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Injury: It’s not all physical…

by Dr.Jeremy Adams

So, I’m injured again. It’s not the first time, and probably won’t be the last.

Over 25 years of mountain biking I’ve had any number of injuries, small and large, two of which required surgery. I’m hoping this one won’t result in a third.

Every time I’m injured a number of things happen. First, I sort of pretend it hasn’t happened. Assuming I’m OK to get back on the bike, I often keep riding with the hope that nothing’s really wrong. Then it starts to sink in, and I get annoyed.

Then I try to pretend that, even though I might be in a lot of pain, that it’s not really serious and I’ll be back on the bike in no time: two weeks tops… Then it sinks in, I see a physiotherapist, and realise that it might be a longer recovery. Crap, how am I going to cope with six weeks off the bike?

Let’s talk about risk

When it comes to mountain biking, one of the more challenging ideas is risk. To put it simply, my chosen (and beloved) activity comes with the risk that I will injure myself. The only way to completely remove this risk is to stop doing the thing I love.

So, it comes down to a clear question: either I give up mountain biking (and reduce my risk of injury), or I keep doing it and accept that I will get injured. If I can accept the risk, I have to accept the injuries that will come as a consequence of that risk. If I continue riding without accepting the risk, and get upset when I injure myself, I only have myself to blame.

It’s probably worth noting that injury isn’t always about crashing (i.e., acute injuries). Risk of chronic injuries (i.e., overuse injuries) is also inherent to the sports we love (mountain biking included). In some ways, chronic injuries are harder to deal with because they don’t always have an easily identifiable cause, or an obvious solution (like waiting to heal post-crash).

Injury as a psychological construct

Injury isn’t just a physical thing. Crashing a bike, and hurting ourselves physically, is more than just a physical trauma. Mountain biking is an inherently dangerous sport, and learning to negotiate fear-inducing features is a big part of becoming an effective mountain biker. But our brains evolved to keep us safe, so, crashing makes our brains freak out; they’re appalled that we’ve just experienced something that was dangerous and try to ensure that we don’t expose ourselves to that risk again.

From your brain’s perspective, there’s very little difference between a mountain bike crash and a bear attack, and it’s going to work hard to stop you from experiencing that danger again. Of course, this is where you and your brain disagree. Your brain might be telling you that you’re in danger, whereas you wantto be doing this inherently dangerous thing. 

“there’s a pretty good chance that you’re going to feel freaked out and anxious about both the accident and getting back on the bike”

Most people draw a blank when confronted with the notion of psychological injuries as a consequence of physical injuries. It’s not until they try to get back on the bike, and baulk at that drop they always used to navigate easily, that they’ll realise that something isn’t right. 

In other words, there’s a pretty good chance that you’re going to feel freaked out and anxious about both the accident and getting back on the bike, and this will be annoying because it’s the opposite of what you want. It’s deeply frustrating when the activity we love is both upsetting and exciting.


mtb psychological injury

Once we get over the fact that we’re going to be off the bike for a while, we have to get on with the job of recovery (so that we can get back on the bike). The first part of this is getting the right diagnosis and working with the right people (a good sports physiotherapist is definitely your friend). Another important part of recovery is giving ourselves enough time to heal appropriately, to reduce the risk of reinjuring, or of developing a chronic injury. 

But assuming that you’re able to do some sort of activity whilst injured, it’s vital is to find a physical and psychological outlet that can be used as a stand-in until we’re ready to ride again. For example, I’m rediscovering running with my dog while my shoulder heals – it’s not as satisfying as riding, but it’s not bad (and it helps that I have bush trails from my front door). 

“You can’t go back in time and change what happened, and fixating on recovering won’t make you heal faster”

Psychological recovery is also really important, and usually overlooked. As we’ve talked about, injuries are stressful, and it’s very tempting to obsess, not only about our recovery, but also about the accident itself. Recovering psychologically means giving yourself a break (see below) and working with what’s actually under your control.

You can’t go back in time and change what happened, and fixating on recovering won’t make you heal faster. Working with a sport psychologist during your recovery can help you to address any lingering issues, deal with emotional variability, stay reality focused, and help prepare yourself for when you do get back on the bike.

Acceptance and Kindness

Accepting your injury sounds a bit strange, but it can make a big difference. Acceptance doesn’t mean you have to like what’s happened, only that it has happened. Likewise, frustration is normal, but giving it a lot of your attention can make things worse – when we’re cranky because we can’t ride, we tend to stop focusing on other important things, like recovery, our friends, our relationships, and our work.

Constantly talking about the injury and how much we hate it might feel good at the time, but tends to reinforce the frustration, whilst also pissing off the people around us. Accepting what happened allows us to acknowledge reality, and to focus on getting on with our lives (which, after all, have more in them than just riding bikes).

It’s also worth briefly discussing pain. To be blunt, injury hurts, sometimes a lot. Your pain might reduce quickly, or stick around for some time. Pain is easier to deal with if you can accept the fact that it is a natural consequence of injury (this might sound dumb, but struggling with pain tends to make it worse), and that injury is an inevitable aspect of mountain biking. In some ways, your pain is the natural end point of your enjoyment of mountain biking – you simply can’t have the fun without the inevitable pain.

“Do not try and force or push through pain; if you’re not careful, this can lead to pain sensitisation and increase the risk of developing chronic pain”

Pain tends to feel worse when we struggle with it. The more tense we get, and the more we become overwhelmed by uncomfortable feelings, the worse we perceive our pain to be. This, in turn, can lead to a negative cycle of pain avoidance, which can actually reduce the likelihood of recovery because we avoid active rehabilitation.

It’s important to get appropriate advice about what you can and can’t do during recovery from a sport physician or physiotherapist so that you can get the balance right. The main aim is to expect pain, and to work with it. Do not try and force or push through pain; if you’re not careful, this can lead to pain sensitisation and increase the risk of developing chronic pain.

Being kind to yourself whilst recovering is also a strange notion to many. In fact, many people are actually quite harsh with themselves in their quest to force recovery as fast as possible. This drive to get back quickly can be counterproductive; not only can you overdo your rehab, but it is also very stressful to add a different and often dissatisfying “training” load that comes with the big expectation that you “should” be improving rapidly.

“Self-kindness during recovery doesn’t mean being weak. It means doing what you can, without placing large (and probably unrealistic) pressures on yourself.”

More often than not, recovery from injury doesn’t follow a linear curve, and there are usually setbacks along the way. Harshly forcing yourself (without being kind) removes any chance of finding the recovery process meaningful, and makes for a miserable recovery period.

Self-kindness during recovery doesn’t mean being weak. It means doing what you can, without placing large (and probably unrealistic) pressures on yourself. I always have to come back to acceptance: once I’m injured, it will take time to recover, and I might as well use this time meaningfully rather than being angry that I’m not healing fast enough, that I’m in pain, or that I’m not riding.

Coming back – refinding your mojo…

I’ve already written a fair bit about getting your mojo back, and you can read one of those articles here. To summarise, however, try the following steps:

  1. After a crash or injury your brain’s “anti-bear” systems will try to protect you by keeping you away from similar activities. This is what they evolved to do, so don’t freak out about it too much.
  2. A part of the protection mechanism will be a temptation to replay the accident or incident in your head, over and over. This is normal, but it doesn’t help. Instead of humouring the memory (and the surrounding thoughts) “thank” your brain, take a deep breath, and refocus your attention on your surroundings. Do this over and over, whenever you find yourself indulging the temptation to mull over what happened. By refocusing your attention you’re training yourself to attend to what’s important (i.e., the here and now) rather than focusing on a memory of something that’s already happened and that you can’t change.

In other words, you are not your brain’s survival system. It’s just a part of your brain that evolved to try and keep you safe. That means that just because you feel it, doesn’t mean that you have to pay attention to it (even if it’s really loud).

  1. Give yourself a break. Instead of trying to get back to full pre-crash/injury level in a short period of time, recognise that it might be difficult, and stop being so hard on yourself. Instead, once you’re ready to start riding again, pick a series of fun rides without a lot of challenge and let yourself get used to riding for fun again. Once you feel a bit more relaxed, start upping the challenge slowly. In the meantime, focus on other fun physical, work, or social opportunities.
  2. After an injury, make sure you’re signed off by your surgeon, physio, or other health professional before you start riding again. But also remember that most injuries are fully healed by around six months. After that time, the chances of reinjury are effectively the same as they were post-injury. In other words, once you’ve healed, the only way you’re going to hurt yourself again is by having another accident, and the more you freak out about that happening the greater the chances that it will!
  3. If you’re really struggling to get your mojo back, and it’s just not working, don’t try to do it by yourself. Asking for help is not an admission of failureit’s an indication of how important mountain biking is to you! I’d recommend looking for a psychologist who has experience in sport and exercise psychology, especially around reengaging after an accident or injury, and work with him or her to get you back to what you love.

To finalise..

Although your injury will suck, it’s also a chance to spend some time on other things in your life that might have been neglected because of mountain biking. To be honest, mountain biking takes up a lot of my time, and not doing it means I have more time to focus on socialising, and other types of training, as well as my recovery. You’ll probably be back on the bike soon, but in the meantime, instead of putting your life on hold, why not enjoy living it?

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