Coping with injury: What happens when you're forced to slow down?

I recently crashed my mountain bike, resulting in a broken leg. While I've been hobbled, this injury has given me pause for thought about what happens when we get hurt. What is the process we go through on the road to recovery and what physical and mental changes take place? What happens when we are forced to slow down?

To find out more, I contacted Martin Krause, a physiotherapist and owner of North Sydney-based clinic Back in Business. Mr Krause is himself a keen sportsman and I caught him for a chat as he was cooling down after a lunchtime run.

Mr Krause explained that the physical rehabilitation journey begins with managing the acute symptoms of pain and swelling during the first two to six weeks after injury. Once stabilised, patients move into sub-acute treatment, which is all about working toward regaining maximum capability, something that can take up to six months for a tendon injury.

I was surprised to hear that muscle loss can start as quickly as 48 hours after injury and Martin emphasised the need to keep as active as possible, without making the broken bit of you worse, to minimise degradation on the body. Long gone are the days of complete bed rest. Speaking of which, Mr Krause highlighted the big disruption to our sleep pattern when we get injured. Suddenly the ability to stock up on restorative, quality shut-eye is lost; impairing our judgement and performance at work and relationships at home.

Physical impacts aside, we talked through the mental impact of injury, which can be just as tough to tackle. Injuries test the essence of who we are. One minute we are cyclists, runners or surfers and, one accident later, this fundamental building block of our identity is taken away, leaving a gap that anxiety and vulnerability can easily fill.

Having broken my leg only a couple of weeks into a new job as the HR manager for a busy media firm, I can see what Mr Krause means. While I've kept smiling, I admit to being worn down by the recovery process and less surefooted in my decision-making, not just through poor sleep and painkillers but also in coming to terms with asking for more help than I'm comfortable with.

An injury is an unexpected and confronting change to our identity and current stable state, and we must hang on tight through the rollercoaster of emotions that play out as we come to terms with its impact. This emotional rollercoaster is the  "grief cycle", which begins with shock before moving through denial, anger, bargaining and depression and finally onto acceptance (Elisabeth Kubler-Ross, On Death and Dying, Macmillan, NY, 1969).

To navigate through these emotional states without falling off the rails, the key is to focus attention ahead, rather than looking back with regret. Mr Krause's advice is to find a compelling goal, a future event or activity you really want to accomplish, and put it in the calendar with a big circle around the date. Next, with the help of your medical and rehab practitioners, set a series of realistic targets that will accumulate towards your physical recovery. Importantly, as you move toward your goal, reflect often on the progress that is being made. The patient who is frustrated by not being able to walk up a set of stairs this week has forgotten that they were unable to put weight on their foot just a few weeks before.

Georgia Ridler, director and principal sport psychologist at SportPsychQLD, has over 15 years of experience working with professional athletes and Olympians and shared her experience about coping with injury. For her, finding the opportunity in the injury is key to a fast and fruitful recovery, but easier said than done.

Two to four weeks after injury, once the rehab plan is in place, Ms Ridler works with athletes to "twist their thinking" away from the injury itself. She challenges them to pinpoint how they can invest the time and energy available during the unplanned convalescence to come away better off. Perhaps it's to build core strength for better control and performance?

Maybe it's to study the strategic side of sport to enhance their game play? It might even be to rebalance other aspects of life that they have ignored or neglected. Whatever it is, once unlocked, it's realising this opportunity that is the focus of the recovery period; not boring rehab itself.

Ms Ridler reframes injuries as a beautiful opportunity to reflect; something we don't often pause to do. She asks clients to consider the real purpose of the pastime or passion they are pursuing. People quickly identify the obvious and important physical health benefits of their sport but are slower to recognise the social interactions and relationships we get from being part of a community or tribe, which fulfils an important psychological need.

It's the loss of this psychosocial side of a beloved pastime that can really impact our state of mind, and it's this which I have felt but had not been able to identify until now.

Suddenly, without the excuse of a bike ride, gym class or a game of netball, we can become isolated as access to our social group is cut-off. Some of my cycling buddies have gone out of their way to catch up while I'm recovering. Others have dropped off the radar completely. Once back on the bike, I will be much more conscious and appreciative of the social side of my hobby.

Successful recovery is about sticking to the plan, something most people will find difficult to do without the help and encouragement of family, friends and rehab professionals.

Ms Ridler recommends getting a good support team in place including someone to lean on and vent to when things don't go as planned — another reason to stay connected to your sports tribe.

I set off on this mission to understand how to cope with injury — having been forced to slow down by one. And with some expert guidance, I've come away better equipped to survive the recovery process. Here are some key takeaways I can share with you: 

•    The road to recovery will be winding and hilly with a couple of wrong turns – acknowledge the physical and psychological challenge it presents. 

•    Get a rehabilitation plan in place and the support you need to stick to it. Build recovery milestones up over the weeks and look back often to realise how far you've come.

•    Pinpoint how you can best invest your recovery time to get something meaningful from it, either for your sport or for better balance in life — make this opportunity your focus.

•    Take the initiative to stay connected to your sports tribe or community. Don't be too proud to ask for help – people respond well once they realise you need it.