Injury & Mental Health

The hardest part of most injuries aren’t the injuries themselves (although they are horrible). It’s the resting, the waiting, the uncertainty about the future. This time period forces you to confront uncomfortable thoughts and you can start to question everything you took for granted before. Pain is also an ideal habitat for worry to flourish, and more often than not, this leads to more frequent negative thoughts.

· December 7, 2019

Injury & Mental Health

The hardest part of most injuries aren’t the injuries themselves (although they are horrible). It’s the resting, the waiting, the uncertainty about the future. This time period forces you to confront uncomfortable thoughts and you can start to question everything you took for granted before. Pain is also an ideal habitat for worry to flourish, and more often than not, this leads to more frequent negative thoughts.

The definition of an existential crisis is “a moment at which an individual questions if their life has meaning, purpose, or value. It may be commonly, but not necessarily, tied to depression or inevitably negative speculations on purpose in life”. This may ring true to you if you have recently been injured; it can feel like your life is on hold.  It is really important to acknowledge this feeling and talk about it when you can. Clients often say things like  “this may sound stupid, but I feel like some of this is in my head…” to which I always want to reply with the wise words of Albus Dumbledore; “Well of course it’s happening inside your head Harry, but why on earth should that mean it is not real?”

 

This state of injury-induced “existential crisis” isn’t necessarily a bad thing but it’s definitely an uncomfortable, underdiscussed and under-addressed aspect of injury. The reason it’s so important to acknowledge is simply that our mental health whilst injured plays a huge role in our physical recovery.

Recently, there has been a lot of research telling us that psychological aspects of pain/injury have a huge impact on our recovery. Negative beliefs, a perceived lack of control and a passive coping strategies are, perhaps surprisingly, the most significant risk factors in developing a chronic problem. For example, a person who has been led to believe their injury is more serious than it actually is or who has limited understanding of their injury , who relies on someone else to take control of the recovery, and does not take a proactive approach in dealing with their pain is at much higher risk of their pain being more severe, and lasting longer. The reasons behind this are complex but ultimately, we know negative thoughts and attitudes are highly detrimental to recovery.

I talk often to my clients about the influence that our “software”, or the nervous system, has over our “hardware”; our joints and other soft tissues. This is often overlooked during recovery, and knowing how the nervous system affects our injuries and our pain experience is crucial in managing it well. For example, during the acute pain period the pain will generally be at its most severe. This can give us the impression that something REALLY bad and REALLY serious has happened – what else could this pain mean? This is where these negative beliefs come into play and naturally we can feel very scared about the future. Pain is complex and often difficult to understand (I sense another blog coming…) but what we are sure of is that PAIN LEVELS ARE NOT DIRECTLY PROPORTIONATE TO TISSUE DAMAGE. Pain can be agonising when very little to no tissue damage has occurred at all. You need to have a good understanding about your injury, your pain and what contributes to it to facilitate speedy recovery, and physiotherapists are best placed to help you here.

 

It's very easy to get caught up in the negative thought cycle and spend a lot of time feeling down and sorry for yourself. This is totally understandable, and happens to everyone… remember that Andy Murray press conference about his hip where he broke down in tears? 

This is why I can’t stress enough that physiotherapy often isn’t just about making you ‘feel better’, but also increasing and improving our ability to ‘feel’ in the first place. It’s a great opportunity to understand how your body works, and get to know your warning signs. Injuries and training mistakes can often be avoided with better kinaesthetic awareness, but the catch here is that awareness only improves through a consistent and conscious effort to develop it; it almost always takes an injury to realise this!

 

I have developed some tips to help you use your existential crisis period wisely:

  • Most importantly, take an active role in your recovery. Do what you can, when you can. Read things, ask many questions. The more you understand your problem, the less you will fear it and you can concentrate less on worrying and more on moving forward.
  • Develop a healthy curiosity about your pain – how does it behave? What can you do to effect it? What does it respond to best?
  • Find a trusted physiotherapist. Chances are your GP does not have a specialist knowledge of your injury, and it helps so much to have a trusted specialist that can guide you through the recovery period. Why should you have to do this on your own?
  • You CAN train around your injuries to maintain a level of fitness, whatever the injury. For this reason, a gym is often most useful for people who are injured, although this seems counter-intuitive. Talk to your physiotherapist about what other types of exercise will be most helpful for you.
  • Understand what may have contributed to your injury in the first place (without beating yourself up about it) so that you can make some lifestyle changes if you need to.
  • Focus on other aspects of your well-being that maybe you didn’t prioritise prior to injury (family, relationships, friends, sleep, mental well-being, other non-active hobbies). Did you ever think “when I have time I’ll read those books, or watch that TV series, or finally learn how to play my guitar”? Perhaps there’s a new skill or hobby that you can put some energy into.
  • Find the silver lining. What has this injury taught you about yourself? Is there anything you want to change moving forward?

It is difficult to see the wood from the trees when you are the one with the injury. Getting an outside perspective from a healthcare professional can really help you understand these questions; it is our job to help decipher if there is an underlying cause to an injury (if it’s recurrent; there almost always is) and more importantly to then help you to change. Your body and mind are incredibly resilient (even if it doesn’t feel that way) and there is always room for improvement; you just have to know where to start.

 

 

Thanks for reading and if you have any questions you contact us here: https://lmcphysio.co.uk/contact-us

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