Meditations on Injury

Our thoughts and beliefs regarding injury drive our decisions and overall mentality. As I win a few more years, I’m convinced that one of the ways we derive meaning in life is in striving for good health in a holistic sense. However, the body is a massively important part of our health as the most tangible part of our person. Many of us live huge portions of our life paying little attention to the body but, regardless, we’re all invested in avoiding injury. Some people enter into an event knowing they will give their whole person up to and including injury. However, most injuries occur as a result of lack of attention and these should be avoided. Moreover, the over attention we give to the possibility of injury can be even more devastating as we’re unable to handle risk while we live a life of mitigated risk every day. How can we shape our attention to injury in a way that supports us?

It’s taken me until midlife to realize the ways I was shaped around injury as a child. This is, of course, important for any of us to realize in order to understand our own baseline. In yoga, we would call this our samskaras, or emotional ruts. In our youthful experiences, we observe the world and develop an idea about what’s safe and what’s dangerous, sometimes sensibly and sometimes less so, and by sensible I really mean generalizable. Dogs, for example, are often afraid of some specific characteristic, like hats, because they had some experience as a puppy. In those moments, that fear may have served them well and helped them survive but they developed a samskara to respond to all people wearing hats instead of meanness. They generalized the wrong characteristic and, as people, we do the same.

I didn’t get injured much as a kid. I played outside constantly so bruises and cuts were so common I didn’t even notice them but I didn’t experience many real injuries until around early adulthood. However, I also grew up watching my dad deal with a few injuries that were so consistent, painful, dangerous and generally troublesome that I knew deeply that I wanted to avoid injury. Specifically, I learned how many injuries could heal back to complete function but others turned persistent. My dad dealt with hypertension, and knee and back injuries. The origin of his knee injuries was absolutely unavoidable. Another driver hit him with their car and he’ll deal with that knee for the rest of his life. Alternatively, he talked with me about avoiding back injury and his main tip was abdominal strength. Since then, I’ve learned about core strength much more deeply and work for balanced core strength through the deep and surface layers, back and front, and it was a great lesson for a young man to understand the idea of opposing actions. Your back is most fragile in back bending so abdominal strength opposes that weakness and supports the back in the fragile part of its range of motion. As I read and learned about heart health, it became clear that this is a condition I will likely also deal with as a result of genetics and dealing with heart problems is like planting a tree. “The best time to plant a tree is 20 years ago and the second best time is today.” These injuries highlight the two common types as I think of it: unavoidable, and possibly avoidable through life long attention. As a result, we have to first make choices that support us in avoiding injury but we will also have to deal with injury when it occurs.

As I grew a bit older, I discovered a deep love for American Football, which will shape anybody’s thoughts on injury. As anyone who has watched a game knows, every game, every practice, every play that occurs, every player risks injury. However, there are significant ways to manage that risk. I immediately invested in learning to make contact with my body in positions that are more likely to incur small injuries, and not catastrophic ones. Regardless, the risk is significant and I saw several friends deal with injuries that became reoccurring after the initial event. One player, Nat, was already a footballer on my first day. He was about my height and weight and played the same positions but had already developed the skill set of a veteran and so he became my first role model. In other words, my first goal in football was to play as well as Nat. The thing I remember working hardest to replicate is how Nat hit hard. He was fast and low to the ground and would look to initiate contact. As I developed that skill, our competitions became fierce. We were both religious in the weight room and grew to be quite powerful young men. One day we were competing in a hitting drill and Nat fell for a juke that I threw, leading to a hit where I had a full head of steam and Nat came to meet me a step behind. Great competition, and it felt good to get the better of him but I learned the next day he tore his rotator cuff on that play. These are some of the experiences that make sportsman better people. I injured my friend but I was just playing my best and so was he. I wouldn’t change anything and I don’t think he would either but now he deals with a chronic injury. It could have been me many times and I’m obviously thankful to have made it out with no persistent injuries to show. (I did get a wrist x-ray later in life and the doctor told me I’d broken my wrist many times without knowing. Nobody gets out of American Football totally clean.) As a result of these experiences and others, I chose not to play football in college. At the time, I think I cited other reasons and it’s taken me the decades since to really parse my incentive. At this point, I’d say the primary reason was a desire to have a healthy body as I age.

These stories and discussion leads to some of my foundational beliefs about injury. First, no normal event is worth an injury. (There are, of course, some extreme events where people will choose to act regardless of injury, usually when our or a loved one’s safety is in jeopardy.) Therefore, attention to our bodies is paramount in every event. Yoga perfectly serves this as we spend time on the mat dedicated to attention to our bodies. Secondly, we must make choices that risk injury on a regular basis and should be prepared. I like to state this as, if you don’t do something uncomfortable today, you will be weaker tomorrow. Part of that preparation is risk in smaller events. For example, if you take care not to fall for 40 years then a fall could be catastrophic as you haven’t practiced that action. In any sport, we practice falling and recovering for good reason. Yoga does not serve this so we need to train outside yoga in order to achieve physical balance and prepare for the future. Lastly, we will likely incur some injuries over our lives and need to learn how our bodies operate differently than others’ bodies and our previous self in order to protect it moving forward. These beliefs build well into a very simple action plan.

While we can’t eliminate the possibility of injury, we can take daily steps to avoid many injuries and mitigate others. The first step is to develop holistic health. I love describing my exercise plan as “Yoga +…” As mentioned above, yoga helps us in ways that other training does not, but it doesn’t cover all the bases so we should also be doing some activities moving our bodies through space and carrying loads (think running and weight lifting, or anything else that serves those purposes). The second step is to develop mindfulness, and this is where yoga and meditation shine. Our physical capabilities aren’t much use if we don’t pay attention to how actions make our bodies feel, and avoiding many injuries is simply a matter of attention to our bodily actions. Meditation, specifically, teaches the skill of focus and placing attention with agency and yoga asana does this as well to a lesser extent. Thirdly, we need to understand the ways our bodies are different than others and respond. In yoga class, most students push to reach the “full expression of the pose” which is a huge issue as the poses weren’t designed for our individual bodies and we need to adapt any movement to our own capabilities. Many students should be taking “simpler” modifications. Other students possess hypermobility in some joints so they have the ability to push their joints in a way that their musculature can’t support very well. In order to realize this we have to practice often and pay attention not to what we can do but to how stable and easy we can make the poses.

As a final exercise, I’d like to apply these ideas to my dad’s aforementioned injuries in his knee, back, and heart. Being the result of a car accident, his knee injury was likely unavoidable. (It’s possible that mindfulness can improve your driving but he’s a very safe driver so I’m willing to bet he was mindful and, regardless, some injuries are unavoidable.) Since that injury, he gives tons of attention to his knees and how they feel all of the time and he also understands the limitations he now has as a result. Attention and mindfulness drive him to use supports and braces, and also to avoid actions that feel dangerous because no event is worth an injury (or another injury in this case). With regard to hypertension, certainly the only prescription is holistic health. My dad was (and is) very healthy and active but I gather that, being unaware of his blood pressure and cholesterol, he ate very differently before and after his first heart attack. It’s possible that earlier changes in diet could have delayed or staved off the issue but hindsight is 20/20. The only way he could have been alerted in order to know a change was necessary is attention to his body but, in this case, people often don’t feel rising blood pressure or other symptoms so it’s important to have data to rely on. I believe we should all be taking our blood pressure at least once a month after a certain age so that we can respond to the metrics. This is the major difference between his hypertension and his back trouble. He developed worn and eventually slipped discs (that have now been surgically fused) over a lifetime of hard work. That hard work likely did wonders for his general health and also for his fulfillment, but back injury is a high cost. This is to say, we should all strive to be active but that activity introduces danger, especially when we perform repeated motion. (Yoga practitioners should think about how many vinyasas we do. Does is serve us to do so much repeated motion? If the answer is yes then we need to give extreme care to alignment that supports our long term health.) My point is that my dad had holistic health nailed here. I expect, however, that increased mindfulness to alignment of the spine in that work would have saved him lots of pain. I’m extremely fortunate to have had him as a model when I started weight lifting in high school as his example gave me the urgency for perfect form, at least in my back. The last piece is that, after each injury, his physical capabilities changed. The important thing is to realize that change and support your new capabilities. Back injuries are so debilitating that people are forced to respond but attention and modification is essential.

In our pursuit of health, we will all have to consider how we deal with injury. I propose that there are exactly three useful actions on this front. 1. Develop holistic health. This mostly means training includes “Yoga +…” and also includes dietary consideration. However, it’s also important to consider how well we sleep, our patterns of thought, and connection to others. 2. Develop mindfulness, specifically to our bodies. Mindfulness is hard to develop without meditation. If that seems daunting, then simply sit comfortably for 2 minutes each day and give all of your attention to your breath and body. Then, throughout your day, try to remind yourself to keep part of your attention there. I promise you’ll get better over time. 3. Understand how your body is different than others and different from your previous self. We’re not all ballerinas who will look instagrammable in every pose but we all have bodies that need to push their capabilities. The idea is to learn what your safe capabilities are and do exactly that. Don’t try to be somebody else, or your past self.