“If you want to make someone unhappy, tell them they’ve never suffered,” said Dr. Bob Duke at the beginning of his weekly podcast, 2 Guys on Your Head. He and Dr. Art Markman conjure up the Car Talk guys, Click and Clack, only they discourse about psychology and human behavior.

From Bob’s opening line, I knew the week’s topic—struggling versus suffering—would resonate with me and my injured athlete community.

This self-admitted 2 Guys on Your Head superfan obsessed and listened to their seven-minute podcast about seven times. Hey, at least it wasn’t seven times in a row!

2 Guys on Your Head

Following my listening binge, I wondered how I’d define struggling versus suffering.

To me, suffering is the inability to accept what is; in the context of most athletic injuries, I believe suffering is a choice, not a consequence of injury.

I believe when expectations don’t meet reality, suffering begins.

Then I began wondering how my friends, husband, and clients differentiate between struggling and suffering, so I asked.

Each one had varied and valid thoughts on the subject; there’s no one answer here.

I’m sharing everyone’s point of view for your consideration and cogitation.

I’ve broken this blog down into two sections: 1) perspectives…each person’s thoughts on struggling versus suffering followed by; 2) guidance to help you suffer less.


My husband Dan

Dan had a perspective on suffering versus struggling I hadn’t consciously considered, even though I’d experienced it. As our conversation evolved, I realized so many of my clients fit this mold.

Speaking to the injured athlete, Dan said, “Everyone is a member of multiple tribes. One of your tribes that has meant the most to you is your sports tribe—your running buddies and training partners.

Because of injury, you’re not going to be close to them for a while. It’s not like you’re thrown out of the tribe, exactly, but you’re not going to have that same connection because you’re going to be on the injured list for a while.

You’re going to read their Facebook posts about their PRs and races and you’re not going to have the ability to really add anything.”

I said, “Oh yes, and reading about all your friends’ adventures can be a real source of irritation and alienation.”

Dan said, “We all want to be part of a tribe. That’s the way we are wired evolutionarily. So, your brain is going to search for a new tribe. Maybe that new tribe is people who have the shared experience that you have of a particular injury. Maybe it’s not the exact injury, but if you have a severe injury—maybe it’s chronic or debilitation or limiting—you are going to search out people who share a similar experience, and you’re going to have an immediate connection with them because of that shared experience. That’s going to help you form bonds.

That’s good because we all want to be part of a tribe and tribes are supportive of each other’s members.

It’s bad because if you overly focus on hanging out with injured people, there could be a lot of negative energy, and that negative energy can feed and grow.”

I said, “So, do you believe it’s a matter of choosing your tribe wisely?”

Dan said, “Yes, but also consciously being a positive influence to that tribe and encouraging other people to be a positive influence to that tribe is vital.”

More on that later…

Swimming tribe

My post-injury tribe…I took an 18-year hiatus from swimming, returning after my knee fracture in late 2010 forced me to find injury-friendly ways to move. I didn’t want to stare at the stripe on the bottom of a swimming pool–ever–so I began swimming outside year round in a cold, crystal clear spring-fed pool in the middle of Austin called Barton Springs. It’s a natural bottom pool full of fish, turtles, and plants. Over the years, I’ve met some remarkable people, and they’ve become my new tribe. We took this photo on Christmas Day 2017. While it appears to be sunny and 80 degrees outside, it was really below 30 degrees! Left to right–Joe, my husband Dan, me, June (Joe’s wife), and Steve

2 Guys on Your Head: Dr. Art Markman and Dr. Bob Duke

At the beginning of the 2 Guys podcast, Art pointed out, “To be a full-fledged member of any community, there has to be a shared experience that you go through. In many of those communities—if not all of them—a significant chunk of that shared experience involves some degree of struggling.”

This is a very important point I’ll talk more about in the interpretations section.

Later, Bob said, “It’s important that we make a distinction between what we’re saying when we talk about a struggle and when we talk about suffering. Many peoples’ conception of suffering involves being in a situation that is inescapable and unavoidable—that things are being done to you and there’s nothing you can do about it. That’s a suffering position to be in. The word struggle has a sense of optimism to it because you can take action that is actually going to lead potentially to a better outcome. We know something we value will come of a struggle.

All the things that lead to struggle are predicated on the idea that the struggle is going to lead to coming out the other side now having been changed in a way that’s, on balance, positive, even though you’ve been through this difficult thing.”

Our ancestors’ lives had magnitudes more strife and stress, yet, for example, when I talk with my 100-year old grandmother who traveled to the US on a boat from Sicily when she was 11, she doesn’t talk about being a victim or how awful life was. She does talk about the challenges of discrimination as an immigrant, poverty, and learning a new language. But, she says, all of these struggles shaped her into a strong and resilient woman.

To this end, Bob said, “Art was mentioning nostalgic views of the past and how difficult it was. I think everybody who has come through suffering in a positive way, and I think about elders in my family who have lived in serious poverty. They don’t talk about their experience purely in terms of suffering. They talk about it terms of difficulty and struggle, and actually words in those situations matter.

The notion of suffering and the attachment of helplessness to that does the opposite of what people intend.”

Indeed, Bob. It does.


Austin graffiti found on a mountain bike ride

My friend Doug Kelsey

After my first injury and subsequent existential crisis, my physical therapist (and now dear friend), Doug Kelsey, PT, PhD, reached waaaaay down into the deep, dark hole of suffering in which I’d face planted. He hoisted me out and reminded me of one of the most important gifts of life—creativity.

Kelsey appealed to my nerdiness by imploring me to get a camera, and he made a rule. “No shooting photos in ‘automatic’ mode.” He encouraged me to shoot in manual mode, forcing me to learn about the physics light, lenses, and camera settings. All this learning and creativity gave my brain something healthy to chew on. Best of all, it offered a glorious—and healthy—escape from intense pain and suffering.

I credit Kelsey with being the catalyst that ended my suffering. Because of him, I picked up a camera and reconnected with my creativity. To this day, creativity is my most important tool.

Looking through the lens of a camera engaged parts of my brain that prevented me from suffering needlessly and relentlessly.

I thought it only fitting to ask Kelsey’s definition of suffering versus struggling.

He said, “You can struggle without suffering but you can’t suffer without struggling. Suffering is attaching value or meaning to a struggle.

For example, my back hurts. That’s a fact and that’s all. It’s a sensation. I may struggle to overcome it trying various approaches. But, when I attach meaning to it–I’ll never run again or cycle or get over this—this makes me mad. Now I’m suffering.”

Jacob's Well

Beautiful Jacob’s Well, the mouth of a deep Artesian spring. Much like the depths of someone’s struggle, one would never guess its depths from the surface. The well takes an initial plunge through 23 feet of well-lit water to an apparent bottom, but then it veers off into a descent of increasing darkness. It reaches 140 feet at its deepest point; 14 stories underground, underwater. There are two tunnels, A and B. A is 4300 feet long and B is 1300 feet long.

My physical therapist Brenda

Brenda Walk, PT, DPT, OCS, sees the root of suffering in our inability to adapt to new and stressful post-injury limitations.

Brenda says, “If all of our happiness, self-worth, and stress relief is derived from an activity you can no longer do, that’s significant.”

If there’s something we’re not going to be able to do short or long term, then we need to find other outlets.

You can only have a negative or pessimistic outlook for so long. Then you have to say, ‘Okay, this is the new reality, so I need to make the best of it.’ The people who are able to adapt are the people who successfully avoid most suffering, and the people who get bogged down with, ‘I can’t participate in my sport anymore and this sucks,’ are the folks who run into suffering.”

Brenda sums up her view with, “The struggle is figuring out ways to change habits. Suffering is when you’re unable to change habits.”

Needless suffering

Sisyphean struggle

My client C

An insightful and intuitive client who is also a Marine officer offered the following thoughts. She said, “Suffering is a choice. Struggles are actionable (whether they are manufactured to build resiliency like in the military or not). I know sometimes (a lot of times) I feel like I’m suffering…but I also know that’s when my mental strength is a bit weaker.”

My friend, artist, physical therapy student, and old soul Jordan Spennato

My friend Jordan is recovering from years of chronic pain and a recent hip surgery. Having surgery meant she had to take a year off physical therapy school—talk about stressful. Though Jordan is in her 20s, she’s an old soul overflowing with the wisdom—and musical taste–of a 70-year-old.

Jordan has both struggled and suffered plenty in the past eight years. She’s also written about and expressed her darkest days in beautiful prose and art, so of course I asked for her perspective.

She said, “I think that with struggling you are doing something with intrinsic motivation you KNOW you can get through. You know you’ll be a better person after.

Suffering to me feels like it’s extrinsic…we SHOULD be doing this/feel this/think this and so we go through possibly the same motions that struggling would entail, but there’s no internal growth from it.

Suffering is usually done in isolation, whereas people are more prone to asking for help when struggling.”

Curly hair

Jordan and I taking a break from physical therapy together–seeing just how big we can make each other’s hair during the height of humid weather in Austin, Texas.

Dr. Art Markman

I emailed Art asking him about his view on the difference between struggling and suffering.

He wrote, “Struggling happens whenever there is some goal that you want to achieve and cannot for some reason. How you react to that blockage determines whether you suffer. If you feel psychological pain from that blockage, then you are suffering. It is natural to suffer from goal blockages–at least for a while–but how you choose to deal with them in the long term determines whether your struggle continues to lead you to suffer.”

In part 2 of this blog, I’ll talk about actions you can take to suffer less.

If this blog resonates and you feel you’re struggling or suffering, please drop me a note at heidi@injuredathletestoolbox.com so we can get you back to feeling like you.


Special thanks section: I’m grateful for: Rebecca McInroy [with Austin NPR’s KUT] for producing 2 Guys on Your Head; the 2 Guys Dr. Art Markman and Dr. Bob Duke; the people who shared their views on struggling versus suffering—friends Kelsey and Jordan, husband Dan, physical therapist Brenda, client C; my friend Kim for reviewing this blog-novella and offering feedback, and; my friend and writing mentor, Max Woodfin, for taking time to answer my grammar questions, review this blog, and offer thoughtful input.

  1. So much of this rang true for me and relates to life in general, as well as injury (I’m familiar with both). I agree with Jordan about the isolation vs reaching out aspect of suffering vs struggling. It’s been a game changer for me to develop the ability to tell a capable person that I’m struggling. Also, the quote regarding expectations and reality – YES! When I had an existential crisis a few years ago (it was not related to injury), I realized that my expectations were the primary culprit in my unhappiness – what an empowering epiphany! Thanks for all you do Heidi 🙂

    • Thank you for reading, Lara, and I’m so glad this blog resonated. I tell myself that a problem shared is a problem halved. We *have* to reach out most when we feel ashamed or beaten down. That connection is how we survive. Expectations…sigh. Sometimes I wish I could be a monk and not have expectations. They’re the root of so much suffering. Awareness of that fact helps us make a shift in mindset. xx, Heidi

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