When "Bummer" Sets In : The Psychological Effects of Injury in Women Runners

Sunday will mark one week since I sustained the ITB injury that will likely keep me out of training for several more weeks.  In response to my injury, all of a sudden, the entire rest of the world is running, (or at least it seems that way to me.)

I have done all the research, adapted a regimen of icing, stretching and moderate exercise to help me maintain a base-line fitness level while I heal – but I am beginning to realize that the psychological effects of this injury are at least as great as the physical pain.

According to sports psychologist Paul Russell of the FitPro Network, a whopping 65% of all runners are injured in any given year  - an average of one injury per 100 hours of running – and runners miss about 5-10% of their workouts due to injury annually.  And as Russell explains, the field of exercise physiology is well advanced in terms of being able to treat athletes’ physical injuries – but the treatment of the psychological issues that accompany injury are much less understood – or treated.

“No one enjoys sports injuries,” says Aynsley Smith, R.N. of the Mayo Clinic.  “The physical damage is bad enough, but injury causes psychological pain too.  Injured athletes become depressed and angry, while their energy level decreases.”  And, according to Smith, “The longer the layoff from your sport, the more depressed you will become.”

John Heil, author of the book The Psychology of Sport Injury explains it this way: “(One of) the reasons runners have such a hard time dealing with sports injuries is that many use their running as therapy.  When you can’t get to your therapist (or back on the roads), you can get pretty stressed out.”

According to Heil, everyone’s sense of self-identity is constructed of separate components from a number of areas from which that individual gains reward and satisfaction.  For the committed exerciser, a large part of self-identity and self-worth is ingrained in their “active life.”  The more committed and serious an individual is with their exercise, the greater contribution their athletic self-worth will have on their global identity.  If injury undermines an individual’s athletic self-worth, for the committed exerciser, this can lead to a dramatic decline in how they value themselves as a person.

For women runners, the psychological impact can be even more complex. “I run for control,” says Susan Kalish, Executive Director of the Running and Fitness Association in an article for RRCA Footnotes.  “As the mother of two small children and the executive director of two large organizations, I can rarely do what I want to do—except when I run.  It’s my time, and if I want to do a tempo run, I do.  I’m in control.  But when an injury develops, I lose control.  It’s as if my body, my running partner, has betrayed me.  And that’s depressing.”

John Heil’s book points out that running injuries can have a multi-dimensional impact on our well- being and can negatively manifest in four key areas:

1.     Physical Well-Being: Physical pain, temporary physical restriction, Permanent physical changes.

2.     Emotional Well-Being:  Feelings of loss and grief, threats to future performance.

3.     Social Well-Being: Loss of important social roles, separation from fiends/teammates.

4.     Self-Concept: Loss of send of control, dealing with altered self-image, threat to important life goals and values.

…and that impairment in these four areas will in fact, have a debilitative effect on the physical healing process as well.

According to all the experts, the key to psychological healing after a sports-related injury is the adaptive movement through the various stages of “grief,” from denial and depression to acceptance, understanding, and a shift to a future orientation.

All of my research on this has definitely helped, as I have really felt low for the last several days – as I said previously – as though a good friend has left town.  I even find myself feeling real anger at the runners I see happily moving down the road pain-free (why me?)  I really thought I was going crazy.  It’s good to know that this kind of response is real and experienced by lots of other people.  It’s also a very interesting opportunity to take a look at how I define my own self-worth and persona.  But most importantly, it reminds me of the fact that running is a gift – one that believe me, I will never take for granted again as long as I live.

• Currently 4.0/5 Stars.