NOTE: If you haven’t read part 1, please check it out before you read part 2. Otherwise, you won’t have the necessary background for part 2, where I talk about how to suffer less.

Dr. Art Markman and Dr. Bob Duke, co-hosts of one of my favorite podcasts, 2 Guys on Your Head, inspired Part 1 of this blog. In it I shared varying views on struggling versus suffering. Again, there’s no right or wrong answer. Each person’s thoughts are valid; consider them all and how they apply to your specific set of circumstances.

In part 2, I’ll talk about how all these thoughts apply to injury recovery and how to curb your suffering.

Note: Over and over I’ve witnessed injured athletes returning to their sport before fully healing in an effort to avoid emotional suffering. Unfortunately, such strategies almost always fail and result in further injury.

My friend Kim thinks of returning to your sport before fully healing as taking an elevator. She says, “If the only way you ever learned to get out of your hole is by taking the elevator, you’re in trouble when the power goes out.”

My friend, Kim, and I love riding bikes. I took this photo on a ride we did several months ago, during which I learned the phrase “party break.” Both of us have to take rests while we’re riding. Rather than feel shame about that, Kim decided to have fun and call the rests party breaks. I can say with confidence our party game on this ride was strong, as indicated by the simultaneous kite flying and bike riding–which, sadly, didn’t last long. We have made plans to attempt kite flying again, this time while riding on a tandem.

As a coach, I work with clients to teach them the necessary tools to climb out of the suffering hole under their own strength and resilience–no elevator necessary. Why? Taking the elevator–aka returning to your sport before you’re ready–won’t serve you well…ever.

If you’ve read this far, I know you’re committed to feeling better. Promise me you will follow the guidance in this blog and climb out of the suffering hole under your own power. Forget about the elevator.

PART 2—HOW TO SUFFER LESS

ABOUT YOUR TRIBES

Tribes and our desire to be part of a group

Human beings evolved to live in small groups where they shared duties such as hunting, gathering, raising children, and looking after the sick. They were able to accomplish formidable feats that they never could have accomplished alone, for example hunting large beasts.

Human beings survived by living in groups. If one person became isolated from the group, that person was vulnerable, but so was the group without them.

In his book Lost Connections (which I recommend), Johann Hari interviewed loneliness researcher Dr. John Cassiopo who said, “Every human instinct is honed not for life on your own but for life like this—in a tribe. Humans need tribes as much as bees need a hive.”

Your “pre-injury” tribe…Is it contributing to post-injury suffering?

Most of you participate in a sport that involves some degree of social connection. You have teammates, training partners, or coaches.

In the 2 Guys on Your Head podcast on struggling versus suffering, Bob describes the social aspect of sports precisely.

He says, “We are a social species and one of the things that allows social groups to function is there’s something that causes them to cohere. There’s some common experience.

Those bonding experiences have the ultimate effect of pulling people together in a way that allows them to work together toward other goals.”

Think about, for example, a running tribe where everyone is training for a half-marathon. That shared experience and shared struggle begets strong bonds. Your particular tribe may have completely different goals. No matter, tribe members share collective victories and hardships during months of training.

This is all good and well…until injury happens.

A light at the end of a cedar tree tunnel…nature art found while mountain biking

If your sport becomes the glue holding your relationships together, you stand to lose those relationships when injury strikes.

Art says, “It’s easy to be a member of a community when everything is going well, but if you want to believe that you can rely on somebody, then you need to know that they’re going to stick with you even when things aren’t so great.”

Many injured athletes face a frustrating and unfortunate reality: friends and teammates disappear, leading to social isolation.

Injury isolates. John Cassiopo discovered isolation leads to depression. Depression leads to suffering.

You have to think about what’s right for you—checking out of your pre-injury tribe for a bit while you find another tribe or deciding to stay engaged and participate however you’re able. Consider this a “choose your own adventure” opportunity. There isn’t only one good answer, and what works for you today may be different than what works for you in a few weeks or months.

A beautiful stone path outside of Manchester, England

So what can you do to limit suffering in this situation?
Note: Plugging into your athlete tribe will yield one of two results: 1) You may feel energized and fulfilled by your friend’s accomplishments. By continuing to be welcomed, you feel inspired, motivated, and happy to participate even if only indirectly or as support, or; 2) Stress. Perhaps you’ve been forgotten or dismissed. You can’t participate in the activity, and you no longer get invites to the social functions. Maybe you’d rather not embrace the people who have abandoned you. (If this is happening to you, please don’t get anxious. This scenario is actually more common than scenario #1. I write more about this here.) There are pros and cons with either scenario, and of course your situation will probably land somewhere in the middle. I want you to choose what’s best for you. There’s no right or wrong direction here.

• Set up movie nights with your closest teammates or athlete-friends **who are invested in your recovery and you connect with outside your sport.** Have a potluck dinner and choose a movie together. Perhaps suggest they read this blog I wrote about how your friends can best support you—before they come over.
• Is there an activity you can do with your friends and teammates that would benefit your tribe’s health and well-being? Lots of linear sports (running and cycling) benefit by yoga. Think about finding a class that is friendly to your injury and helps balance their bodies. Remember that in a yoga, cross training, or other class, never hesitate to modify (or skip) an activity to be respectful of your injury.
• If it’s not going to sabotage your physical recovery and you’ve weighed the emotional impact, go support your friends while they’re racing. Many of my clients fear showing up at a race in which they cannot participate. Far too many others regret not getting over their fear and miss an opportunity to connect with friends, yell and scream, ring a cowbell, be outside, and make someone else’s day.
  PS-This stool is comfy, portable, and you can sling it across your shoulder if you’re on crutches. It has enabled me to get outside and do all kinds of fun activities while respecting my limitations.
• Ask for help! Yeah. I know what you’re thinking, but really—asking for and receiving help builds connection—connection you desperately need. I talk all about that—while addressing your asking-for-help-phobia—in my blog here.
• Read or listen to Johann Hari’s book Lost Connections.
• Read my guest blog posts on Joletta Belton’s brilliant “living well with chronic pain” website. The first post about understanding social isolation is here. The second post about ameliorating social isolation is here.

Your “injury” tribe…does it offer support or amplify suffering?

Human beings didn’t evolve to take down a beast like injury on our own. Yet, almost all of my clients report feeling alone or isolated while they’re recovering from injury. In fact, John Cassiopo proved being deeply lonely is as stressful as experiencing a physical attack. Just think about that for a moment.

Dan and I met Delaney after my second surgery at The Steadman Clinic in Vail, Colorado, in 2011. We’ve been friends ever since. Delany and I are veterans of many surgeries. Together, we choose to focus on positivity, while still allowing each other space to have hard times and bad days. We’ve come a long way together!

Injured athletes who lose their pre-injury tribe (teammates, coaches, friends) suffer. They feel lonely, isolated, dismissed, and misunderstood.

Instinctively, they search for another tribe. Usually, their new tribe includes other athletes who share a common experience of injury.

On the surface, this sounds like a perfect tribe—and it can be.

However, this new tribe can devolve into a vortex of negativity leading to more suffering. Just like Bob said in the 2 Guys podcast, “The notion of suffering and the attachment of helplessness to that does the opposite of what people intend.”

A quick-time out: Earlier in this blog I outed myself as a nerd. As my husband Dan and I talked about post-injury tribes, I envisioned the potential for a tribe of injured athletes to create a collective negative energy, and that conjured up the concept of constructive interference. Constructive interference is the combination of two or more waves of equal frequency and phase, resulting in their mutual reinforcement that produces a single wave whose amplitude is equal to the sum of the amplitudes of the individual waves.

Diagram courtesy of University of Connecticut Department of Physics

In other words, negative energy and suffering has a high potential for magnification in a tribe of injured people. So, beware.

Back to our regularly scheduled blog…

A former client chronically bragged about how hard things were for him and how his injury was worse than others. He adopted the role of a victim and became a vortex of negative energy. He didn’t brag about how resilient he or the human body is. Nor did he brag about, or even truly appreciate, his exceptional medical team or supportive family.

He made a conscious choice to add drama to his struggles. His emails read like a soap opera script.

That’s suffering. And his suffering was like a magnet for other peoples’ suffering. The collective negativity and drama of his new tribe of injured athletes simply reinforced—and amplified—suffering instead of helping the members move forward with reassurance and encouragement.

Some people are wired predominantly with an inherent negative outlook. I believe, however, that we can all—if we’re reminded—take the opportunity to make a conscious decision about our mental disposition. We can all choose—and practice— to focus on the things that are going right rather than what’s going wrong.

To that end, tribes can exhibit the physics of constructive interference where everybody makes a choice to amplify positivity and progress.

Sometimes our instincts or emotions may overwhelm us. We may find ourselves unable to stay positive. But, if we join a tribe with the mantra, “My emotions and body language and words have an effect on other people. I’m going to do my best to promote positivity in this tribe,” everyone benefits. We know the body follows the mind, and positivity breeds positivity.

If we all think about this before joining a tribe, we have a better shot of contributing positive energy.

Remember: Your tribe will reflect back the energy you put out in the world. This is constructive interference in a positive sense.

So what can you do to limit suffering?

• Positivity is—in my experience—a verb. It’s a practice. I’ve written two blogs about exceptional people who epitomize positivity as a practice. Both blogs contain practical, actionable guidance. I suggest reading this blog about how I called for a taxi and it changed my life and this blog with advice from 60+ year-old cyclocross national champion.
• Evolution forces us to feel bad when we’re disconnected. Volunteering and getting out in nature will provide perspective and reconnection.
  a. Volunteer on a regular basis. When you help someone else, you help yourself. Volunteering changes your focus to empathy, appreciation, and someone else’s needs. It allows you to use your brain in ways you normally don’t, removing the fog of self-pity, frustration, and impatience.
  b. Get out in nature. Even if you’re a fluorescent light-loving indoor creature, get outside. John Cassiopo said, “Nature is connection.” Data show that being in nature has a positive effect on the brain. One study found quantifiable evidence that walking in nature can lead to a lower risk of depression. If you’re inclined to read more about this topic, I recommend Florence Williams’s The Nature Fix.

Second to swimming in cold water, there’s no better salve for a struggling or suffering person than nature.

YOU HAVE A CHOICE

Some aspects of injury are clearly not controllable. However, how you cope with and what you learn from your injury is a choice.

If you choose to view injury—as I do—as an unforgiving but rewarding teacher with a purpose, you’ll struggle like every injured athlete; however, injury will inevitably catalyze your personal evolution. You’ll eventually look back on your injury with gratitude, the same way you look back on a challenging school teacher who changed the course of your life.

I believe if you choose bitterness and frustration, you’re choosing suffering.

Choice 1: Choose your words carefully

One of my all-time favorite quotes is about words.

Maya Angelou says, “Word are things. I’m convinced. You must be careful about the words you use.

Words are things. You must be careful.

Some day we will be able to measure the power of words. I think they are things. I think they get on the walls. They get in your wallpaper. They get in your rugs, in your upholstery, in your clothes, and finally into you.”

Bob also said words matter in his podcast. For years I’ve witnessed how word choice affects my and my clients’ attitudes positively or negatively. And then who can argue with Maya?

The reality of an injury is the reality. How you choose to describe injury with your words is, to a large extent, your choice.

We’re lucky. Inspirational graffiti abounds in Austin.

While having a positive demeanor and choosing positive words doesn’t change the reality in the moment, it can affect your outcome in the future. By choosing positivity, you’ll surround yourself with positive energy and a care team that truly cares about you and wants you to succeed. They will be inclined to work harder for you and get more engaged. Everyone works harder for you when you’re a person for whom they want to work.

Injury overwhelms our bodies and brains. We all need to acknowledge that when in stress we digress, that is, we revert to our natural, perhaps not so positive, selves—and that’s perfectly normal. Start anew the next day.

Don’t create an echo chamber of negativity with your words. Your attitude and your words matter—not just in the moment, but also as time goes by. Attitudes build and reverberate off the people around them, and the effect snowballs.

So how can you limit suffering and choose positive words?
Remember the former client I mentioned earlier who was so attached to drama? More than once I said to him, “Be conscious of the words you’re using, and specifically speaking in hyperbole or using superlatives to describe your experience. Stick with the “just the facts” approach so your brain doesn’t hear emphasis on and inflation of negative aspects of your recovery.”

Nobody is asking you to lie about your symptoms or situation, but we are just asking that you don’t exaggerate your symptoms beyond what’s necessary to describe them.

Growth can happen in the most unlikely of places. This giant, old live oak is growing out of a limestone overhang and a cave below.

Choice 2: Avoid comparison

Almost immediately during my research with injured athletes, I appreciated threads among those who captured the opportunity accompanying injury. Instead of permitting injury to make them feel like they had just done battle with a group of Vikings, these folks were open to the rebuilding and learning process.

One of their recipes for success was “do not compare.” This means do not compare your post-injury self to your pre-injury self, and do not compare what you can do today with what you could do a few weeks, months, or years ago.

Jordan pointed out that suffering occurs when we use the word “should.” Should and could point to comparison.

None of us should like Should: “I should be able to…” Phrases like this devalue your actual capabilities and any improvements you’ve made. Should dishonors what you can do. Should demoralizes and denigrates. When you “get the shoulds” your mind is flushed down a negativity toilet.

So how can you limit suffering by not comparing?

• Make a promise to banish the words should and could from your vocabulary. These words lead to self-flagellation and drain your energy because, all of a sudden, your focus and attention move to the litany of things you cannot do. Understand that if you are fortunate enough to be able to resume your sport, you will be slower, you will have less endurance, and your edge will be dull. Try not to beat yourself up over it. If you can recover from your injury, the edge will come back, sharper than ever.
• Read my two-part blog on comparison. Part 1 is here, and part 2 is here.

Choice 3: Find alternative ways to move

Work with your physical therapist or physician and find some type of injury-friendly activity.

Despite your injury, you still have a strong desire to move. Movement helps diminish stress and decrease pain. Read: it keeps you sane.

Finding new ways to move will use your brain in ways you’re not accustomed.

Note: You likely won’t start off feeling proficient and maybe your new-found activity won’t be your forever-love, but it’ll become a good friend you can always rely on. You’d be surprised how many (very happy) cyclists used to be runners until they picked up an injury, switched sports by necessity, and never looked back.

Finding a different, injury-friendly way to move connected me with wonderful people. In the top photo, I’m swimming in the cold, crystal clear waters of the San Marcos River with my dear friend, Cate (I’m on the left; she’s on the right). In the bottom photo, we’re hanging out at the ladder gathering steam to swim upstream again. Top to bottom: Tucker, me, Cate, Todd.

Choice 4: Help yourself

In order to help yourself, it’s important to understand a bit about why parts of you are feeling so irritated.

Our nervous system is divided into two parts: sympathetic and parasympathetic.

Your sympathetic nervous system allows you to run like Wonder Woman away from hungry tigers. It’s responsible for that fight-or-flight feeling—a racing heart, sweaty palms, nausea, etc.

Your parasympathetic nervous system controls involuntary functions like heartbeat, breathing, and digestion. It also helps slow your heart rate.

When you’re injured, your sympathetic nervous system is on overdrive, and it feeds off of itself in a cycle. Before you know it, you’re living in fight-or-flight (aka feeling frustrated, angry, anxious, jealous, etc.) all the time.

Any activity that allows you to turn off your sympathetic nervous system and turn on your parasympathetic nervous system will enable you to relaxed and accept.

Me floating in the cold, magical waters of Barton Springs during a rainstorm

So how can you help yourself?

• Creativity…Gravitate away from the “faster, harder, stronger” part of your brain, for using it will only lead to anguish…but exercising the creative side of your brain leads to patience and peace.

  Think of it this way: You’re used to working out your body most days, now it’s time to work out the quarterback of your recovery, aka your mind.

  Every time you exercise creativity you wear a path in your brain that engages your parasympathetic nervous system. The more worn the path, the more you find freedom from things like: wondering what you’ll do with all the extra time on your hands; jealousy of your friends who can do what you can’t; and pent up stress and frustration from missing self-imposed goals.

  I’ve written more about the importance of creativity in two blogs here and here.



Helen Lundeberg’s beautiful painting “The Tree.” The light and dark/hole contrast conjure up memories of injury recovery.

• Therapy…for your brain…My physical therapist, Brenda, hit the nail on the head when she said, “If all of our happiness, self-worth, and stress relief is derived from an activity you can no longer do, that’s significant.” It’s extremely common for a newly-injured athlete to face an identity crisis.

  Pre-injury you could run, walk, cycle, or move in some way to cope and relieve stress. Now, those activities are out of the question. You feel trapped, forced to lie beneath the pile of stress with no means to process and escape it. This usually brings up all kinds of feelings that are difficult to just sit with.

  So, I highly recommend two specific types of psychotherapy: Eye Movement Desensitization and Reprocessing (EMDR) and Internal Family Systems (IFS). I believe EMDR and IFS therapies can be very helpful for anyone suffering. I’ve written about EMDR in this blog.

  IFS therapy is based on the fact that, as human beings, we are made up of parts. For example, we may have an anxious part, an angry part, a jealous part, a grateful part, a frustrated part, an impatient part, etc. IFS explores the parts’ roles and why they exist. Then we begin to understand exactly why we feel how we feel. Understanding is power.

  Both EMDR and IFS have been life-changing enough for me that I can confidently say I would not be here were it not for them.

  How do you know if it’s time for therapy? Sometimes a feeling can be acknowledged and you can move forward. However, if a feeling keeps coming up with intensity and frequency, there’s a part of you screaming for help. Listen. Go to therapy. It will change your life.

A light at the end of a tunnel beneath Whiteface Mountain in the Adirondack Mountains

I asked Art Markman for his thoughts on how to ameliorate an injured athlete’s suffering.

He said, “The energy that comes with a goal blockage can be spent in many ways. When it is spent by feeling and nurturing psychological pain, then it leads to extended suffering. That energy can be used to rehabilitate the injury, to train and coach others, to learn new skills, or to pursue plans that were put on hold because of an engagement with sports. All of these are potentially productive ways to use that energy. In general, suffering is not productive, while these other approaches are productive uses of this energy. As I often put it, in physics, energy without direction is heat, while energy with direction is work. Psychologically, it is better to generate work than heat.”

I wonder how Art knew I’d appreciate an answer involving physics.

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.

Forward>>>Heidi

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.