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Pandemic Injuries: Accepting the Scribbles During Recovery

The current pandemic has presented great uncertainty about health, education, and future goals combined with a lack of predictability about the pace of recovery to more usual activities, including sports.

In times of uncertainty, which I often see with patients who have serious injuries or illnesses, I start with acknowledging that in the ideal situation, we would always package recovery in a positive and predictable direction. Draw up a straight line that points consistently upward and everyone seems to be more comfortable and confident moving forward.

The reality of recovery is often far, far different. 

If you were to graph most recoveries, instead of being a that clean, straight toward the desired goal, there is often a jumbled scribble moving forward and backward, up and down before eventually hitting some target. Another good visual is trying to organize holiday lights. It takes more time than expected to move things around, go backward to go forward, untangle loops, and eventually everything lines up as initially desired. The tangle or scribble accounts for unexpected events, new challenges, and things that just take longer or need extra effort. The initial challenge presents a certain level of stress, and those setbacks only add to heightened emotional distress. 

As we look toward a new year with great anticipation, what are some ways to best handle the tangles and scribbles of the pandemic recovery process?

  • Start with acknowledging the scribbles. Accept that setbacks and changes to the plan will occur. Mistakes are going to happen.

  • You may not feel in control of any part of the process and may not even agree with those making the decisions that are contributing to the scribbles. This may leave you feeling that the only certainties are change and uncertainty. In this situation, realize that on occasion, going backward might initially be undesired, but ultimately may be needed to lead to future progress. Don’t always fear that with new knowledge may come changes. Some of these changes may actually be favorable. 

  • To best help untangle things and take some charge in times of uncertainty, I recommend the scheduling of regular times for mindfulness (and yes, exercise can be a part – we’ll cover that more below) including devotions, prayers, focused breathing, journaling, and times for reflection. Put these activities in your schedule and stay dialed in with them.

  • Find something new – a new craft, baking skill, or instrument? Channel portions of your frustration and uncertainty into something where you can have some sense of control and see results of your efforts.

  • Don’t be afraid to have open and regular discussions about emotional health with trusted friends and family members. Share struggles about feelings of anxiety or depression. I guarantee that others are experiencing the same challenges. Don’t try to go at it all by yourself. Find partners to keep everyone accountable and offer mutual support.

  • Seek immediate emergency medical care if you are feeling high levels of despair or irritability that include thoughts of self-harm or harming others. Do not hesitate to contact your regular medical provider for assistance with emotional health issues.

Now, let’s turn back to the role of exercise in recovery.

[RELATED CONTENT]: Staying healthy when returning to sports after a longer break

With the pandemic we are all encountering some unique physical and emotional stress injuries.

There is abundant evidence that regular physical activity can reduce anxiety, depression, and other mood disorder symptoms. However, not being able to exercise the way you want, or when/when you want, can actually add more tangles and scribbles that increase instead of decreasing emotional stressors.  

Those lack of opportunities have led not just to increased signs of depression and anxiety, but also contributed to some unique physical stress injuries.

Let’s call it the stuck in time phenomena. Many sports groups are stuck in the 2020 rut of having lost almost all sense of a normal calendar. With some exceptions, the usual turnover of seasons, competitions and performances has been placed on perma-hold. Gyms and indoor venues are able to open, then close again- and there is no crystal ball here to predict when things will change.

Being stuck in time means doing the same thing over and over again for months. Without end of year showcases for dancers, there are only on-going technique and choreography courses. Cross country runners who haven’t tapered for end of season championship meets are still putting in 40-50 mile weeks usually seen only in summer times. Multi-sport athletes don’t have the fresh and different transition from Fall to Winter seasons.

Doing the same things over and over without change can lead to bone and soft tissue (muscle and tendon mainly) overload injuries. There is a concept called periodization where changing the type, amount, and intensity of exercise over cycles of weeks to months can reduce injuries and increase performance.

Since the calendar (or lack of scheduled events) is not doing any favors with periodization, I’ve asked athletes and coaches to once again acknowledge the scribbles and be receptive to making changes and being flexible:

  • Throw in some non-traditional activities (tag with some physically distanced modifications is always is a favorite).

  • With more inactivity due to online learning (versus walking around campus, up and down stairs, etc.) do some short-burst activities between class session. Yes, that mean you can walk up/down your own stairs, do a short walk, or do sets of push-ups, sit-ups, and lunges.

  • Add in some fun skill or outcome-based competitions between group members, even on video if necessary, to add some variety.

  • Consider some new non-training activities, maybe a service project or outreach effort, to assist with team building.

  • Work on learning new skills.

  • Add in an injury prevention program (great holiday gift that can pay dividends for years to come).

  • And most importantly, don’t be afraid to take some breaks.

Okay, I get it. After months of being limited to on-line and individual exercise programs, no one wants to take more time off after those long breaks. I can understand the desire to keep “catching up” for that lost time and being best prepared for when events may resume. 

I also do realize that overloaded athletes may not be best prepared for competition and stress injuries will definitely require breaks from future training and competition. Even short breaks (3-4 days) will pay off huge in both physical and emotional health.

In these times of uncertainty, make changes in areas that you can control. And remember to be flexible and creative in drawing your own scribbles as much as possible.