#729 Logical vs. Psychological barrier to healing running injuries - DOC

#729 Logical vs. Psychological barrier to healing running injuries

What’s the difference between logical versus psychological barriers to healing injuries in runners? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



One of the things I have put together recently is the runners mindset reset and this is just a short course on how you can use the science of neuroplasticity to help you reprogram your brain when you’re injured and you’re having a hard time regaining your running fitness. There are a lot of different things that go into it.

This episode is not really about that, other than I just had a discussion with a guy who’s a really interesting patient, he was a pro triathlete, and he was having a lot of difficulty in terms of getting past particular injury. And we were talking about all of the ways that you can have barriers to actually healing.

I was talking about two different things, logical and psychological barriers. The first thing is that the logical barriers to healing are really simple to understand based on just simple physiology. You have too much tissue stress, like let’s say you have a metatarsal stress fracture, and you walk on it and run it, you’re bending the bone, you’re loading the bone, you’re stressing the bone, you’re straining the bone and you’re preventing the fracture from healing. Well, that makes sense.

If you have an Achilles tendon that has a partial tear in it and you’re doing box jumps and running up and down stairs and it’s actually pulling the tendon and creating a gap in the tendon where it’s actually been injured or partially torn, that’s a logical problem, this is tissue stress.

Psychological problems that are barriers to healing are actually real, even though they’re a little harder to understand. For example, “worry” is not really helpful to you. If you worry and you stress and you are afraid to actually progress and you’re afraid to do stretches because you’re thinking you might load it too much or you’re afraid to actually start exercising because you think it’s too early based on where you are in that part of the recovery. That’s reasonable.

But once you pass that point, for example, if your bone is healed enough that we can see on an X-ray that it’s stable enough that there’s no way you can really harm it with starting to return to running, well, then if you’re just worrying about that this is a problem and it’s a problem for two reasons.

Number one, you’re not taking action when you should and you’re losing fitness unnecessarily. Number two, the worry, the stress, the mental anguish, the things that go on that I think are psychological contributors to this, well, they actually have a physiological effect on you. This causes pathologic changes in your biochemistry, meaning that if we actually draw some blood, we can see a rise in your cortisol levels and stress hormones. We know that cortisol and stress hormones are counteractive to wound healing.

It doesn’t matter if you have a skin incision, or you’ve had a tear on your Achilles tendon or a plantar plate sprain or a metatarsal stress fracture. If you have high levels of stress hormones because you’re not exercising and because you’re worrying, well, then that can actually cause pathologic changes in your body chemistry, including maybe even additional swelling, that’s not really necessary, and it makes it feel even worse.

So, you have to really think about what’s going on if you have a running injury, and you think you’re doing right stuff, but you find you’re just not able to make any progress. So, if you hit a plateau, and you’re not getting anywhere, you need to think about whether or not you might actually have some built-in psychological mechanisms that are kind of protecting you and kind of serving you trying to keep you safe, but they’re actually unnecessarily preventing you from making real progress.

If you want to learn more about that you can check out the runners mindset reset. You can get it at www.docontherun.com/mindsetreset, all one word.

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