5,000m and stopped the Kenyans taking a clean sweep of the medals. The race was incredibly exciting and inspiring – as this race report summarises https://www.bbc.co.uk/sport/commonwealth-games/28626133, but how Jo had come back to win this medal (and a Gold medal at the European Championships 2 weeks later) is even more inspiring.

Here are the top three things that I took away for injured athletes specifically:

  1. Having been British Champion in her late teens, Jo had six years in her 20’s of not being able to train and compete. She hung in through this – did not let it get her down and also qualified as a physiotherapist (which must have helped her to understand how to rehabilitate her injuries). Six years! And yet she came back to win major medals in her 40’s – to me that shows such true grit, resilience and mental strength.
  2. With her coach (and husband), Jo managed her annual, training block, weekly and daily training schedule and sessions based on what was possible and what her body responded best to. The fact that she could turn out amazing track performances in spikes, having done almost all of the training on much softer and more forgiving surfaces and in trainers says that peak performances are still possible when we do the right things for our bodies.
  3. After her stress fractures Jo threw away her orthotic supports in her shoes and concentrated on strength training to address the functional muscle, joint and bone issues.

I don’t under-estimate the incredible dedication and hard-work that lies behind the achievements. But if we could all soak up a little of the balance with which Jo has managed her way through the lows and the highs, this could help any injured athlete move forward.

Enjoy the book. It is great.