Unfortunately, the injury rate among endurance runners is very high. Many of these injuries are chronic in nature and may require months of rehabilitation, which brings a variety of psychological challenges. Acute injuries can also come as a shock and at inconvenient times. Given ultramarathon runners typically only have a few major races each year, it’s important that a runner is going to be both physically and mentally ready by the time they finally get to their first post-injury race. It’s crucial that we address athletes’ confidence and motivation as they return from injury.
While there haven’t been any studies directly looking at the specific challenges of injured trail and ultramarathon runners, there have been plenty looking at other athletes. An athlete’s initial response to injury can be one of stress and/or grief, and some research suggests that some athletes display a grief response to injury that is very similar to that of losing a loved one.
While acute injuries like an ankle sprain might have a well-defined point of injury, for other chronic overuse injuries like tendinopathies, there might not be a clear initial time of injury. Ideally, we want to catch these injuries early, but in some cases, the athlete will continue to train and compete (and possibly even hide the injuries from you) and require an extended break from running to recover. Regardless of the situation, it can be emotionally difficult. We should be empathetic to their situation and offer social support to increase the athletes’ sense of connection. This may simply involve listening to them vent their frustrations and acknowledging their current emotions. While it is necessary to allow this grieving period, we shouldn’t let athletes ruminate for several weeks either. We want to make sure they swiftly move into the rehabilitation process.
In this initial rehabilitation stage, they might still be able to cross-train. Addressing their basic psychological needs (see the ‘motivation’ section) early will set them up well for the later stages. Competency issues might be addressed by discussing previous successful returns from injuries either by themselves or by other athletes. It’s also a good time to set a variety of mastery-approach goals to map out the athlete’s potential return to competition (refer to the ‘goal setting’ section). You can also set various milestones for their return to running and ultimately their return to racing. Ensure that the goals are coming from the athletes (and not all coming from you), which will help provide a sense of autonomy. Make sure these goals are realistic, as we don’t want to create an overwhelming sense of pressure to return too quickly.You may also want to discuss the possibility of setbacks along the way, so they are open to reviewing their goals (if needed).
If the injury is going to require several weeks or more of cross-training, you may even want to set some cross-training related goals to help motivate that process. If appropriate, they could even potentially compete, e.g., Zwift offers the chance for indoor cycling races. They may also maintain their connection with the sport by volunteering at events, or crewing for friends at races, or simply cross-training with others.
Once your runner is cleared to run again, they’ll be starting off with short, low intensity runs. Make sure you’re checking in regularly with your athlete and ensuring there is no internal or external pressure to run more than they’re ready for. They may be quite fearful of re-injury and overly cautious, in which case you may need to reassure them that they are ready to run again. You can refer to any milestones they’ve met that have demonstrated their readiness to run. In other cases, you may have an overly eager runner and need to rein them back by discussing the importance of taking a long-term view and helping them build a clearer picture of what the process of returning to full training is going to look like. They may want to begin running again with training partners. This will enhance their sense of connection, but you’ve also got to make sure they don’t become frustrated by any fitness they’ve lost (compared to their training partners) and that they continue to train at an appropriate level.
As they keep gradually building up their training load, you should keep checking in with how they’re feeling and referring to any milestones you’ve set for their return to full training. If they’re worried about racing again, it may be appropriate to use shorter races as part of that build-up to help re-expose them to the specific challenges of racing. This could potentially help build both the athlete’s sense of competency and connection by getting them to engage in events with other runners.
Finally, they will be ready for their first major race post-injury. For ultramarathon runners, this will typically be longer than anything they’ve done in training, so there may still be a sense of fearfulness of reinjury. However, if they have successfully cleared all your pre-agreed milestones, then you can use that as evidence for them that they are ready.
Along this whole journey, make sure to keep checking whether they feel that their basic psychological needs are being met, and whether there are any external or internal influences raising concerns or pressure for them. By making sure that their needs are constantly being met and that they are on board with a thought-out return to competition, we can maximise the likelihood of successful rehabilitation and performance.
Key takeaways
1. Injuries pose a major psychological challenge to runners
2. Listen to your athletes’ concerns about injury, but don’t let them ruminate
3. Ensure their basic psychological needs are being met throughout the rehabilitation and return to competition processes
4. Use goal setting and milestones to help motivate their comeback and to provide a sense of competence and confidence