Building the Resilient Athlete: Why are we still getting injured?
We have a serious problem in the running community, and it is not improving.
Fifty percent of all recreational runners and seventy five percent of elite runners are injured yearly. There are even some studies that claim numbers as high as eighty five percent because it is difficult to classify and define what constitutes a running injury. BUT it doesn’t matter if fifty percent or eight five percent of runners are injured. It is too many.
On top of high injury rates, once an athlete is injured, they become twice as likely to be injured again. This cycle continues on and on with no light at the end of the tunnel. In our sport the culture is to ignore pain and push through until we can no longer perform. Then most athletes try to diagnosis themselves online or wait it out until they can run again. When they finally get frustrated enough, they may seek medical care. The USA Running National Running Survey suggests that less than twenty three percent of injured athletes seek medical care when they are injured. Most elite athletes have access to medical care, and they are still getting injured.
What is going on?
The answers is far from easy. I believe we have a complex problem that is deep rooted in societies beliefs about athletes. It is a problem that has been created and amplified by medical practitioners, coaches, fans, and athletes alike. We have a culture of injury.
I have seen thousands of injured and frustrated athletes in my career. They all have the same thing in common. It is never just a physical issue- it always runs deeper. Their injury occurred because of an imbalance in their system. They were unable to handle the physical, emotional, and mental load they were under around the time of their injury whether they realize it or not.
Our physical body is only twenty five percent of who we are as athletes. We absolutely must address that twenty five percent and care for it, but we cannot ignore the other seventy five percent just because we don’t understand it. Nothing in life is black and white and neither is a running injury. So why do we continue to try and make it that way?
Most running injuries occur in conjunction with or directly following a major life event. I started my residency program and hurt my back a few days before the Chicago Marathon. I dislocated my shoulder the week before my wedding. I had my worst marathon ever right before I moved from Boston to Atlanta. If you stop and think for a moment you will probably be able to make similar connections in your life to an injury you have had.
Every athlete’s body has a threshold and once that threshold is breached the athlete will become injured. Your body doesn’t know the difference between the stress from a workout or the stress from life events. It is all the same.
I am not saying that injuries can’t occur from an increased training load, increased intensity, and poor biomechanics. They absolutely can and do. However, we have become better at addressing biomechanics, modifying training loads and intensities. The reason our athletes are still injured is because we are still ignoring everything outside of the physical body AND athletes don’t always trust that their healthcare providers or coaches know what’s best for them.
Why else would they avoid medical practitioners, wait out injuries, and not take the advice given to them by their coaches?
It’s not going to be easy, but we need to change the culture and fast.
We need to…
allow our athletes the room to be both athletes and human
rebuild trust between the medical community and the athletes
rebuild trust between coaches and athletes
medical partitioners, coaches and athletes need to work together as a cohesive team - no egos allowed
listen to our athletes because they live in their body every day, we don't
address mental, emotional, and spiritual health
prioritize recovery and rest
educate athletes from a young age that they are more than their body or sport
We have a lot to do.
To change the course of running injuries we must begin to also change the definition of what a healthy athlete is. This means we must do a better job of tracking biometrics like HRV, heart rate, sleep, physical fatigue, mental and emotional fatigue. THEN we must implement strategies based off this data to create a healthier athlete.
None of this will not be easy.
There will be a lot of resistance.
There will also be a lot of payoffs for those who decide to embrace a new culture around athletes and runners. Let's get out of our own way and start changing the face of sports.
Desai P, Jungmalm J, Börjesson M, Karlsson J, Grau S. Recreational Runners With a History of Injury Are Twice as Likely to Sustain a Running-Related Injury as Runners With No History of Injury: A 1-Year Prospective Cohort Study. J Orthop Sports Phys Ther. 2021 Mar;51(3):144-150. doi: 10.2519/jospt.2021.9673. Epub 2020 Dec 25. PMID: 33356768.
van der Worp MP, ten Haaf DS, van Cingel R, de Wijer A, Nijhuis-van der Sanden MW, Staal JB. Injuries in runners; a systematic review on risk factors and sex differences. PLoS One. 2015 Feb 23;10(2):e0114937. doi: 10.1371/journal.pone.0114937. PMID: 25706955; PMCID: PMC4338213.
Teixeira RN, Lunardi A, da Silva RA, Lopes AD, Carvalho CR. PREVALENCE OF MUSCULOSKELETAL PAIN IN MARATHON RUNNERS WHO COMPETE AT THE ELITE LEVEL. Int J Sports Phys Ther. 2016;11(1):126-131.