How I Found Gratitude in Injury
For years, this elite runner, coach, and surgeon specializing in lower extremity injuries treated hundreds of runners. Until it was her turn to be sidelined.
Heading out the door? Read this article on the new Outside+ app available now on iOS devices for members! Download the app.
For the last 11 years, I was fortunate to never get sidelined from the sport I love because of injury.
I know how rare that is. In fact, sometimes I roll my eyes at how incredulous and privileged it sounds. Regardless, I am proud of my durability and attribute it to a handful of reasons: no issues with food restriction, a vehement stance that centers around pulling the plug on my training if my menstrual cycle ever disappears or becomes significantly delayed, consistent strength work, and what I perceive as a healthy relationship with running (I don’t need it to be happy; I want it in my life because I love it).
But somewhere along the way, I started to feel I was invincible from the ailments that took out friends, teammates, family members, and competitors for varying periods of time. It felt as though I had some protective armor shielding me from the risk of injury, even though my life was centered around trail and ultrarunning.
Enter the fall of 2022. I went all-in the preceding summer to train for Javelina Jundred, a 100-mile race through the desert just outside Phoenix, Arizona. Admittedly, I leaned into the “more is better” mentality, knowing full well, as a coach, that’s not the ethos I ever encourage my athletes to adhere to. My logic came from the fact that I had put up those weekly mileage and vertical gain numbers before. The difference between the fall of 2022 and the seasons prior was that my stress levels outside of running skyrocketed. I was facing an imminent loss of a chronically ill family member. Despite knowing the gravity of her cancer, my emotions duked it out with my prefrontal cortex’s reasoning powers until I slipped into a state of denial.
There were physical warning signs that an injury was brewing. Lack of power in my glutes. Fatigue. A compensatory soft tissue strain on the contralateral side. When my family member died, a pain in my femur finally arrived, ironically leveling up with my heartache. I knew better than to run through it. The MRI revealed a stress reaction in my lesser trochanter and medial femoral neck (the inside portion of the femur, just below where it sits in the hip socket), fortunately caught before the bone screamed “Enough!” with a visible fracture line.
RELATED: Your Five-Minute Stress Fracture Gratitude Meditation
A bone stress injury in a high-risk anatomical area. My first injury in 11 years. Why couldn’t this have been in a metatarsal, or at least somewhere less significant than the largest and strongest bone in my body? The diagnosis was a punch to the gut.
My sports psychologist identified me as a double downer. This injury sparked what I now recognize as irrational shame and guilt, followed by embarrassment over that shame and guilt (hence the double downing). It was hard to explain why these two emotions so quickly took the wheel. Was it because I went so long avoiding significant injury? Or was it because I place so much importance on setting an example for my athletes, with my primary goal always to protect and safeguard them from injury?
Either way, I was forced to reckon with the reality of two months off from running and an uncertain path ahead that I wasn’t used to. Pulling out of Javelina was disappointing, but what about 2023? I had graciously received an entry into Western States 100 in December, the same week my hip pain presented itself. “Will I be ready to train for and race Western States?” I asked my sports medicine doctor. The answer I received: “I’m not sure,” made me wince. I’m a planner. I like to develop a clear methodology forward then execute it. The process, the grind–that’s where my confidence brews and grows. Instead, I was forced to take each day as it came, unsure of how I would feel and just sit with myself until the osteoblasts completed their job, and until my pain was under control so I could begin subbing in cross training.
I quickly realized I had two choices: wallow in self-pity and frustration, or take every possible silver lining from the situation in order to become a better, wiser athlete and coach. I did plenty of the former for a few days: throwing my crutches around the house, deleting Strava off my phone, tearing up the Post-it notes taped to my bathroom mirror with all my spring training goals. Christmas Day stands out in my mind as a turning point. I silenced my phone, laid in an old recliner, housed a lot of cookies, and watched cringey holiday movies until I fell asleep. And then I decided it was time to be a student of the sport again.
As a board-certified physician and surgeon, I am used to delivering challenging diagnoses to patients, scrolling through MRI slices and pointing out areas of concern. I am also accustomed to consoling and bolstering athletes after receiving those challenging diagnoses, prescribing cross training, and easing them back into running once cleared to do so. But this was the first time the tables were turned.
If I’ve learned anything over the last several months, it’s that the human body is wildly and innately intelligent and will force the treatment it needs. For me, that was rest.
While I grieved the loss of my family member, I became acutely aware of the parallels of grief that come with injury. I was familiar with the stages of injury grief described by those forced down this road many times prior, but experiencing both losses in tandem elucidated it all for me. Admittedly, sharing about my runs with my family member and running for her was all I focused on in 2022 as her health failed. Losing her and running all at once magnified my grief, yet brought a great sense of perspective during a time when I really needed it. I was pulled from this tunnel vision path of training, racing, training, racing and realized that all that really matters in life is health and love. Through processing both losses, I clumsily, but steadily gathered tools to better empathetically serve my athletes.
It’s not that I’m wholly grateful for the injury. But a small part of me genuinely is. I think over the last decade, I took my body for granted. I expected it to rise to the occasion over and over again, rather than being proud of its ability to do so. In retrospect, I am glad it hit the panic button as I bulldozed my way through stressors that I really didn’t have the emotional capacity for, without removing at least some of them from my plate. If I’ve learned anything over the last several months, it’s that the human body is wildly and innately intelligent and will force the treatment it needs. For me, that was rest.
RELATED: Why Rest Days Are Important For Long-Term Growth
Prior to my own experience, I frequently relayed a phrase from an old friend to athletes and patients struggling with injury: “This is a setback but also a reset, not a game-ender,” willing the words to be fact. “You will come back stronger from this. Trust that your best days are ahead because they are.” My words were far from empty, but I hadn’t lived them myself. On the other side of it now, I wholeheartedly stand by these idioms. I now have the perspective that a setback is an opportunity to fly even higher than one initially imagined.
After nine weeks away, my first running steps back felt a little awkward, but the body quickly fell right back into its habitual routine, remembering all the miles it endured over the years. I anticipated the overwhelming gratitude I would feel to be back on my familiar, sinuous singletrack but I wasn’t prepared for the deep sense of relief to be home–at peace with my body, no longer fighting an internal battle, and once more trusting the vessel that always has my best interests at heart.
I wanted so desperately to be able to tell my family member no longer earthside about this run and how it felt to have the wind in my hair again. But then I thought…she already knows. She is the wind. The journey of healing, both physically and emotionally, is something I will always be grateful for because it gave me the chance to zoom out and have humility for the fact that we’re all human, vulnerable and finite.
I let out an exhale as I allowed my stride to open up on the final descent back home, knowing I would never take a single run for granted again.
Stefanie Flippin is a professional trail and ultrarunner, holding three of the top ten fastest 100 mile times ever for North American women, and is the 2021 national champion in the distance. She partners with athletes of all abilities and surfaces through her coaching service. She strongly believes in the power of representation and lifting athletes up at every stage of the journey. Stefanie is also a board-certified foot and ankle surgeon and private practice owner. She is a writer for Trail Runner Magazine and Relay, a collaborative running media and content group on Patreon.