PriTSD: Post-running-injury Traumatic Stress Disorder

For a while now, I’ve been intending to write on every runner’s favorite topic – injuries. I’m certainly no sports medicine specialist, but let’s face it – my share of close encounters over the past several years makes me almost as qualified. Having stayed remarkably healthy over the recent months, my original vision for this post was to highlight my invaluable (ehem) insights into injury prevention. Had I written that post and adhered to my own advice, maybe I would not presently be discussing post-injury recovery and running withdrawal.

December 26, 2011. House-bound by the bitter cold and snow but needing to release some pent-up holiday energy, I resorted to a treadmill run and treated myself to running the final 4 miles barefoot. A subtle ache appeared on the top of my left foot which, given my surging endorphins, I of course ignored. Over the ensuing two months, this foot issue re-emerged several times without progressing beyond mild discomfort. Assuming myself invincible, I continued to push my limits, simultaneously training for my next marathon and increasing my mileage in minimalist footwear.

Lateral ankle

February 18, 2012. While on my weekly long run, the foot ache re-appeared, but this time worsened from mild annoyance to a cautionary, progressive ache. Of course, I convinced myself it was nothing and completed the 22 miles. The extent of the damage was only evident while attempting to run two days later, each step coupled with a shooting pain along the top of my left foot and ankle. I had run myself into a full-blow case of extensor digitorum longus tendonitis.

Today. Three weeks later and still unable to run. It may appear ludicrous that runners voluntarily run themselves into such debilitating conditions. Yet I’m convinced the very qualities that make us so vulnerable to overuse injuries are also what make us so well-suited for distance running. We persevere, adhere religiously to our goals and tend to have remarkably high pain tolerances. Running is a phenomenal way to heighten bodily, mental and environmental awareness; however, when those sensations are overwhelmingly positive and rewarding it can be exceedingly difficult to detect subtle messages of injury or imbalance. It is therefore crucial to heed those quiet warnings which we too often acknowledge only in retrospect.

These past three weeks have been a genuine physical and emotional rollercoaster. At the risk of sounding melodramatic, for a runner the post-injury period can remarkably parallel the aftermath of other major traumatic experiences. The process begins with denial, during which you stubbornly insist the condition is minor, fleeting and can be run through. This is followed by acceptance of the injury’s severity but also shock and irrational fears that you will never run again. This can also coincide with veritable physical withdrawal, making this the most difficult stage. For me, going from running 60-70 miles/week to zero sends me into a physical and mental downward spiral. The crash is characterized by a paradoxical combination of lethargy and anxious restlessness. During my first post-injury week I essentially shut down, my motivation and productivity in lab and school plummeting.

Eventually, healthier coping mechanisms take hold, allowing you to start taking proactive steps towards recovery. In week two I replaced the couch with cross-training, forcing myself to go to the dreaded … gym. With no apparent improvement from the standard RICE (rest, ice, compress, elevate) approach, during week three I began to seek alternative methods to expedite the healing process. I’ve begun acupuncture, homeopathy (ruta graveolens) and K-laser therapy and have since noticed marked improvement – namely increased range of motion, reduced inflammation and the ability to walk pain-free! I can only speculate whether this change is attributable to any one of these treatments, a placebo effect or simply reflects the natural time-course of my body’s recovery process. Regardless of their source, such improvements are a comforting reminder of the body’s innate healing powers and the critical importance of a positive and proactive approach towards recovery.

I won’t lie. Three weeks and counting of no running is driving me crazy. But I suspect these periods may be invaluable for an endurance athlete’s long-term growth, complementing our physical stamina with invaluable training in psychological endurance. Stay tuned for progress reports … I foresee a strong tendon and lots of running in the near future!

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2 thoughts on “PriTSD: Post-running-injury Traumatic Stress Disorder

  1. I agree with your post absolutely and I am now interested in reading some more of your posts on your blog and see what you have to say. I just bookmarked this one and do you mind if I tweet your blog post out to my followers on twitter? I think they would also enjoy the blog post.

  2. Shawn says:

    How was your extensor Tendonitis after the acupuncture treatment? I’m very curious to learn more! My name is Shawn and I am a college soccer player with this injury. It’s driving me nuts! Started Feb 4th, this year and yet still flaring up…leaning more towards a cortisol shot at this point and then with ultra sound and possible a few sessions on acupuncture. Hopefully this will heal it up for good. Please email me so we can chat! Would be amazing!!

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