Recovering From an Injury? Don’t Forget to Rehab Your Mind – About Your Online Magazine


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Long before I rip my ACL, dropping an unexpected star Ski racing– before finding out that really appreciated down steep slopes – I used to joke that skiing was just an expensive way to get hurt. The thought of twisting a knee I put enough fear in me to stay cautious down the hill – until the worst happened.

In fact, breaking the ligament turned out to be the least painful part. The mental anguish of standing up during my first hiking season living in Boulder, Colorado made it difficult for me to follow post-surgery rehabilitation. Instead of leaning into painful exercises that I knew would benefit me, I gave up.

We often don’t talk about the mental impacts of physical injuries. But they are often just as – if not more – serious than physical damage, says Sarah Ellefson, a physical therapist who has Altuis Physiotherapy and Wellness in Avon, Colorado.

“I think this mental piece is perhaps one of the most important components of the recovery process, and it needs to be considered in a person’s plan from the beginning,” she says. Often, Ellefson sees patients discouraged when they compare their own progress with the average mobility recovery times. “It is important to recognize that each person has their own unique set of physical and mental circumstances. Post-operative protocols should be used as a kind of trail map for the recovery process, but each person will need to deviate from that trail from time to time, ”she says.

I am guilty of this damaging comparison. Before the surgery, I was proud to see that I gained more strength and mobility than was expected from me based on these average results, so my confidence suffered a big blow when, after surgery, I needed to count on my then boyfriend for almost all small chores around the house. I desperately wanted to be one of those people who let go of crutches in a few days, but I wasn’t. Instead of using them for extra stability to walk a few blocks from home, I simply stopped walking unless absolutely necessary.

During many weeks of my recovery process, my only rehabilitation came from my actual physiotherapy consultations – I did few or none of the exercises required in between. I was embarrassed to climb the stairs in my office slowly, making sure to climb with my left leg – the wound – before going up the right to find it. I skipped all the little opportunities to make progress that could have helped me get back to walking much faster.

Over time, the pain in the knee decreased and it became easier to walk greater distances, little by little. I got tired of being very cautious and anxious to fall again, grabbed a pair of trekking poles and started pushing myself out again to regain my strength on shorter hikes. At the end of the summer, about four months after surgery, I was able to tackle a 16-mile backpacking trip at night with minimal lift gain (and lots of rest stops).

Now, almost five years after the surgery, I finally have my knees back. They are not as agile as before – I swear I hear them squeaking sometimes – but I no longer ask if my legs can take a walk. It took years to fully understand the mental impact of that injury and even to recognize that it was always a problem. So, I asked Ellefson what advice she would give to other people struggling with the same tiredness of recovery. Here are your top suggestions.

  1. Choose the right team. If you have the ability to be demanding when choosing a surgeon and a physiotherapist, Ellefson strongly recommends you do so. In her early days as a physical therapist, she worked in an office that treated several patients in the same large room and saw patients comparing themselves to others recovering from the same injuries. Now, she treats only one person in her studio at a time, so no one is tempted to see how they are doing. If you live in an outdoor area, you are likely to meet some people in your community who have recovered from injuries and undergone PT. Seek recommendations and don’t be afraid to ask your potential surgeon or PT about their approach to mental health and how they will keep you motivated.
  2. Ask what each exercise is for. If you understand why you are doing exercises that may seem totally meaningless, you are more likely to work on them even when they are difficult or painful, says Ellefson. That’s why she says she always tries to contextualize for patients why she makes them, say, stand on one foot on a soft foam mat and turn their heads. “There is no reason to go hiking if you are not able to look around and see everything around you,” she says. “So, the purpose of this [balancing] exercise is to take you to a place where you can safely, and with good alignment, balance on one leg momentarily while looking around. “
  3. Be kind to yourself. “You need to show grace and respect to your body,” says Ellefson. “There is a practice of gratitude that comes with that, in being grateful for what your body can I do and feel encouraged by the fact that your body has the ability to heal. ”She knows that it is much easier to speak than to do, she says, but if it is any consolation, sometimes she also needs these reminders.
  4. Consult a sports psychologist if you need to. “There are days when patients arrive and I know they are exhausted, mentally and physically. Sometimes, we hardly do any physical work and I just listen, ”says Ellefson. “I think this is just as healing and necessary as anything else.” If you think you need more mental health support, you can seek out a sports psychologist who can help you work through the mental aspects of rehabilitation and any anxiety you may feel when you get back on the trail.
  5. It is never too late to return to PT. Even though it has been years since your injury, you can always go back to physical therapy if you want to regain strength or confidence, says Ellefson. “You can start from scratch,” she says, “and say, ‘This is what I want to be able to do. This is where I feel apprehensive. Can we work together to set realistic expectations and goals? ‘”