Navigating Pain after a Physical Injury
A part of what makes physical injury so impactful on our mental health is the way it shifts our sense of self. It’s as if we are a different version of ourselves Before and After, where things we believed to be true about our identity, capabilities, and meaningful activities are suddenly changed or taken away.
In my world, when my knee pain was diagnosed as permanent cartilage damage in my patella with a partially torn patellar tendon, the doctor said: “you could keep competing, but it will only get worse.” If things got worse, I would need knee surgery. I realized that I could not be able to be an elite level javelin thrower and end my collegiate throwing career.
I retired from athletics because I knew that I had to choose between my identity as an athlete, or the long-term health of my body. Though it was an easy choice at the time, I had to navigate the grief, shifts in how I saw myself, and sense of purposelessness in the years after. I hadn’t achieved the all athletic dreams I’d had for myself, and I didn’t feel as vibrant and self-assured after the injury.
It took me years to rehabilitate after my injury, both mentally and physically. I used to have pain anytime I went from sitting to standing, and with that pain came a constant barrage of anxious thoughts. I had difficulty engaging in physical activity, because if it wasn’t competitive, I wasn’t sufficiently motivated to do it; but, if it was competitive, I was scared I would look bad in front of other people, as I’d lost a lot of my fitness and was still struggling with pain. I was afraid of what other people would think of me and scared to test out what my body was capable of. At the same time, I was afraid that my body would continue to decline, and at 22 felt like I was trapped in a body I didn’t know anymore.
This sharp decrease in confidence is so common, regardless of the type of injury. We want to know for sure what we can trust our body to do. When we are used to a body that feels and looks a certain way, when specific movements and activities are anticipated to be easy or fun and then we encounter pain or difficulty, it can degrade our sense of self. Suddenly, our body doesn’t feel like the physical home we could always count on.
These changes might be temporary or permanent, but a lot of times whether they are complex or serious injuries, the scary part is that we just don’t know. Medical reassurance helps to a certain extent, but we might ask ourselves: what if this is my new normal? What if things get worse? We often feel defeated, anxious, and disconnected from self and others.
A significant part of rehabilitating any injury is having the willingness to experience some level of pain, acceptance that grief and disappointment will be part of the journey, and that confidence and trust in relationship with ourselves only comes through persistent and consistent effort.
Even as someone who works in the field of rehabilitation, whenever I feel a pain in my knee, I notice my nervous system ramping up; when I detect that pain, whether it’s familiar or unfamiliar, my body gets primed for self-protection. It’s what our nervous system is designed to do.
With that in mind, how we work with this activation plays a big part in our rehabilitation journey. A few things that you may find helpful as you navigate this process:
Pain is inevitable. Active rehabilitation is going to induce muscle soreness, fatigue, and likely achiness or some brief moments of sharp pain as you relearn your body’s limits and work to expand them. Accepting that pain is a part of the process, and not always an indicator of something being wrong or further damaged, is hugely important for managing our stress during recovery. Of course, not all pain is created equal (think: the sharp, acute pain of stubbing your toe is different from the aching muscle fatigue of doing pushups) and learning about your pain will help guide you through your recovery process. It’s highly recommended that you talk to your doctor and other clinicians like a physiotherapist to get a sense for what to expect during physical rehabilitation.
Curiosity over judgement. Especially when it comes to pain and fatigue, most people quickly come up with a story to explain why it’s happening, and those stories are often littered with judgements. With judgement, we also try and create distance between ourselves and the unpleasant thing: we try to avoid it at all costs, especially when it comes to pain. As best you can, I invite you to be curious about your pain. Notice how it changes as you pay attention to it. Learn about what soothes it, and what flares it up. Be mindful of how your thoughts or emotional experiences might alter it. Be curious about things like food, sleep, stress, medications, or other lifestyle factors that may impact your experience of pain or fatigue. When we better understand our experiences and are able to meet it with compassion over judgement, we are in a better position to do something helpful about it.
Rehabilitation is retraining your body and your mind. Understand that you are bound to have good days and bad days, both mentally and physically. There are going to be times where you feel hopeful, and others where the anxiety feels overwhelming. If possible, I encourage you to speak with someone you trust about what emotions and fears come up as you work through your rehabilitation. Having care providers you trust, like your doctor, counsellor, occupational therapist or physiotherapist, can bolster your confidence and guide you through progressions of activity that keep you safe and moving in a helpful direction.
If any of this resonates with you, or if you find yourself needing help in your recovery, you can reach out to me (Serena Graf, counsellor) or Caitlin Preston (occupational therapist) at Panorama Wellness Group. We would be happy to work with you on your journey towards wellness. You can find our contact information here.
