A Silent Struggle

While physical injuries are often viewed as temporary setbacks, their impact can extend far beyond the realm of physical discomfort. Long-term physical injuries have the potential to unleash a complex array of adverse mental health effects that often go unnoticed and underappreciated. This article sheds light on the profound psychological toll that prolonged physical injuries can inflict on individuals, emphasising the need for comprehensive care that addresses both the body and the mind.

The Complex Relationship Between Physical and Mental Health

Physical health and mental health are deeply interconnected. Research has shown that individuals who suffer from long-term physical injuries are more likely to experience mental health challenges. The pain, disability, and restrictions that accompany these injuries can lead to emotional distress, anxiety, and depression. Furthermore, the process of recovery itself can be mentally demanding, as it requires patience and resilience in the face of adversity.

For the past 50 weeks I have been injured - and it hurts. It hurts my body, it hurts my head and it hurts my family and my lifestyle. Like most trail runners I am normally very fit and able. In September 2022 I landed hard from a ski jump and damaged my right shoulder. No big deal, I’ll bounce back… A year later I have not bounced back, and it hurts.

As adventurers our nature is to battle on, no matter what. When we are unable to do this it can deeply affect our sense of self. Most people won't admit it but being a runner, an ultramarathoner, a trail runner is cool. You do cool things in cool places with cool people. You enter cool races and live a cool lifestyle that others envy. Being broken is uncool.

One of the hardest things for me was that when I was broken I was fine, now that I am fixed I’m broken. During the months between my injury and my surgery I was medicated to the point of being entirely pain free - I was back at work and life was relatively normal - I ran the 73km Ring of Fire ultra-marathon during this time.

Since the surgery I have been laid up, sore and frustrated with how slow the recovery process has been. And it hurts - it hurts all the time, and I’m sick of it.

Social Isolation and Loneliness

Long-term physical injuries can also lead to social isolation and loneliness. As individuals experience limitations in their mobility and participation in social gatherings, they may withdraw from social interactions, leading to a lack of emotional support and understanding. Prolonged isolation can further exacerbate mental health conditions, amplifying feelings of depression and anxiety.

Blokes aren’t known for sharing their problems or talking things out - but simply being in a social setting with friends and colleagues and getting out and doing physical activity has a decompressing effect and is an important aspect of recovery.

Family life can be hard at the best of times. Being around more is great, being around more and unable to do anything sucks. It is frustrating for me and for my wife. It is difficult for my kids that want to bounce on the trampoline with me or play hide and seek. It is hard when the lawns get long or the window latch breaks and you cant do anything about it. It can be very hard when we are the problem that needs solving, and someone we love has to do that solving! You can feel powerless and useless. Going from the person that always has the solution to a burden is a hard fall for someone with an athlete's personality.

In the olden days many people belonged to a club or even multiple clubs - we still have groups of like minded people that gather together, but they tend to be virtual clubs (meet Up, Facebook or someone’s database). And for the past 4 months I have disappeared from those clubs and no one has noticed. I’m not pretending I’m important or special in any way but I have missed every race in the Xterra series after 14 years of running on behalf of Buff and the event organisers. I have missed every Thursday night trail session (I know I didn’t get to that many!) and I have not been at any events - but our virtual clubs didn’t notice. No one rang, or text or emailed to check in. Both Logan and Buffman just stopped and anyone out there that wondered where I was never did more than wonder. We need to care for one another - we need to support one another - we need to build real relationships when our virtual clubs bring us together.

Loss of Identity and Purpose

For individuals who are actively engaged in physical activities and sports, a long-term injury can result in a significant loss of identity and purpose. Not being unable to participate in the activities they once enjoyed can lead to a sense of isolation and disconnectedness from their social circles. The sudden shift in roles and identities can be emotionally distressing and may even trigger feelings of worthlessness.

I am an ultra runner. I am a mountain biker. I am a climber, or at least I use to be. For now I am a couch potato and I hate it. 9 weeks post surgery I got on to the donated stair climber machine at one of our work gyms and it changed everything. I could work out. I sweat for the first time in a long time, and it felt great. Careful, considered exercise can be important to recovery but is critical to improved mental health.

Since May 10th I have done a 4km shake out with my wife, a 5 km run with my friend Joe and today I knocked out an 8.6 km at a pace of 5:40/k. My shoulder hurt, my legs hurt, my chest hurt and I was grinning from ear to ear.

Whilst training I could easily burn between 10,000 and 20,000 calories a week. Since my surgery I have put on 4 kgs - getting rid of that is hard work when you’re in your 50’s. Just something else that can play on your mind while you recover.

The thing that kept me going was that stepper machine - it is zero impact training and when I was able to get back on there my recovery took a turn and I actually started to feel like there was going to be some light at the end of the tunnel.

Financial Stress and Uncertainty

The financial burden of long-term physical injuries can add another layer of stress and anxiety. Medical bills, rehabilitation costs, and loss of income due to the inability to work can create a cycle

of financial strain, contributing to feelings of helplessness and despair. These added pressures can drain your desire to run.

Chronic Pain and Psychological Distress

Chronic pain, a common consequence of long-term physical injuries, can be debilitating. The continuous discomfort and frustration associated with chronic pain can severely impact an individual's emotional well-being. Feelings of helplessness, hopelessness, and loss of control can become overwhelming, leading to depression and anxiety. Additionally, chronic pain often disrupts sleep patterns, which further exacerbates mental health issues.

Post-Traumatic Stress Disorder (PTSD)

Injury-causing accidents can be scary and even traumatic. Depending on the circumstances surrounding the accident, the injured person might experience increased stress and anxiety if they have to face similar situations daily. For instance, someone who gets hurt in a car accident will likely feel apprehensive every time they need to drive or ride in a car.

In some cases, individuals who experience severe or traumatic physical injuries may develop post-traumatic stress disorder (PTSD). PTSD can arise when the traumatic event triggers intense fear, helplessness, or horror, leading to recurring intrusive thoughts, nightmares, and flashbacks.

Reliving the traumatic experience repeatedly can severely impact an individual's mental health and overall quality of life. 

Coping Mechanisms and Substance Abuse

Struggling to cope with the emotional distress caused by long-term physical injuries, some individuals may turn to maladaptive coping mechanisms, such as substance abuse. Alcohol and drug abuse may provide temporary relief from emotional or physical pain, but they can lead to a host of new problems, worsening mental health and perpetuating a destructive cycle.

Getting support

If you’ve started to experience negative emotions or uncomfortable mental states after a physical injury, then it’s crucial to understand where those feelings are stemming from. There are many avenues for help and support. What is right for you may not suit someone else and some of these options may feel more difficult due to your physical condition. You may find the following information helpful when dealing with a long-term injury.

Talk to friends and family

Some symptoms of a long-term condition, such as tiredness and pain, aren’t always visible. Other people might not realise what you’re going through. If you can, talk to someone you trust about how you’re feeling and what support you need.

Peer Support and counselling services provided by mainstream health providers.

Contact an organisation that supports people with your particular health or physical condition.

Having reliable information about your condition, treatment and management can help you feel more positive and in control. Some organisations may also offer practical, financial or emotional support.

Talk to your GP

The Patients’ Association has some suggested questions to ask your GP if you have a long-term condition. It's important you feel supported and understood by your GP, especially if you need to visit them regularly: consider switching GPs or making a complaint if you don’t.

Find a support group

Support groups let you connect with other people who have the same long-term condition. You can share experiences, problems, tips and support. The Befriending Directory lets you search for support groups for specific health conditions.

In my personal experience I have found the recovery more challenging and far more painful than the surgery (I was asleep for that) and the pain experienced when I first injured myself. It has been unexpected slow and painful but soon it will be just another physical scar - and not a mental one.

The adverse mental health effects of long-term physical injury are often overlooked or underestimated, overshadowed by the visible aspects of the injury. It is crucial to recognize that these injuries can deeply impact an individual's emotional well-being, often requiring professional mental health support in addition to physical treatment. 

Comprehensive care that addresses the mind-body connection is essential for the recovery and well-being of those enduring long-term physical injuries. Supporting individuals through rehabilitation, pain management, and psychological counselling can foster resilience and provide a path to healing for both the body and the mind. Additionally, promoting social support and understanding within communities can help reduce the stigma surrounding mental health challenges and encourage a more compassionate response to those struggling with long-term physical injuries.

The important takeaways from this are: if you are suffering, ask for help. If you know someone with a physical or mental injury please support those silently suffering.

If you have nowhere else to turn, drop me a line… tarpropertygroup@gmail.com

Helpline services are available right now in New Zealand that offer support, information and help for you and your parents, family, whānau and friends.

• Need to talk? Free call or text 1737 any time for support from a trained counsellor.
• Lifeline – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP).
• Youthline – 0800 376 633, free text 234 or email talk@youthline.co.nz or online chat.
• Samaritans – 0800 726 666
• Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO).
• Healthline – 0800 611 116