Knee Recovery and Mental Health

Good evening friends.  Tonight’s post is inspired by Anne’s Running Commentary, and her openness about her battle with depression.

Now I don’t want to go on and on about bad knees and feeling down and sound like a reject for a PBS documentary.  The big summer blockbuster features a hero caught in an epic struggle with impossible odds and frequent setbacks, and since Joss Whedon is directing you can’t even be sure it will have a happy ending.  Get your popcorn folks.

Our villain in this story is anxiety and depression.  He’s a coward who doesn’t make obvious frontal assaults.  Instead, he sneaks in the back door and uses his cognitive distortion ray to mess with the wiring, clouding our hero’s perceptions and making him doubt things he should be sure of.  Suddenly, easy tasks that normal people do without a care become problematic.

But first, imagine life without the villain.  Our hero is running down the Frisbee field on a warm spring day and makes a dramatic diving catch.  The kind that would make the sports highlights.  Unfortunately that last burst of speed caused a rather nasty popping sensation in his hamstring, and our hero limps off the field.  It’s a couple weeks before he can walk normally, and months before he’s back to playing Frisbee.  His brain associates “diving catch” with “severe pain, can’t run afterwards”.  The traumatic event has caused our hero to avoid making diving catches, thus preserving the health of his hamstrings.  This is all good.

Now imagine our hero has a chronic knee injury.  There was no dramatic moment when something popped.  It just gradually appeared over the course of a few weeks.  The hero visits the doctor, and the villain subtly adds some anxiety to the situation.  Our hero fidgets and worries about the outcome.  Waiting has become a traumatic experience.  When the doctor says to stop running for a while, the villain fires the cognitive distortion ray.

And here’s what happens:  The same pathways in the brain that remember traumatic events with bad outcomes now associate “doctor visit” with “stressful, can’t run afterwards”.  The exact same mechanism that worked so well to preserve hamstrings is now an obstacle to getting better.  Our hero, at an emotional level, really believes that going to the doctor was the reason he can’t run.  The mere mention of the word “doctor” is enough to reduce him to a dysfunctional wreck.

This is the part of the story with an unexpected twist:  I am not the hero described above.  Yes, we have had similar experiences, but I’ve gained a level of self-awareness and have some knowledge of how anxiety and depression work.

Cut back to the scene in the exam room, except now it’s me instead of the hero.  The effects of anxiety are starting to be felt.  I take a breath and calmly look around taking note of the surroundings.  Unfortunately those surroundings include a poster of the inner workings of a knee, with descriptions of everything that can go wrong.  Yikes!  Okay, maybe I’ll just sit here and meditate with my eyes closed.  By the time the doctor arrives with his verdict, I am almost asleep in the chair.

I also frequently remind myself that the home remedies weren't working.  To continue limping through runs and expect to suddenly get better one day is the very definition of insanity.  On the other hand, going to a doctor and then onto physical therapy gives structure to the recovery process, and also raises my level of commitment to recovery.

Doctor visits and physical therapy are now viewed as the path to recovery.  The story ends with an inspiring message of embracing one’s limitations and thus learning to transcend them.

Except it wasn't quite that rosy.  Somehow, this story didn't include the parts where I pestered my friends with messages such as “Sigh, I feel so sad today and have no idea why”.  If you were the lucky recipient of such a message, my apologies and thank you for your support.

To be continued…