Q&A: Dealing with Injury, or Comebacks!

by hillarybiscay

I often receive questions about dealing with injury and / or surgery and keep meaning to put my thoughts together into a post here! So this is actually a response to many different questions, but since reader Colleen posed a question on the topic last week, I will use hers here.

Question from reader Colleen:

I am currently facing hip surgery now and am depressed beyond anything at the thought of not being able to run etc. for a while. How do you deal with injuries mentally? Have you ever had to totally shut down?

My two cents:

I actually have a lot of experience in the realm of hip surgery and not being able to run. Back in March of 2004, I broke my hip when I ran too long on a stress fracture and developed a crack clear across the neck of my left femur. At that point in time, I had never suffered a major injury and simply did not know how to interpret what was too much pain—what to push through and what not to . . . Long story short, I ended up crawling the final miles of Ironman New Zealand when my hip finally gave out.

Since this post is about how I dealt with the aftermath of all this, if you aren’t already familiar with the above story and want more gory details,  you can read more here and here.

I ended up having a surgery the docs call “ORIF,” or open reduction-internal fixation; this meant the doc used three titanium screws to secure the neck of my femur. I was on crutches for two months. This means no walking for two months, and it was another 6 weeks or so after that until I could attempt to “run.”

2004 was to be my last year racing as an age-grouper. I had already qualified for pro status many times over, but wanted one more year to get stronger and have another crack at Kona as an age-grouper. But because I hadn’t made it to the finish line of Ironman New Zealand and ended up needing surgery, Kona was out of the question. Suddenly I was dealing with my plans and goals for the year going out the window, who-knows-how-long of no running, and certainly no smashfests of the sort that I loved.

Here are my COMEBACK TIPS based on my experience with hip surgery:

Acquire temporary amnesia about your old “normal.”

This is essential. After a surgery or the like, assume you are starting at zero. This is the only way you are gonna be able to get excited about 20 minutes on the recumbent bike at zero resistance, but believe me, that feeling is possible if you forget about what you used to do . . . Indeed this is where I started after a couple days in the hospital and then a couple more stuck in bed at home, so when the docs allowed me to do this, I was pumped! It was a step forward from zero—the first step in my comeback.

Set small goals.

I focused on just doing a little more each day—from 20 to 25 minutes on the recumbent bike, to the stationary bike, to adding resistance, and finally to the trainer . . . That was all I could control—just improving a little bit from where I was each day.

Set big goals.

While every day I would wake up thinking about what I could do that day to take myself one more step forward in my comeback, I also set big, long-term goals. These gave me motivation for, say, boring PT exercises and aqua-jogging—things like that.

My goal was to finish an ironman before the end of the year.

Focus on what you can do and max that out!

Once my stitches came out, I could get back in the water. Granted, I couldn’t use my left leg, so at first this meant everything was done with a buoy, open turns, and one-legged push-offs from the wall. Although I eventually mastered one-legged flip turns, in the beginning, I had to be happy with just doing laps like a lap swimmer. Real swim workouts were, in the beginning, a thing of the past. So every day, I did as many laps as I could! If I could do that without slowing my hip’s recovery, by all means, I was going to “swim” as much as I could and hang onto every last ounce of fitness that I possibly could.

Find another outlet for your energy.

I think the easiest way to keep your mind off what you can’t do is to keep yourself busy! For me, this meant going from about four hours per day of training to, well, starting back at twenty minutes. Granted, physical therapy can get pretty time-consuming. But to keep myself from sitting home contemplating the long run I would wish I could have been doing, I studied harder. At the time, I was in graduate school and teaching at USC. There was really no end of studying to do, and I’d skimp on that during hard training, so I poured myself into my work while I was recovering.

Expect a bumpy road.

Okay, this one is in hindsight. Once I was able to start jogging, it was not a steady progression back to “normal.” By the way, I remember my first day back and being thrilled to “run” eight minutes! But for the first two months of running, there were days when I’d limp around for the rest of the day after a run. It almost felt like I was re-injuring myself, but I wasn’t. It just took about two months after I started running for me to be able to run consistently without pain again.



I went from not walking on May 1 to racing Ironman Florida in November—exactly 6 months later. I actually had to get my pro license just to gain entry into this race and attempt my goal of completing an ironman that same calendar year. But surprisingly, I managed to avoid embarrassing myself by PR’ing not just the distance but my ironman marathon as well; I finished 10th out of 21 pros and decided I’d stay in that category from then on!

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