How do I build confidence after returning from injury?

Returning from Injury

Struggling with own list of blog topics, I thought I’d reach out to the twittersphere for inspiration.I asked @UKrunchat if their followers had any strength and conditioning and running related questions and received several interesting replies. As it turns out, the response I decided to write about was not strictly strength and conditioning related but more aligned with the psychology side of things. As I am currently rehabbing from a nasty knee injury myself (don’t play rugby - its dangerous) and my background in psychology, it really appealed to me, so here goes:

'How do you get confidence back after injury. After the physio. Back to form, but every step is more thought about'

The question sounds as though it comes from someone who has been cleared to exercise again, but is now struggling  perhaps more with certain psychological aspects relating to her running as they are getting back into it.  First, its important to caveat the rest of the answer with the obvious shortcomings of 140 character tweets - It’d obviously be useful to understand more about both the nature and severity of initial injury, length of layout, details of her experiences during rehab, any other psychological interventions etc. These will all play a critical part in the eventual outcome and any exercises that might be suggested as the issues could be rooted in a number of areas. With that said, I’ll try to outline what I would consider MIGHT be some useful techniques and approaches in this situation.

1) Retain perspective and adopt a whole-person philosophy throughout the injury process

Although you have been cleared to exercise again, it is important to continue to retain perspective on the process you have gone through. Remember that you are not your injury, so don’t let it subsume your athletic or even personal identity. When exercise or sport is a big part of your day to day life, it can be a real knock to your sense of self, when your ability to exercise effectively is taken away from you. Any particular injury might cause a given individual to experience a whole range of feelings and emotions - inadequacy, fear, frustration, anxiety etc. throughout the entire journey to complete recovery. Recovery takes time, and patience is required. Understand that these types of recurring thoughts during runs are a frequent and completely normal experience for someone recovering from injury.

Cartoon of glum looking frankenstein-like zombie holding his own arm
It is easy to for your injury to subsume your personal or athletic identity - don't let it!

Try to retain and re-connect with your social support networks - talk to other injured athletes, or those that have had similar experiences. You are not alone in this, and as a person first and foremost, both informal and formal types of support can help improve ongoing motivation and rebuild your confidence. Even just a small conversation, tweet, text or call could be the conversation to help unlock and shake these intruding thought patterns! If they don’t happen to lead to that ‘light-bulb’ moment, over time these connections will help you to appreciate and normalise your current thought patterns. You’ve successfully negotiated your injury so far, this is just another small step in that ongoing process.  Having chatted with friends and fellow runners, next time you go running, try to spot these thoughts as they occur. Acknowledge them for what they are (just normal thoughts), as even the process of noticing and labelling (give them any name you want) can help lessen their salience.

2) Practise thinking differently 

Once you have started to spot these thoughts as they arise, you can then start to implement the process of thinking differently when they do.  The fancy terminology used for this by Sport Psychologists ‘cognitive restructuring’ and the aim is to replace the negative thought patterns with more positive ones. Now, I don’t know exactly what you are saying to yourself or thinking when these patterns occur, but  as an example, instead of thinking ‘I can still feel my injury, its not fixed, I’m never going to run properly again’, you might learn to say to yourself ‘STOP!’ each time you notice your thought patterns running away with themselves, and instead saying 'I’ve done the rehab, these sensations are a normal part of recovery and adapting to running again’.  Choose your own, make it specific, and practise - it won’t necessarily come easily or straight away.

Depitction of cog-like workings of the brain
We learned to think the way we do, so we can learn to think differently too

3) Positive self-talk    

You’ll probably have heard of this. It’s similar to cognitive restructuring, but these are more intentional, pre-rehearsed statements that you can recite (internally or out loud) to help pre-emptively combat negative thoughts. They can be used motivationally or again in a cognitive way. Try both, but I think that the latter would be more relevant to you. Again I don’t know what your injury is, or if it relates to your form, but if it did, something like ‘high hips, light feet, great running’ could be appropriate. Say it to yourself - and mean it, it won’t work if you don’t buy in.

4) Practise asking yourself questions that won’t lead you down the garden path.

If the question you ask yourself is ‘how does my *previously injured area* feel?’, you leave yourself open to becoming lost in a rabbit hole of thoughts to follow. The question is open-ended and general, and can subsequently be interpreted in a multitude of potentially unhelpful and distracting ways. Make the questions you ask yourself offer specific, targeted and useful answers. You might want to develop some highly structured, short-term performance goals and seek out feedback in relation to these. Do you have a checklist for running form? Use this to evaluate your running, as opposed to nebulous and intangible thought-patterns.

Hopefully some of the above techniques and hints will prove useful, and I'd love to hear if any of it helps. Its difficult to be specific without knowing more - please do email me on if you have any questions or feedback. If all else fails....

Don't worry, be happy text image
Wise words from Bob Marley

Good luck!