Five Stages of an Injury

Header image - woman with a leg injury and the Ordinary Runner logo

The Law of Inevitability

Look at you. Running freely. Pushing for PBs. Feeling like you could run forever.

Make the most of it. Because, while I hate to be the bad guy, someone has to say it – one day, you’ll suffer an injury. It’s inevitable.

Sorry to bring you down like that. I’m sure it’s not what you want to hear right now. And who could blame you?

In fact, if you’re not ready to read about injuries, bookmark this page and head over to my playlist post instead.

You can always come back when the time is right. Because the time will be right.

The Five Stages of an Injury

When that day comes, you’ll follow a process. That process won’t always be the same, but there are certain stages to any injury. Your recovery depends on how you manage those stages.

I’ve borrowed from the Kübler-Ross model for dealing with grief. With all necessary perspective, it seems appropriate – running injuries can feel a little like grieving.

Stage One: Denial

There are two types of denial – pre-injury and post-injury. They’re the most dangerous part of the process. The part where you risk turning a minor injury into a major one.

We’ll deal with them separately.

Pre-Injury Denial:

It starts as a twinge. You run it off. After all, twinges are a near constant in the Ordinary Runner’s anatomy.

However, there are twinges and there are twinges. Deep down you know which twinge this is.

Woman holding up her hands in denial

But, you’re in denial. You tell yourself: this is a normal twinge. It’s an everyday, getting out of bed twinge. It’s a what you feel every time you climb the stairs, twinge.

This twinge, you announce in your head, is definitely not the beginning of an… you don’t say the word. To say it is to accept it.

You’re not ready to accept it. You’re in denial.

So, you run. The twinge remains, but you ignore it. Then you get used to it.

It’s how your leg feels at the moment. Sure, some days it’s worse than others. But, that’s always the case. Right?

Wrong.

Because, like it or not, this isn’t just a twinge. It’s an injury, and all the denial in the world won’t change that.

In fact, each time you run, you make it worse. Each step, every kilometre, all those miles. They compound the injury and guarantee the lay off is much longer.

But you ignore it. You keep going. You take it one run too far.

And you’re forced to stop.

At that point, you sort of accept it.

Post-Injury Denial:

Okay, so you’ve conceded that a couple of days off are necessary. You have a slight (searing) ache (agony) in that tiny spot on the tip of your ankle (your entire leg).

Well done. You’re into Stage One proper – Post-Injury Denial.

Of course, having denied the injury for so long, you’re still not really ready to acknowledge it.

It’s fine, you think, I’ll miss a couple of runs. I might even pop a bit of ice on it. It’s not really an injury, it’s a niggle. I’ll be running again in no time.

This is every bit as dangerous as pre-injury denial.

What often happens here, particularly when the injury is closer to niggle than chronic pain, is that you give yourself a little break, then you start running again. Too soon.

Perhaps the pain has relented. It’s possibly (almost) completely gone.

So, you lace up and head out. Straight back to pre-injury denial.

But you’re a runner. You plod on. And you aggravate the injury until, as before, you’re forced to stop.

Although you still won’t accept the injury, you know you can’t deny it forever.

Instead, you head into stage two.

Stage Two: Anger

Man holding up two fingers on both hands - flicking the vees.

“What kind of idiot keeps running through an injury?” you ask. “I’m a fool. Why couldn’t I accept that I was injured. Now I’m never going to run again.” You stomp about (gingerly – remember, you have an injury).

You might externalise your anger, looking to place blame elsewhere. You think, “it’s my body’s fault, that pathetic, worthless bag of meat.”

Whatever works. You’re furious and you need that fury out of your system.

All that hard work. Those hours of training. The miles and miles you’d logged in your legs. All for nothing.

Bottling it up won’t help. You must plough through the anger to progress onto stage three.

Stage Three: Bargaining

There’s no good time to be injured. There are bad times and there are really, awful times. Then there are injuries in the lead up to a race.

I’ve run a few half marathons. And I’ve not run a few half marathons (and some other races) because of injury.

As much as I remember the elation of crossing a finish line, I also recall the crushing realisation that I won’t even make the start.

Before that realisation comes bargaining.

“What if I run the race, then take a month off afterwards?”

“How about I rest from now until the day of the race?”

“I’ll tell you what, I’ll see how I feel tomorrow / next week / the morning of the race / when I get to the start line / after the first 100 metres, etc.”

I once even hobbled through a 10 mile race, convinced I’d stop when the pain got too much. It was a long time before I ran again after that one.

Of course, no amount of bargaining will get you to the start line. And it definitely shouldn’t be used to get you through the race. But you do it. Then you move on to stage four.

Stage Four: Depression

Before almost every run, I’m told “enjoy your run” and “don’t get injured.”

Nice sentiments, for sure. But, the second one isn’t entirely benevolent.

You see, I’m a nightmare when I’m injured. I think we all are.

My family tell me I’m prone to grumpiness. I suppose they’re right. But I’m a forty-something-year-old dad. Being grumpy and knowing things is my job.

When I’m injured, particularly in the lead up to a race, it’s a whole different kettle of grumpy fish.

The depression is real.

Running is great for our mental health. Some people rely on running to keep the black dog under control. Others just do it for that wonderful surge of endorphins.

Whichever camp you fall into, not running can affect your mental well-being. Particularly if you’re forced to stop by an injury.

Man staring forlornly towards green fields contemplating an injury

Don’t ignore the depression. The sooner you manage the mental impact of an injury, the sooner you move onto stage five.

Stage Five: Acceptance

Some say the journey is more important than the destination. Not this journey. Not by a long way.

Reaching Acceptance Town is what it’s all about. Getting there can be an awful, tiresome and challenging slog. But once you get there, your recovery can begin.

Man's hand held out in acceptance

Whether you ask on social media, attempt your own remedies or visit a physio*, the sooner your rehabilitation begins, the sooner you’ll be back on your feet.

*Wherever possible, visit a physio. The other options can be a return ticket to Stage One.

Key to accepting the injury is to clear your training and race plan. And not for only one week.

Be honest with yourself. Then be more honest with yourself. Then be really, really honest with yourself.

You’ve been here before – you didn’t wait long enough and you started running again too soon. Straight back to Injury City.

Proper rehabilitation can make your body stronger. Not rehabilitating properly will almost definitely leave you weaker.

Stage Six: Starting Over

Woman swimming in choppy water
Swimming, cycling or just stropping around the house – we all have ways of coping with injury

You’ve done it. A week, a fortnight, a month, whatever. Your trainers have gathered dust while you swam, cycled or stropped around the house in a grumpy slump.

Now it’s time to start again.

Accepting the injury was a big step. Accepting that you’ve lost fitness because of the injury is equally important.

How much fitness you’ve lost depends on:

  • your fitness level before the injury
  • how long your recovery took
  • what you did during your recovery
  • and your age

No one knows your body better than you. You know what you’re capable of and how long it takes to get back to full fitness.

Just, please, give yourself a break. You won’t be as quick. You won’t run as far.

Be careful not to aggravate your old injury. And while you’re at it, don’t pick up any new injuries, either.

If you take only one thing from this…

It should be – don’t hang around in denial. Most of my injuries are made worse that way.

In fact, as I write this I’m back in post-injury denial. This ‘niggle’ that I tried to run off, started over a month ago. It’ll be at least a couple more weeks before I’m over it.

In the meantime I need to catch the train to Acceptance Town, calling at Angryville, Bargaining City and Depression-by-the-Sea.

Let’s hope it’s a one way ticket.

Image credits

Header image by Victoria Borodinova from Pixabay

Denial image by unsplash.com/@priscilladupreez

Anger image by unsplash.com/@harryjamesgrout

Depression image by unsplash.com/@mdesign85

Acceptance image by unsplash.com/@ruisilvestrecreative

Starting over image by unsplash.com/@marcisberzinsx