Ms. Kübler-Ross and the Inevitable Stages of Your Running Injury

19 December 2008



Symptoms of my ill-defined lower abdominal injury first appeared in August. Now, the Winter Solstice approaches and my Inov8 Rocklite 305s still lie fallow in the closet. In Orwellian Newspeak, this whole predicament is DoublePlusUnGood.

I feel trapped inside an uncooperative body and I’ve grown obsessed with the injury that has incarcerated me. More pointedly, I fell I’ve lost something. In my hour of desperation, I turn to the only book that can truly help the beleaguered runner make sense of it all: On Death and Dying.

Writing in 1969, Dr. Elisabeth Kübler-Ross, death expert (and apparent enthusiast), introduced the groundbreaking Five Stages of Grief. Her model predicts the emotional roller coaster people typically experience when confronting the specter of death. The stages are remarkably similar to the experiences of the injured runner.

Stage 1 – Denial
Runners are world-class deniers; just like the WWE referee who won’t acknowledge that the Undertaker is pummeling John Cena with a flagrantly obvious foreign object. We won’t admit what’s in plain sight. So naturally, we push through injuries that would down a bull moose. This is done for extremely important reasons like “shaving 10 seconds off a 9.5 mile trail run” or “Winning an online mileage contest with someone from Uzbekistan.”

When confronted with an injury we can no longer ignore (like debilitating pain in the pelvic socket) we howl with melodramatic angst like the overacting Mark Hamill in The Empire Strikes Back, “That’s not true! THAT’S IMPOSSIBLE!”

We refuse to accept facts, and Darth Vader predictably kicks our whiny ass.

Stage 2 – Anger
Like petulant toddlers who haven’t gotten their way, we feel that life has purposefully struck us a cruel blow. “How could this happen? I wanted to qualify for Boston.” “I was going to run a marathon up a mountain.” “Now how will I test the wind shear resistance of my new Saucony running shorts?” It’s just not fair.

Divorced from our primary means of stress relief, we runners become ill-tempered monsters. A toxic stew of displaced aggression and unseemly narcissism rule the day. It’s best to avoid us entirely, especially if we’re related to you.

Stage 3 – Bargaining
Injuries can help runners regain lost faith, though the recovery may be shallow. The temptation to mold divine providence to our purposes proves difficult to resist. Spirituality may compliment running, but offering bail-out funds to a higher power in return for a pain-free hash run hardly amounts to sound religious practice. Even if we promise something noble, like never again out-kicking a senior citizen in a marathon finishing chute, our injuries will not magically disappear.

Yet we still try to control the uncontrollable. Rather than endure the consequences for our folly, we want to buy some sort of Medieval Indulgence to get early release from Injury Purgatory. Didn’t America fight a Reformation over this or something?

Stage 4 – Depression
The sick sometimes wonder if they’ll ever be well again. Injured runners wonder if they’ll ever compete again. We sit on the sidelines as the race calendar inexorably rolls on. As days turn into weeks and weeks into months, we succumb to listless melancholy. We lose hope.

Because nothing seems to matter, self-destructive choices begin to make sense. We hop off the wellness wagon into the non-judgmental, deliciously nutritionless arms of our favorite junk foods. Complete lethargy follows. Supine on the couch, we command the nearest child to fetch us Mountain Dew and Pepperidge Farm Mint Milanos because “Soda and cookies won’t just walk to the living room by themselves.”

This is rock-bottom stuff; the injured runner’s equivalent to the post break-up ice cream binge. It’s all very sad.

Stage 5 – Acceptance
With nowhere to go but forward, runners grudgingly acknowledge reality and begin the slow crawl back to dignity and fitness. The journey usually begins at the doctor’s office. We visit specialists and submit to the inevitable X-Rays and claustrophobic MRI scans. We hope this will lead to a concrete diagnosis – a clear plan of action. Any plan will do.

Alas, such certainty proves elusive. Cosmologists have deduced the precise composition of the universe at less than a trillionth of a trillionth of a second after the Big Bang, but medical science can’t tell me why my groin hurts when I run. Apparently this is too much to ask.

For Kübler-Ross, acceptance is the last step before peacefully embracing death. Most runners just end up in physical therapy. There we’re measured, assessed, stretched, electrified, and put to work in the weight room. But we embrace it all the same. At least we’re doing something constructive.

It’s all quite simple. We do whatever our physical therapist tells us to do. Along the way we breathe the crisp, invigorating oxygen of a clearly defined goal, which reminds us of how it feels to run.

- Dean

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