How to "Be Careful" and Excel After Injury

If you Google the topic, the idea of being careful regarding pain and activity is obviously widespread. One of the questions on The Tampa Scale of Kinesiophobia (fear of movement) is as follows: Simply being careful that I do not make any unnecessary movements is the safest thing I can do to prevent my pain from worsening.

Clearly, my client’s ideas as well as a simple Google search’s results show the prevalence of this underlying belief: that sports or movement can be dangerous to our bodies and cause harm. Hence, we think that we need to proceed with caution when we’re being active. Makes sense, right?

Consequently, if we believe this, fear actually drives our movements and also limits them. I don’t know about you, but I don’t want to live with fear as my guide. In addition, consider all the extra mental focus necessary if you are precisely monitoring every move you make. That sounds exhausting! It’s also counterproductive to peak performance. Thoughts such as these often create tension in our bodies, which limits the ease and coordination of our movements. So, it makes sense that when we are at the top of our game and in the state of flow, our minds are not cluttered with thoughts on how to execute skills. Instead, our minds are fully absorbed in the present experience.

Related Blogs:
Conquer Your Fear of Pain with Movement
Transforming Your Limiting Beliefs
Flow Experiences, the Zone and Optimal Performance 

Uncompromised Athletic Performance

So, in response to my client’s comment, I explained this. If you want to perform at your best, you need to be willing to push yourself to your limits and go all out. This is clearly in contrast with being careful, a synonym for which is “playing safe.” Unfortunately, my client had the idea that because of her hip surgery, she would always need to hold back and should be wary of overtaxing her body. In essence, she thought she was going to have to reduce her challenging athletic life down to moderate activities. She believed that her long and demanding adventures were over.

Since her hip surgery was similar to the one I’d had, I explained to her some things. For example, after I recovered from my pain and surgeries, I competed in two of the most strenuous athletic events I’ve ever done. These events included two multi-day mountain bike stage races: the nine day joberg2c that I talk about in my book, Winning the Injury Game, and the six day Pioneer race in New Zealand. If you want to learn more about this latter race, you can read about that epic in my blog: Determined to Finish: Our Experience of The Pioneer MTB Race.

In other words, the takeaway point here is that you cannot “be careful” during high level competition in which you are putting out your maximum effort. However, having the confidence to get back to the start line and test yourself again does require a conscientious and systematic approach leading up to and following the event. Instead of holding back during the competition, you can “be careful” in your preparation and recovery. 

How to “Be Careful” With Your Preparation and Recovery

Prepare Your Body

Following your injury, you likely did some form of rehab to regain your form and function. Now, just because the pain is gone doesn’t mean you should abandon those exercises. At this point, you can incorporate those movements into your warm-up. This provides you with an opportunity to check in with your body. When you do these warm-ups, you can observe your alignment, muscle function, range of motion, and flexibility.

If you find deficits in any of these areas during the warm-up, your risk of pain or injury with exertion is higher. Thus, consistently checking in will alert you to imbalances in your body early. That way, you can take preventative action. This, in turn, will help you to avoid a more serious injury and set-back to your training.

Before engaging in your workout, take the time to do your corrective exercises. Then you can confidently proceed with your workout. The more often you feel strong in your body, the more sure you will be in your ability to perform.

Have a Backup Plan

However, if, during your warm-up, you find that your body is not in ideal condition, you may need to change your plan for the day. What can you do that will still satisfy your need to be active but that won’t jeopardize your body? For me, it might be switching from a technical, rocky and steep mountain bike ride that would overtax my hip to a flat road ride that doesn’t require explosive power. If you find yourself implementing your backup plan often, though, you might need to reassess your training plan. Perhaps more recovery is needed. 

Progress Gradually

When we are feeling good, we all have a tendency to go too far, too long, and too hard. This can cause our symptoms to flare up. And what often follows a flare up? A crash! Now, we cannot do anything because we have to take time off in order to recover. Unfortunately, we frequently repeat this cycle, which leads to frustration and lack of fitness gains. Instead of overdoing it, here’s a good rule of thumb. Increase your exercise duration by just 10% each week. That will push you just enough to increase your fitness but not so much that you go beyond what’s productive.

Plan for Extra Rest

We grow stronger after exercise only if we allow the body to rest. If you constantly push hard, you will break your body down and possibly heighten your pain. To elaborate, think about this. Movement is stress. It activates the sympathetic nervous system (fight, flight or freeze response). When under sustained stress, our body does not recover. It does not rebuild stronger. Especially after an injury, we must ensure that we are providing our body with the necessary time to adapt to the increased activity.

Monitor Yourself

Just as you checked in with your body prior to your exercise, you also want to notice how your body responded to the workout. So, here are some questions to ask yourself. First, are you noticing anything out of the ordinary? Also, is there an unexplained increase in your level or soreness or fatigue? Next, are you having one-sided soreness? (This is a possible indicator of compensated movement during activity.) Also consider these broader questions. How are you sleeping? Additionally, what is your mental state? How’s your digestion? And, are you feeling irritable? Clearly, the idea is that you want to consider not merely your cardiovascular and musculoskeletal systems, but all of your systems and how they are interacting. In other words, how is your activity affecting you as a whole person?

Develop a Winning Mindset

“Whether you think you can, or you think you can’t – you’re right”
- Henry Ford

In addition to following a conscientious and systematic approach when returning to exercise, as outlined above, the attitude you bring into activity also impacts your experience. Despite following all the strategies above, if you don’t have the right mindset, you could still have pain. That will cause your progress to fail.

Think about this. Do you anticipate that you will have pain with [fill in the blank with a movement]? If so, it shouldn’t be a surprise when you feel it. Through your anticipatory thought, you have unknowingly primed your body and nervous system, including your brain, for pain. Likewise, if you hold the belief that the activity is dangerous and capable of worsening your injury, your brain may create a sensation of pain as a means of protecting you from this threat. Until you change your thinking patterns, competitive sports and some movements will be out of your reach.

I experienced this with cycling during my recovery. I had felt pain so often with cycling that I anticipated that I would hurt when on the bike - and I did! Nevertheless, I was able to run. Running was an activity that I hadn’t been doing prior to my injury. So, why didn’t I feel pain while running? My guess is that it was at least in part due to the fact that I didn’t expect to hurt when I ran. 

One sign that you are ready for more intense exercise is when your mindset is strong and confident. You no longer fear a challenge, but rather are excited by the opportunity it presents. Creating this shift in your outlook takes time. You can achieve it through small, consistent successes. For example, a 5 K run leads to a 10 K run, which then leads to a half-marathon, and then to a marathon. Maybe, it finally even leads to ultra-endurance events. Step by step, you’ll get there. 

If you are patient and trust yourself, you will reach your goals!