Identifying Injuries

(photo credit: Visionari Studio, Alexandria, MN)

You know how it goes. You are running along, enjoying the scenery, a conversation with a friend, or a good song, when a little ache forms somewhere in your calf muscle, gluteus maximus or hip flexer. Just a little ache, one to remind you your brain is attached to appendages that are doing the work of carrying you on mile after mile. The salutation of this uncomfortable ache isn’t enough to send you to the physical therapist (PT) but is enough to take a mental note of post-run. And you carry-on with “normal” life.

Then you wake up the next morning, no aches or pains. Yippee! Yesterday’s nuisance was just a fluke. But then. . . a few more times over the course of the next few weeks the ache becomes a pain and at some point every run is hard and your mind knows your body isn’t keeping up with the repair process. You realize you are on the brink of an injury or have already stepped over to the dark-side, and are on the verge of hearing the words--you need to take some time off and heal.

To many avid runners, the “take time off” prescription may as well be a four-letter word, kick-punched smack to the heart. Partly because time off messes with our heads, but also because most of us know better. We know that we should be proactive against injury with stretching and strength training. And that we shouldn’t ignore our little aches and pains. We know that we should seek counsel or therapy when the pain starts, not six weeks later. We know that even a minor ache  can cause more injuries because we compensate our form to avoid the ache we are trying so badly to ignore. We know the warning signs. But sometimes we are either too stubborn or too full of wishful thinking (It’ll just go away on its own, right?) to honor the signs and take action.

If neither of these are the reasons you choose to avoid getting help when an injury sets in, perhaps an unidentified injury experience from the past is the culprit. Perhaps you have experienced a time when seeing a physician didn't lead to answers-- the identification of injury alluded even the MRI machine. This just might be one of the most discouraging places an athlete can find herself: injured with an unidentified diagnoses. ​

The result, an unclear or guesswork kind of plan to recovery.  Many a runner has been sidelined for months, years or a lifetime by such experiences. Others find their way back on the course after working through the set-back with a different kind of perseverance than what is required on the racecourse--persevering to understand the injury, persevering in physical therapy or strength training rehab, and persevering in believing that one day she will be back on the road if she can follow the path toward healingslowly, earnestly and mindfully.

So, what makes the difference between a comeback versus hanging up the running shoes in the entryway closet? Elena Sonnino, a contributor at U.S News, Wellness/Eat + Run, says, “The roadmap to recovering from an injury starts first and foremost with identification.” In other words, the first step is finding your way back on course is identifying what is hurting. That sounds so simple, right?

And yet, how often have you found yourself sitting in a physician's office explaining your problem with a level of vagueness that is so embarrassing you nearly stand up and walk out the door? Certain there is no way the she will be able to help because you can’t even get the proper words out to describe what's going on. 

Me too. This is likely what I sound like, “This hurts right here when I sort of like, run this way, but then not when I do this. And I think it hurts the most in the morning. Or maybe after speed work. But then I think this other area over here is strained. Ya’ know what I mean, right, doc?”

Fifteen minutes later, the physician spews out vocabulary that I know is English, but the words don’t compute. In fact, I am sure I could only spell the conjunctions and pronouns she is using. Nonetheless, the process toward healing can begin because the injury has been identified by someone with the necessary vocabulary and knowledge. Next I set my healing journey's path in the trust of the one who is identifying the injuring and providing the treatment plan based on that identification.

The crucial next step in the process is all on me, the injured one. It is on me to trust that the identified injury is accurate and take the rehab plan seriously by putting it to action. I can know the fancy vocabulary to describe my injury, and understand how the muscles and tendons and bones need this and that to heal, but the actual healing can only come when I take action and work daily on the physical therapy, strength training or stretching regime designed for me based on my identified injury. I can keep reading about my injury. I can buy new shoes. I can set goals for what I will accomplish when I am back to strong. But none of these actually help me get back on course unless I put what I know to work based on the type of injury I am aiming to overcome. 

So too with the injuries of heart, soul, and mind we experience through living daily in a chaotic world full of relational, emotional and spiritual fractures and sprains. I think it is safe to say we are all walking around with some injuries that have been left unidentified. Or injuries that have been identified but have remained gaping wounds because the work toward healing is a prescription we have avoided committing to.

​Just like in running, injuries can creep up on one's mind, heart or soul. These can start with a snarky remark from someone we love, and nag at us for a while. We can think that that little bit of bitterness, fear or unforgiveness isn’t really harming our progress toward our goals, because it is just a little ache. It doesn’t stop us from running. It doesn’t even hurt every day. Yet, like an ignored ache in a runner’s heel can lead to plantar fasciitis, the aches and pains of our souls, minds and heart can bring us to more severe injuries over time.

Physical injuries are obvious, and sometimes even those aren’t quickly addressed in our lives. Injuries of the heart, mind and soul are not obvious, making them even harder to identify. Thus, resulting in a lot of aches and pains becoming debilitating or festering deep inside. Emotions, behaviors, habits, thought-patterns and beliefs can be just as injured and broken as the bones that hold our skeleton together and allow us to live healthy and productive physical lives.  With proper identification, all of these unseen injuries can be redeemed, and restored to wholeness, just as most physical injuries can be nursed back to strength. 

The roadmap to recovering from injuries of the soul, mind and heart begins in the same place as the one for physical healing--identifying the injury. But if we find we can’t even explain our physical injuries in intelligible or specific words, how in the world are we able to identify these injuries that lie below the physical and outside of the typical assessment of health? How do we identify hurts we can’t see? ​

I believe it begins with self-assessment and reflection. By this I mean, having the discipline to check-in with your emotions, behaviors, motives and beliefs on a regular basis. When was the last time you sat down with yourself (or another person) and reflected on these kinds of questions:

• How am I doing emotionally? Can I name the emotions I feel each day?
• ​What behaviors and habits make up the days of my life?
• Do I like what I see myself doing and hear myself saying?
• Why do I do the things I do?
• What do I believe about this life or what comes next? How do these beliefs impact the decisions I make?
• What hurts am I feeling about myself, my relationships, or the world around me? What am I doing with what hurts?

Your answers to these questions can be an indication of the “health” level of your heart, soul and mind. In addition, answering these questions may lead you toward identifying an injury that needs some treatment. The identification of an injury may not come right away, but building into your life this kind of reflective practice will likely get you there sooner than later. Sometimes a runner needs to see a physician more than once, or even multiple physicians, before a proper identification of injury is found. Trust and perseverance are required in this process in a runner’s injury experiences, as well as in the process of identifying and understanding the pains that hinder the heart, soul and mind. ​

One more reason the identification of non-physical injuries is a challenge is that we Americans just don’t like to talk about or express our feelings. Really. I will prove this to you in one simple exercise.

Stop reading. Take out a paper and pen. Write a list of the words you have been taught to describe your feelings. Write a list of word you typically use to describe how you are doing when someone asks, "How are you, today?"

​How many did you come up with? Ten to twenty, maybe?

Did you know there are more than 200 words we can use to describe our feelings? Yet, on average we use less than ten percent of them in typical conversations with each other. A huge indication we are not in the habit of identifying our feelings accurately or precisely. My research and reading on this topic has left me wondering if very many of us even know what we are feeling in either the peaceful or painful experiences of our lives. And if we can't identify, how do we move toward understanding our aches and pains, or recovering from injury? 

The Center for Non-Violent Communication, has compiled a two page list of feeling words that can be used (and taught to your kids), in order to better understand yourself, and explain yourself to others. The Feeling Inventory is divided into two categories: 1) Feelings when your needs are satisfied and 2) Feelings when your needs are not satisfied. (Click on images below to see the lists, from Non-Violent Communication, by Marshall B. Rosenberg PhD.)

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Isn’t that brilliantly simple! Because if we think about the injuries we experience in heart, soul, and mind, don’t most of them relate to times when our needs weren’t met?  Times when we needed something emotionally, spiritually or mentally and an injury occurred because the need was left unmet (or at least from our perception it was left unmet). These experiences may be the hardest to process and identify. Taking the time to extend our vocabulary in this area might be one of the best ways to begin to understanding what is going on inside our minds and hearts.

How do we move forward in the process of identifying injuries (or unmet needs) in our lives?

One place to begin is with analyzing and understanding our behaviors. Our actions and behaviors are kind of like our running form. How do you know a runner is nursing an injury? Look at her stride or her face. Your negative self-talk or less than desirable reactions can help you identify your injuries because they reveal how you are running--full of strength and without a limp, or leaning to one-side with a grimace on your face. ​

​When a runner changes her form to compensate for injury, another part of her body begins to become warn-down from improper use. So too with injuries of the heart. We may try to cover them up and ignore them, putting forth extra effort in another area of life, but deep down experiencing a wound that is waiting to be identified and treated. The identifying of what’s hurt may likely come from understanding more clearly the met and unmet needs of your life, along with the corresponding feelings for both kinds experiences: Often exhibited in how we behave, react or speak.

​One powerful piece of information that helped me in navigating the injuries of my heart, soul and mind (as exhibited by behaviors and actions coming from my body that were as foreign to me as the customs of the Incas) was this: all emotions, and thus following actions, are born out of either love or fear. The end. All of them. One or the other. 

Heather T. Forbes and B. Bryan Post, in their book, Beyond Consequences, Logic, and Control: A Love-Based Approach to Helping Attachment-Challenged Children With Severe Behaviors, explain, based on brain research (which happens to also align with Scripture) and their experiences in children and family therapy, that in all situations, there are only two primary emotions: love and fear. Thus, we are constantly either making decisions and choices based on feelings of love or based on feelings fear--out of health or injury. 

“If you look underneath your depression, you’ll find anger. Look under your anger, and you’ll find sadness. And under sadness is the root of it all, what’s really masquerading all the while -- fear.” ~Candace Pert, Molecules of Emotions

When experiencing and living out of love, we are confident, secure, able to understand, grow and make decisions based on our values and beliefs with our upper level thinking brain. In fear, we are thrust into fight, flight or freeze, our lower-level thinking brain. In any of these fear modes, access to our higher-level thinking is shut-off and we make decisions based on habits we have learned from past experiences. Habits most often built out of simply surviving or self-protection. ​

Fear: fear is an internal stress reaction to a perceived threat that lies internal to the body-mind or external to the body mind.    ~Forbes & Post, Beyond Consequences, Logic, and Control: . . .

 Love:  Love is being present. Love is not possessive or controlling. Any two people are capable of experiencing love at any given moment if they are able to put aside their fears and preconceived notions for what love is supposed to be. Love is full presence in the moment.  ~Forbes & Post, Beyond Consequences, Logic, and Control: . . .

​This knowledge was a moment of identification for me because it helped me to see some symptoms of fear and lack of love in my life. I am not a worrier. So, I don’t easily identify with being fearful. (Or so I thought.) And yet, when I started looking at my frustrations, anger and other negative thoughts and words in this light, an aha moment arrived! I could see clearly I was acting out of unidentified fear. Both through the above resources and a couple sessions with a counselor, I was able to identify injuries:  1) fear that some [hard] things will never change  and 2) an unmet need for order and predictability (aka fear of loss of control). My words and actions revealed the symptoms, and also became the measure by which I could determine progress toward healing.

To be honest, I am still in search of the rooting of my injury. I am still trying to excavate the initial ache in the my mind and soul that has led me to fear in these areas but I trust that in time that will come. For now, I have been given the gift of the identification of the injury, and the makings of a map to guide me toward wholeness. And that is enough to begin the process of restoration--slowly, earnestly, mindfully.

For now we see in a mirror dimly, but then face to face. Now I know in part; then I shall know fully, even as I have been fully known.  ~1 Corinthians 13:12 (ESV)

​As a parent, there are times I give my kids the amount of information they need to understand, but not the whole story. Not because I am holding out on them. But because I know they aren’t developmentally ready for the big picture of some things. God does the same for me, in time, he reveals what I need to know for the level of development at which I am operating out of in my faith, trust, hope and theology. And his grace leads me down the path that is timed just right for my processing-speed. He wants me in the race just as much as I want to be in it. That truth alone helps me to look up and keep pressing on.

Injuries to our physical body, our heart, our soul or our mind hurt. No doubt about it. Hurt in this world is unavoidable. Seriously, it is and it isn’t healthy to believe otherwise. However, there is a God who is willing and able to provide a map to redemption and restoration in all the areas of injury we experience. But here is the thing about a map, it isn’t a guide until a beginning point and a destination are identified. Where you are right now, and where you are going from here rest on taking the time to identify both point A and point B.

A runner knows her course because a race director draws it out before the event begins. A runner knows how to show up ready to run strong when she follows a training plan a coach or online-training app provides for her. A runner knows if she shows up at the start line injured, she will likely limp her way to the finish line. But she also knows that if she can identify her injury prior to the race, and then work on a plan toward recovery, (maybe even missing a race or two in the process), when she returns she will run with a fierceness she may not have run with prior to persevering through an injury.

Identifying injuries is often time consuming. The plan to work toward healing takes effort and most often more pain. But getting back on the course with an effective and powerful stride is worth the it all.  When you are built to run, sitting on the sidelines won’t do. And we were all built to run toward eternity with faith, hope, love and trust as our sources of strength. ​God has our race marked out. He has given us a training plan. And he is also the great-physician who nurses us back to strength when injuries attempt to pull us down or knock us out. ​

​What injury is holding you back from living to your fullest capacity? What healing do you need? Redemption and restoration are provided by the immeasurable love and grace of a God who sees you. He is waiting and ready to help you identify an injury and also provide for you the strength needed to commit to and complete a rehab plan that will get you healed and running again. He wants to see you running your race of faith with power and strength, even more than you do. Lean into His voice and believe in His plans.

The finish line is coming either way. Today is the day to choose to live like you believe you were born for such a time as this.  The key to staying in the race isn't ignoring or avoiding injury. Instead, it is working to identify the hurts that inventible come our way. (Preferably while they are still aches and not sever injuries.) And then submitting to a treatment plan that helps you to slowly, earnestly and mindfully return to the race marked out for you. 

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Photo credit: Visionari Studio, Alexandria MN

This is one post in a series of posts written to encourage those of you who already run, and inspire those of you who are thinking about picking it up. But even if running is nowhere in your past, present or future, I pray something about the message or the reflection questions will relate to your life. I would love it if we could use this space as a place to have a conversation about the questions posted at the bottom. So, please lend me your thoughts in the comment section below. It will spur me on, I just know it. ​