Coping Strategies for Acute and Chronic Injuries

I herniated a disc in my lower spine when I was 18 years old. My back has never been the same since. Looking back, it has been one of the most challenging aspects of my life, and yet, possibly one of the most beneficial to me.

Mentally, it matured me through a sudden loss of youth (having the back of an 80-year-old will do that) and has given me a deep humility and sense of appreciation for my health and sense of comfort.

We take comfort for granted. Comfort is the lack of interjecting pain – it's that leisurely feeling of lying on the couch in a state of pure relaxation and dozing off into an afternoon nap.

Comfort is usually only noticed when it is lost. That loss and the disruption to work or other aspects of your life is one of the most challenging things we can face as humans.

Psychology of an injury

In my experience, this is the basic psychology of what happens during an injury. Although listed as discrete, clearly defined stages these usually overlap and multiple feelings can be experienced on the same day.

  1. Anger – Anger at yourself for letting it happen, or someone else for causing it.
  2. Depression – Pain and anxiety about your recovery, loss of habits or hobbies you enjoy, and
  3. Apathy – Feelings that you can't do things with your injury. Usually defined by not optimizing your time which can lead to rumination and feelings of powerlessness.
  4. Acceptance – Engaging with the path forward: "this is a challenge that I'm going to approach with discipline and responsibility."

The trick is to move as quickly as possible from stage one to stage four.

How to deal with an injury or setback

Even after having back pain for years, and feeling a bit like a veteran, it's still challenging to face new setbacks. But like with anything you get better with practice.

Through experience, I've learned a few things that can immediately ameliorate the effect of a new setback or injury. I've broken these into short-term and long-term strategies.

Short-term strategies

  • Immediately find a positive trajectory – After an injury, it's so easy to fall into the trap of rumination, depression, or apathy. Making a positive decision quickly can help you feel like you're on the right path. Identify one thing that will move you incrementally forward and then find another. Call a doctor or a physical therapist, make a to-do list, eat a healthy meal, go to bed early. Just do one thing, no matter how small, to improve your condition.
  • Learn how to think about the past – Don't dwell on what happened or what you could have done differently. I have a saying I like to repeat: "the past is irrevocable". In other words, it cannot be changed and it's pointless to think that way. So only think about the past if there is a specific lesson or purpose to doing so. Don't beat yourself up, or have regrets, or constantly imagine other scenarios that could have occurred. Accept the present moment and make decisions in the here and now.
  • Keep a normal schedule – It's ironic that when you aren't injured it's easier to keep a healthy schedule. Pain can often lead to a self-destructive cycle by making bad habits that you're trying to quit suddenly become easier crutches. Whether that's quitting smoking or drinking less, it's easy to fall into an old habit to temporarily distract from your injury. It's important to do everything you would normally do (assuming they're healthy to begin with). In other words, wake up on time, eat healthily, do your work or hobbies with adjustments if necessary, and go to sleep on time. Don't lie on the couch and get lost in a Netflix binge. Don't get stuck in apathy avoiding the work you need to do. It only makes it worse.
  • Err on the side of caution – At least in the short-term, while you're recovering and potentially fragile: don't do that extra set, don't climb that additional route, don't run that extra mile. This especially applies in moments where you have an intuition that something might be wrong, a "spidey sense" that you're approaching a worsening of your injury. It can often occur on low sleep or at the end of a tiring workout.
  • Pay for expertise – It's tempting to think you can solve all your own problems, but often times paying for expertise, whether that's a doctor, physical therapist, or other health professionals, can dramatically speed up recovery. In the long-term, the time in pain away from work or hobbies you enjoy is easily made up by the cost of the healthcare.

Long-term strategies

  • Focus on the slope, not the amount – Is the slope positive? Are you continuing to improve a little week by week? Good, then you're on the right path. Don't worry so much about where you're at, but rather maintaining an upward climb. The goal is to get to the top of the mountain, and there may be dips and valleys on the way towards that goal, but the overall trajectory should be positive.
  • Accept it as a challenge – You're a unique human being. How are you going to get past this roadblock? Approach this challenge like an Olympic athlete, which, by the way, have often recovered from serious injuries themselves.

The positive side of injuries

Injuries often occur after months or years of bad habits. For example, if you have bad posture and slouch you may well end up with back or neck pain. In this way, injuries can be seen as a trailing indicator of bad habits. Recovering from an injury often involves aligning habits with health, improving your life and the life of people around you.

At some point, everyone will have to face their own mortality, and an injury forces you to acknowledge that. We are human, we are born, we will die, and in between will deteriorate. Just acknowledging that can be humbling and even depressing – but it doesn't have to be.

On the flip side of humility is the pride of overcoming your weaknesses, building discipline, and proving yourself. Accepting an injury is accepting you're not perfect. Accepting you're not perfect (and yet continuing to work to improve yourself) can be freeing, and an opportunity to love yourself. The path back to health can build pride and a deep sense of gratitude for life.