A long-term injury is the blight of athletes the world over. It can cause undue amounts of pain and frustration, and if it lasts long enough, it will affect physical fitness and mental health. Some injuries are simple to diagnose while others remain a conundrum leading to months or years of searching for answers.
I spoke to Gina Pongetti Angeletti, a physical therapist who has worked on elite and amateur athletes and who is the co-owner and sports medicine program director at Achieve Orthopedic Rehabilitation Institute in Chicago. She told me that long-term injuries often occur because athletes wait to seek medical help until their injuries have progressed to “a more complicated treatment protocol, as well as after compensations have already taken place.” When this occurs, she says, the athlete has to address both the original injury as well as the new movement patterns he or she has adopted as a result. This makes recovery a longer, more complicated process.
That’s not the only thing athletes do wrong when they get hurt, though. Here are five other reasons that your long-term injury may be sticking around:
1. Your diagnosis was wrong.
It is imperative to get a proper diagnosis. This step cannot be ignored and can take a very long time. Don’t give up on this step, even if it means seeing or talking to multiple doctors and educating yourself by reading articles from trusted sources. (Message boards are generally not the place to get medical advice.)
Medicine is not an exact science. Gina explained that a proper evaluation is a critical first step and is often followed up by ordering appropriate imaging, like X-rays or MRIs. However—and I have experienced this firsthand—sometimes the imaging is not read correctly. If you are not receiving the care you need, Gina suggests obtaining a second opinion: “Sending for a second opinion must involve a practitioner who takes the time to complete a full medical history, which often is the culprit for a missed diagnosis, even more so than actual objective evidence.”
In addition, you have to be your own advocate. Don’t take no for an answer. Most athletes are shy about pestering their health care professionals. Don’t be shy. Take action. I know from personal experience, after dealing with a long-term injury to my rib cage from a bike accident, that nobody cares more about your health than you. Over the years, I have been a nuisance to multiple doctors—but without doing so, I would not have received the necessary medical interventions.
2. You’re impatient.
Once you know what you are dealing with, make an action plan. Determine how long recovery should take. Gina succinctly stated, “It may take as long to fix [the injury] as it took to create.” Long-term injuries need long-term recovery, and skipping this step will ensure that the injury will not resolve.
Trusting your rehab team will increase the likelihood of being patient, said Gina. In addition, creating a rehab plan with your team that makes sense, is aligned with your personality, and will allow for some type of activity will help alleviate the inevitable feelings of impatience.
3. You’re not following your recovery plan
Long-term injuries need long-term rehab. Ignoring the rehab part of the recovery process will ensure that the injury will linger or a compensatory injury will crop up. It is simple to stick to a rehab plan for a few days or to go into physical therapy for hands-on work coupled with exercises under the guidance of a therapist. But a true rehab plan calls for a healthy dose of home exercises that should be executed daily for many months and even after the injury has resolved to ensure that it does not return.
One of the hardest parts of rehab is pain. The paradox is that the injury itself can cause pain, and the rehab can often cause pain. Gina explained, “A big misconception in the care of injuries is that it will be pain-free.” Pain-free may be the ultimate goal, but it comes at the expense of intermediate bouts of pain. When it comes to the management of injuries, Gina clarified that pain pills and anti-inflammatories mask symptoms, which can actually be a detriment when rehabbing an injury. She also said that an expectation of pain during the rehab process will enable an athlete to better tolerate the pain, so clarify with your practitioner what to anticipate in terms of pain.
4. Your mind isn’t in it
A positive attitude goes a long way in recovery. Believing in yourself, even when others do not believe in you is probably the most pivotal step in the process. If you know you will get better, eventually, you will. Don’t ever give up. It is easy to become disheartened and imagine that the injury will never get better. Indeed, if your injury has been lingering longer than anticipated, it could be that the diagnosis is wrong (see point 1 above). Your team of providers, should, at the very least, help boost your morale. Gina sees herself as not only a physical therapist but also a motivator and cheerleader with an empathetic heart, all of which she uses as part of her recovery tactics.
5. You jumped back in too soon.
One of the biggest problems with an injury is the inability to get the endorphins we love so much. But rather than going back to doing what injured you in the first place, try to find other ways to get that fix—at least for a while. I despise walking, but I make it a huge part of my daily activities when I cannot run. Indeed, many injuries do not require total rest; it is a matter of determining the movement patterns that exacerbate the injury.
Work with your therapist to define what Gina calls “limitations based on pain, and limitations due to mechanics and stress.” Sometimes a seemingly innocuous activity may still be causing problems. Gina recommends that your therapist gives you guidelines for modified training that will not “drag out the recovery process into longer rehab, or a span multiple years/seasons.”
Align yourself with a capable team that you trust, create an action plan that makes sense, and do not let yourself wallow in self-pity. Most importantly, work hard to get back out there!