Coming back to an endurance activity after an injury, especially a traumatic one, is perhaps one of the hardest obstacles to overcome as an athlete. I've learned this from personal experience and through interactions with friends and clients. I want to talk about the steps we can take as athletes to bounce back and be stronger than before.
The Initial Shock
In 2011, I was becoming a well-rounded triathlete but was forced to completely stop run training due to sudden and severe running induced vertigo. I underwent a lengthy diagnosis and treatment, during which time my cycling was unaffected by the vertigo. It was during this time I fell in love with cycling even more and started training for pure cycling events. Even though I can now run without issue, it is now a recreational activity for me as I am very happy with my transition.
It is very easy to fall into a depressed and/or pessimistic state while sidelined with an injury. Your world has flipped - you've gone from high intensity training and racing to a complete withdrawal. Firstly, it's OK to be upset, angry and down about the situation, these are perfectly normal human responses. The first way to start getting over these negative emotions is to focus on the positive. How bad is the injury vs how bad could it have been (having been hit by a car, for me personally this was key)? What can you still do? What activities had you dropped that you can now return to? Figure out what activities you can still do to keep yourself active and engaged physically. I found a positive in my running vertigo, and that was cycling.
The Long Road to Recovery
This past June I was struck by a car and have spent 4 months so far recovering from a broken patella. I'm into my long recovery phase and have thought a lot about what I've been doing right and wrong during these past few months.
I think the first thing to do, and one you can work on while still unable to workout, is to talk with your doctors/surgeons/physical therapist or coach to figure out what caused the injury and how to prevent it in the future. Here you need to be your biggest advocate, stand up to the doctors et al and make sure they know your background and where you strive to be again. The last thing you want to do is repeat poor tendencies or further aggravate the injury. What you don't want is an apathetic doctor or PT used to dealing with rehabbing elderly patients who don't know how to really push an advanced athlete. Personally, I travel 30 min out of the way to see a PT who's a cycling coach and lifetime cyclist himself - no one will understand my needs better than him.
From there, creating a path forward towards recovery will provide positive milestones to focus on. Don't think just about just the long term, which can be overwhelming and seem like a daunting task. Rome wasn't built in a day, nor is a torn ligament mended in a week. A rehab or physical therapy protocol sets out schedule or milestone based steps and you can do the same. By doing this, you can focus on small accomplishments towards a greater goal. Each new step will bring new activities, intensities and/or movements back. In this way you can always have a short term goal to work towards and accomplish, providing the necessary motivation and feedback for a positive mental and physical state. My personal milestones along the way have included everything from walking unassisted and regaining flexion to pedaling a bike and rebuilding atrophied muscle. I can bike again, but it's baby steps in time and intensity to get back where I was and can use my knee on the bike and in regular life without pain.
Regaining Lost Fitness
Fitness is fickle. Hard to gain and easy to lose. All is not lost though, figuratively and literally, when sidelined with an injury. While you will lose fitness, it will come back easier and quicker the second time around. Your body has learned to become more efficient and made adaptations - those are not lost and there is a certain amount your body won't need to "relearn" the second time around. It is just as important to make a plan yourself or with your coach, to set realistic expectations about regaining the lost fitness. It's easy to dwell on how much slower you are, but it's more important to check off positive results - each week can have a goal, e.g. a new running pace met, new long cycling ride or power achievement. Setting these small and manageable goals are the trees you need to focus on instead of the entire forest.
Probably the hardest part of recovery will be in your first few workouts back. Firstly, it is easy to slip into bad habits and out of the good habit of consistent workouts. Set manageable goals - 3 workouts per week, then 4 then 5, etc and build the consistency back slowly. Secondly, the difference in fitness may be a shock and somewhat depressing. The first thing is to accept the reality of your new fitness, then embrace the opportunity to build again. Give yourself the time to rebuild and use reasonable milestones along the way to track your progress and stay positive.
Not all injuries and recoveries will be the same. Some will be simple and some may take years, if we ever fully recover at all. Especially for serious injuries, a positive outlook is important, or you may find yourself losing hope and giving up. The road to recovery can no doubt be a daunting one but by understanding your past and setting manageable short term and long term goals, you can bring yourself as an athlete back to your prime. For me personally, doctors and my physical therapist are unsure whether I will ever regain my former ability or ride without knee pain again, but I'll never know until I try. However, the more I push myself now, the quicker I can get back and the better chance I'll have.