Just As Well, The Women's Health Podcast - So, You Can’t Train: Physiological and Psychological Guide to Injury Recovery

Episode Date: April 27, 2021

What things can you do to cope mentally and recover physiologically after injuring yourself while exercising? It’s a question that our acting digital editor Francesca Menato has sought answers to over the last year. She was training for her fourth - and hopefully fastest - marathon when she caught Covid-19, and the long-term effects on her lungs meant she wasn’t able to run for 12 weeks. Then, when she laced up her trainers once more and built up her fitness over six weeks for a 31-hour ultra relay, she found herself struck down again - this time with ITB syndrome and bursitis, and out of action for four months. She’s doing better now, and returned to shorter runs in early March, but dealing with that injury was tough. And she’s not alone - tonnes of you have got in touch to share your own experience of lockdown fitness set-backs. In today’s episode, we call on Dr Josie Perry, sports psychologist and founder of Performance In Mind, and Emmanuel Ovola, physiotherapist and Nike run coach. They discuss why so many people have become injured during training during the pandemic, the importance of dealing with the emotional fallout of not being able to stay active, as well as tips and tricks to get you actually doing those all-important rehab exercises.   Join Dr Josie Perry on Twitter: @Josephineperry Join Emmanuel Ovola on Twitter: @Manni_O Join Francesca Menato on Instagram: @ces_menato Join Women's Health UK on Instagram: @womenshealthuk Like what you’re hearing? We'd love if you could rate and leave us a review on Apple Podcasts, as it really helps other people find the show. Also, remember to subscribe wherever you get your podcasts, so you’ll never miss an episode. Got a goal in mind? Shoot us a message on Instagram putting ‘Going for Goal’ at the start of your message and our experts could be helping you achieve your health goal in an upcoming episode. Alternatively, you can email us: [e-mail] Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

What things can you do to cope mentally and recover physiologically after injuring yourself while exercising? It's a question that women's health's acting digital editor, Chess Manato, sought answers to her over the last year. She was training for her fourth and hopefully fastest marathon, working with a coach, making major progress with her speed and endurance, and had her eye trained on an ambitious but achievable goal. Then came COVID, which did a number on life as we knew it, and chess's body. after she caught it, the long-term effects on her lungs meant she wasn't able to run or train regularly. Then, when she thought herself recovered, Chess took part in an ultra relay, after which she was left with ITB syndrome and Bocytus and unable to run for four months.

Chess is doing better now and has been running regularly, albeit for shorter distances, since March. But dealing with that injury was tough, and she wasn't alone. Tons of you have been in touch to share your experience of lockdown sports injuries, And in today's episode, Chess puts your questions alongside hers to two esteemed experts very well versed in the psychological and physiological journey of recovery. Hello, I'm Roshin Deverichotane and this is Going for Goal, the weekly women's health podcast. On this show, we chat to our favourite celebrities and wellness heavyweights about what they do to feel and function at their best. And on episodes like this one, we call on top experts to share the tools you need to make good on the health goals that really master to you. The first expert Chess speaks to in this episode is renowned sports psychologist Dr Josie Perry,

founder of performance in mind. The second is Nike run coach and physiotherapist Mani Avola, who's super passionate about the role of autonomy in recovery and has been personally working with Chess on her own. Together they discuss why so many people have become injured while exercising over the past year the importance of dealing with the emotional fallout of injury. Plus, motivational tips and tricks to get you to actually do those. physio rehab exercises. Over to chess. Okay, well, hello and welcome to going for goal. We are talking

today about injury, wanting to train when you just can't train. Now, this is a topic I'm sadly very familiar with. I am a runner and I have had about four months off and I'm actually running again now. So I'm a positive tale for anyone who's still struggling. But yeah, it's been a It's been a slog and I understand both the physical and mental challenges that come with that. And so we're going to cover both those things, which is why we are speaking to both Manny, Physio and Josie Sports Psychologist. So we asked our audience on Instagram if other people like me had come a cropper in the pandemic and thousands of people got back to us and nearly 60% of respondents had sustained an injury in the pandemic.

so I'm not alone. Have you been busy, Manny? You are my physio. So I've been busy with me as a client, but I'm sure I'm not the only one. Yes, I think there's been a rise in, you know, on musculoskeletal injuries and we go through waves, especially in the pandemic of, you know, I think there's an element of, you know, you have motivation that increases and reduces over time. It's a difficult time for everybody so I definitely had been, have seen some more, yeah, more muskish glitre injuries. There's definitely a rise. One of the things that a lot of people came back with when we asked, what's the hardest thing about it is a lot of feelings of guilt about having to rest and that kind of thing.

So, Josie, have you seen an increase in that? Or are you familiar with that feeling? Yeah, I think the two big feelings we tend to see when somebody's injured is, yeah, Yeah, some of that guilt that we know we should be exercising. We know we should be working towards something and we're not doing that. There's also kind of a feeling of grief, especially if you've been working towards something and it was a big goal and kind of you see all those goals like washing away in the distance of I'm not going to be able to do that.

So those tend to be the two big ones that we see. Yeah, I can definitely, definitely relate to the second one. I was training for London and obviously London didn't actually happen. happen in the end, but it was a strange feeling to go from the fittest and fastest I'd ever been. And I actually caught coronavirus, so that was the first start to my sort of injury saga. But anyway, I definitely understand that feeling. And yeah, it takes a lot of processing to get past that. So we asked people what had been the key cause of injury.

So obviously there's all sorts of ways you can get injured, all sorts of lovely ways. The vast majority did say running. I imagine a lot of people took it up in the pandemic, because obviously gyms were shut, and it was definitely a thing a lot of people turned to as a way to cope. People really got into the hit at home and even some tales of doing 100 burpee challenge and something went awry.

What would you say to someone who, kind of they've just found themselves injured and they just really don't know what to do, like what to do next? What would you tell them to do, Annie? I think you've picked up on quite a myriad of things that were going on. And from what I've experienced during the pandemic, it's definitely this spiking activity, but also we have, you know, we've got reduced commute.

So there is also this element of we're not actually being as active as we would, as we would in, you know, in non-pandemic times. So it's a coupled effect. So you do have increased spike in activity and quite aggressive activity, activity that causes a lot of pressure on joints. So for instance, the hit and also running. So all of these exercises, you're trying to control and manage two to three times your body weight, sometimes on one leg.

And you're not supplementing that with any strength work. And we've also got a reduction in bone density because, for instance, we're not walking as much as we would or, you know, we're not doing as much as we usually would. We're not traveling. We're not going hiking. We're staying within cities. So all of this, you just come, you know, it kind of comes into a melting pot. So I would say to people who are new and, you know, have got new for new injury. It's all about settling in and resting and stopping. It's, it's the hardest thing to do, but the most important. And I think one of the things is just being able to you know, probably Josephine will probably be able to tell us a bit more, but sit with

with the emotions that you might feel at first. And, you know, I think we're living in this age of obviously more information and there's an abundance of information, but not all information is essentially going to be attributable to you. So it's not, not all information is going to be to be specific to you. We're all unique. And, you know, something you read on Google or the internet or you hear from a friend, it may not be the same story for you. So, you know, Sess, you've done your rehab. You've been working really, really hard. And you're kind of an example of, you know, somebody who can get that advice and work hard in their rehab and get back to what they love doing. And that's what hopefully us physiotherapists can do.

but yeah, I definitely think that take your time, try and sit with some of the emotions that you might have at first, which can be difficult. Yeah, I'd back that up. We tend to say if you get kind of a sudden injury, so something that suddenly you realize, yeah, yeah, I'm properly injured right now, you are allowed 48 hours to sulk.

So you can throw your toys out of the pram, you can have a tantrum, you can, if you're calmer, you could sit with those feelings, but you're allowed to get out that emotion. of how annoyed you are that all those plans have gone out the window and that that fitness might be going and that you're going to need to feel like you're taking some backward steps to get back to fitness and strength again. But then step two is that you go and do some research about what is it likely that I've done to myself? What's the best advice I can get?

And so you feel a bit more informed. You start to take control of the situation. Then we send you off to find experts. Who are the right? people that can help me with this. Who's the best physio to help sort me out? Do I need medical help? Do I need to see my GP? So what's going to back up this injury? And then once you've got all of that information and you've got kind of a team or the right people behind you, we look at kind of, we call it goal setting recovery. But to really help you feel like, yeah, I can control this. I've been told it's six weeks. Maybe that's two weeks of complete rest. And then it's rehab work. So you've got to. So you've got to. You can control. So you've been told it's six weeks. So you

can feel like you can see steps to recovery and not just getting back to where you were, but getting stronger than you were before. And that's some of the brilliant stuff you can do with rehab of, well, how can I use this? So actually, my strength and conditioning is better than it was before. So I'm less likely to get injured. And then we also look from the psychological side of how do we fill that injury gap? Because I think a lot of people will have really used during lockdown as an opportunity to go out and do fun things and to use time we might have been commuting or we might have been meeting other people to do some exercise. And so it's become really important to who we are. And we need to kind of fill that gap with other things so we don't

kind of sit around and feel like we're not achieving anything. Yeah, I can definitely relate to needing some time to sulk. I definitely had some sulk. I think I think I also didn't have a very linear approach to my sulking. I sort of felt fine and then I was really annoyed again and up and down, which I imagine is quite common. So one of the things you mentioned was seeing a professional or getting assessed by a professional. Now, we are in pandemic times and I have had a few questions about the idea of having an assessment over Zoom. And a lot of people don't really understand how that can work and how you can get the same experience or how you're able to assess properly over Zoom. So can you speak to that a bit, Mani? Of course. So when we go to

physiotherapy school, we are taught to do something called the subjective assessment. So the subjective assessment is where we talk about the exposure, the mechanics, your past medical history, your social history, the things that keep you motivated. And one of the questions I asked you, was do you think your knee pain will get better? Do you remember that? I do. Very much so. Yeah. So what we are doing there is we're evaluating you as a whole person. We're asking questions about your biosococicosocial element. So the biology and the psychology around your injury and what happened. And we are really trying to dig into who you are. And that's really integral. And we do that, yes, over a telemedicine or telehealth appointment. So we can do.

that over video. The one thing that is maybe, you know, what the public think is, physiotherapy is all about is us touching you. And yes, definitely we have this therapeutic element where we can have hand, you know, we can provide hands on treatment and soft tissue care and move joints. And that's definitely something we can do if we are in non-pandemic times. And actually, some clinics we have are still open and their class is medical centres. and they are still open, so anybody out there, there are some clinics still open. But if you are having a telemedicine appointment, it's basically more of an onus on you to be as, as kind of proactive as possible to really try and get to a point where you're following instructions really well. Physical therapists like myself, I work with like a lens behind biomechanics.

So I think about how your limbs move and how you're controlling that movement. And that helps me identify maybe areas where we need to work and which muscles we need to strengthen and how I can provide you with ways to offload tissue, allow it to recover, and then strengthen areas that can support that tissue which may have been damaged. So it can be really effective. It just means that you have to work a little bit harder to follow instructions. the hands-on therapeutic treatment, we call that passive treatment. The reason being is because you're having it done to you when you're injured.

And passive treatment's great. It gives you a short-term solution. It's not a long-term end goal, okay? So passive treatment, we find that the public, generally people feel passive treatment is what they come to physiotherapist for. but we do need to remember that the long-term solutions are with you because you are with yourself for the majority of the day and the time that you're away from clinic.

You come to clinic maybe once or twice a month. That's two hours in a month. All the other hours are all on you. And as Josephine said in thinking step two, you know, about taking action and doing your research and being proactive, but also being aware that, you know, this is a joint journey. And Suss and I have we collaborated and worked well as a team. And I think that's why she's got better.

I wouldn't say it's anything, you know, other than that. And that's, I think, where good health professionals come in. They talk about the dynamic aspects of care and how important it is to get to know somebody. and my passion is actually, you know, trying to change our perceptions. And I think at the moment, our perceptions are I need healthcare when I'm broken. You need healthcare. You need healthcare all the time. You know, you need healthcare for it.

You need mental health care. You need, you don't just wait till your teeth hurting to go to the dentist, do you? You go to the dentist, you go and get a checkup. Yeah. Seth, you wait till your teeth hurt. Yeah. It's not a good example, but I get what you're saying. And that's what I've learned about you as well, Seth, obviously, working with you.

You know, you've got a very kind of keep calm and carry on mentality, which we have to sometimes navigate. And I constantly tell you keep in touch. Do you notice that? Keep in touch is my key word for you. And the clinicians and their patients who, I don't say keep in touch, because I know they'll keep in touch. But for some, like you, we might need that keep in touch moment. And I would say that our health is almost at times, your health is like swimming upstream.

Keep moving your arms and you'll probably stay in one place. If you move your arms quicker, you can hopefully start to move up that stream. If you stop moving your arms, you're going to go downstream and we don't want to go downstream. I really like that. I love that kind of relationship element. Because there's two things we tend to see

and how well people respond to, different types of treatment. And one of them is the relationship they have with their clinician and whether they really trust them and they're going to really go and do what is suggested and follow that. So having that really good relationship is really important. And the other stat that always blows my mind is that 70% of people don't do the exercises their physio gives them. So that passive development feels quite nice because you feel like you've done something towards your health. You go and you lie on a couch and somebody, it feels like they're fixing you. But obviously, we all know the real work is done at home two, three times a day when you're

doing those exercises. And that's what makes the real difference. But actually 70% of people aren't doing that. So if you're one of the 30 that do, you're going to be recovering really quickly, much quicker. And there's some nice research that shows the people that kind of goal set, that recovery, do recover quicker. They do get back to full fitness much faster than those people that don't. So if you can build in any of those exercises into your goal setting and make it a real

project for yourself of yeah, I am going to do these X amount of times per day, I am going to be really diligent with this. It pays off so many dividends because you get back out running or hit or whatever your thing is so much quicker. I can definitely relate to that. The way I, managed to do my physio was to just approach it the way I would approach my marathon training. It was my complete focus and frankly because I had nothing else, I wasn't allowed to cycle. Obviously I was allowed to walk, but sometimes a walk just won't do. So yes, my physio was the one thing I could do that was, I could really, as you say, make it a goal and that was a huge part of. it and that's, I think, the only reason, yeah, that I've recovered. And I can understand the 70%

because I have been in that 70% before. And it's so stupid because you pay for an assessment. Someone who knows what they're talking about tells you what to do and then you don't do it. So there's no logic to it, but I have been there. So with regards to physio at home, One of the things that I think is really difficult is the environment. So previously, when I've had physio to do, you go into the gym and you at least feel, you know, that gym setting makes you feel like you're doing a workout. Do you have any advice for people who, I think it would be harder for some people to make themselves do the work at home, either if they've got kids, they've got distractions,

they just haven't got the setup that makes them feel ready to work. And also, they haven't got a leg press at home as far as I'm worried with those people. You're right about that. And, you know, I think adding on the 70%, we know that there's some key issues with, yeah, you know, rehab adherence. And I think from the perspective of kind of our behaviour, so, you know, I've been doing a lot of research around behaviour and I think it's quite an important aspect of understanding. our kind of patients and clients and ourselves. I think behaviour needs certain structures so that you can actually implement it rather than trying to force it. I think sometimes we think self-discipline is going to win and through.

But I think what we can do is set up – set ourselves up to win. So some of the things I did with you, Sess, I actually set you up to win, although it felt like you were losing something. So the cycling was a specific thing. I think that was setting you up to win because it was a non-negotiable and you didn't have any other distractions. So another thing we talked about was specific exercises

had specific goals. So on the day when we had an assessment, you could do only a certain amount of the exercises. And then I told you your goal would be in two weeks' time to be able to do this amount. And I would prescribe the specific amount for two weeks

time and ask you to do them daily so you'd got up to that total in two weeks. So I think creating some ways that we can create kind of the environment and the tasks so that

we win. So setting ourselves up to win. At home I would say for people who find it hard to do rehab exercise, you need to make sure that you implement this as a way of your lifestyle. So if somebody is not running anymore, I ask them to do their rehab exercises when they would go for a run and they get into their kit as if they were going for a run

and they do their rehab exercises at that specific time because we know that's an automatic lifestyle that they already have. So we set the environment and the context. So their brain, it doesn't have to think. It doesn't have to think, well, what time am I going to do it or what do I wear when I do it, or what do I use and all this kind of stuff. So that's what I would say. When I'm prescribing exercises to people who have children,

I ask them to get their children to do the exercises with them. And then I asked them, how did your children find it? And they tell me, well, yeah, my kid loved this exercise or, yeah, he was doing this great. And it just allows that family kind of environment. And it allows you, again, to not have to think, well, I need to put my kids away to sleep, before I do my rehab. Your kids can do your rehab exercises. They love them.

And a lot of the time, they'll do them better than us. So those are the things I would do. I just, you know, try and create the context environment and opportunity and motivation to do these exercises. So using like the combi model and just trying to create like a, you know, a way for people to just feel like they're going to win without having to try. So for people who are, maybe they're on their physiogny or maybe they've not even got to that stage yet, they're still just resting or moping or whatever. One of the recurring themes of what people said to us about their feeling was just this feeling of restlessness and cabin fever. And also this restriction, you know, running was their freedom or running was their way of clearing their head. like what would you suggest to people with that feeling, Josie?

So the final two stages of our kind of, those kind of steps to dealing with this, one of them is staying social. So we see that in athletes when they're injured, if they suddenly stop going to their club or they stop hanging out at their gym, they can get really, really miserable. So it's really important. They stay in touch with anybody that they were chatting to about exercise. And they keep that engagement.

But you have to be really careful with it because it can make you feel just utterly miserable. If every single time you look at Instagram is full of pictures of people who've been coming back from a run and you can't. So it might be a time to mute certain people or certain brands or things on social if it's making you feel miserable, but not shutting yourself off, not disconnecting from other people. And the other one is filling that injury gap. So we don't want anybody, even the most elite athletes, to only feel like they are a runner or they're a gym bunny. We want people to feel like they've got lots of different self identities. So what can you do at that time?

And what was it about, say, running that you really love? Is it that feeling of utter exhaustion when you get back? Or is it the headspace? Or is it being able to see beautiful nature whilst you're out? or is it half an hour to actually listen to a podcast without being interrupted by other things? And then look at how you can still get those elements, but not necessarily by running.

So it could be a walk, although when you're a runner, just walking can feel really, really tricky. But it could be shutting yourself away on your bed quietly with your headphones on listening to that podcast. Or it could be going for a bike ride or finding something else that still gives you that element you're missing, but accepting that it's for a short amount of time,

and that acceptance can help of six weeks. I can handle six weeks. We've all spent a year doing things that are different than we ever imagined now. So putting it into a much shorter time frame of, I can handle this, but I'm going to use it productively. What can I do during this time? That still makes me feel good. I love that idea about either putting it in your diary

or when you would go running anyway, doing your rehab then. And I'd say put it on your to do list because when you get to tick it off your to do list, your brain gets to release some dopamine. It feels like it's achieved something and you get that nice buzz of reward. So you still get some of those elements

of what makes you feel good from the running even though you have to mix it up a little bit for a while. Yeah, I definitely feel like, I had to treat physio-like my achievement of the day. Because there was one comment that came through that struck a chord that was taking time to heal and not seeing that as failing. There was a lot of people commenting and discussing that feeling of failure. And I suppose it ties into what you said at the start about you're on this fitness journey and then you suddenly feel like you're going backwards.

So is there a way that you can reframe that in your head when you have to take some time? I love Rob de Roosie, the MMA fighter, has a brilliant autobiography. And I love a section in there where she talks about where she was trying to make it. She hadn't made it yet. She was living in her car. She had no money. She was injured.

And her reframe of that situation was, this is going to be the turnaround point in my autobiography. And I love that kind of big picture of going, I will be able to see this as a really important part of my journey. And so being able to see in that bigger picture then of, okay, I feel rubbish right now, but I can see that I'm at the bottom and I've only going to come up from here. And so I like thinking about it in that way of that real acceptance of, okay, everybody gets injured. There was some stats I saw that basically one in 20 million people. have a body that is pretty robust and is unlikely to ever get injured.

That's three people in this entire country. So I kind of like that to put it into the context of it's not a matter of if you get injured, it's when, especially if you're pushing yourself, especially if you're trying something different, especially if you've got all the stress that we've all had going on of this crazy time over the last year. So it's kind of, we're going to accept that we are going to get injured, at some point. And often when I'm working with athletes on goals, we'll almost build in some of that time into their kind of year-long plan. So that instead of getting really upset and seeing

everything disappearing out the window, you can think, okay, this was the injury I was expecting. It was going to happen at some point. Let's get it out the way now. Let's come back stronger. And that can help you kind of deal much better with some of those stresses that it brings. Yeah. I feel like that is so reassuring to find out that. only three people are robust in that way because I remember Manny and I had an assessment where I started off being a bit miserable and I was explaining, I don't know, I just made some offhand comment about not having the ankles to run or something. I don't know.

I was just being mopey and I can't remember exactly but Manny, your reaction was quite, I don't know, quite simple in your disbelief. in your like, where have you got this from? Yeah, I think there's an element where we have to, we have to like re-examine what we think is an injury as well as what rest is. So rest is part of the training schedule. So we have to recover.

Now, if you take a rest day, are you going to lose fitness? If you allow your body to recover, are you going to lose fitness? You know, injuries are hard to deal with? but at times they may be part of the journey and the story. They may be the catapult, as mentioned. They may be the turning point and they may be the fuel that you need. So I'm reading a book called Originals by Adam Grant and one of the lines in the book says pessimism can be the fuel.

I think sometimes with our social media, digital age, we can get obsessed with optimism. And as long as you're pragmatic, I think you probably need a balance of both. And as long as you can really critique and identify, you know, this is a difficult situation I'm going through. But this recovery and this process will teach me that training at this intensity at this time will cause me to have an injury because that's what happened. I need to be a bit more careful about this and it will teach you more about your body and help you understand, you know, how to manage yourself in the future. And one story that I can give you anecdotally about me is I had an ankle fracture for two years

that was misdiagnosed. I went to different A&E departments within London. And it basically gave me the fuel to become a physiotherapist. So you can always use a difficult situation. And, you know, what's the saying? Find some lemons, make some lemonade, right? If there's one thing an injury does, it just makes you learn about yourself. There's a lot of learning every time.

But yeah, I do think you come out. I kind of think when you speak to runners who are lucky enough to have not had anything go wrong yet, you just kind of think, I don't know. You don't know yet. Maybe that's just me trying to make myself feel better. Yes, can I give you a little stat? So research shows once you get to about five years of running, your self-regulation improves so much that your risk of injury reduces by like a huge chunk.

I think it's about 40%. So as you get better and better running, you start to realize when you're going to push yourself closer to injury. So yeah, the more experience you're getting basically the less likely would hope that you should get an injury. Great. I think I've gone past five years, which is a bit... I would add to that, though, something that you tend to do more as you get more into it is keep things like training diaries. And a training diary is absolutely awesome for reducing your risk of injury because you can start to spot patterns and you can spot when you get niggles and you get things that don't feel quite right. And if you start to note that kind of stuff down in your training diary, you can speed up that kind of internal awareness of what your body is.

is doing and what it does and doesn't like doing. And you can go and see somebody quicker rather than waiting for it to turn into a full-blown proper injury so that you don't end up with so much time off. Yeah, I definitely think that's the final lesson to learn for me is the not just dismissing a niggle. Knowing the difference between a niggle and a pain, that's a real skill. But that's also context-specific.

I think, you know, what you're doing there, which is amazing and we need to try and do this more within our profession is teach basically pain science and pain science is one of the myriads of musculosclotal care so pain science is the ability to differentiate and tell the difference between something that's non-harmful to something that you need to get advice about and it's very difficult and we continue to learn as human beings all the time because we get maybe a new injury or a new new input or new pain response and that that all takes time to kind of process and learn so um what you're what you're talking about is it's difficult um so yeah it's a challenge and i think it's important to really try

and read your own body of what's pain and what's discomfort so when you're doing sports it's okay to feel discomfort, you're pushing yourself harder than you have before so you become stronger, but you shouldn't feel pain. And when you can start to really try and learn the difference in your own body, then you can respond in a much better way so you reduce the risk of long-term injuries. Yeah, that's definitely the thing to finesse on my side. So there's been so much discussed there. We've talked about so many steps that people can take. The key takeaway for me is that it's okay to solve, which I'm very happy about. Is there anything else that either

you would like to add? I think just kind of circling back on the pain and discomfort, just a really rough guide, we would expect something that's uncomfortable to be within a pain level score between zero and 10, between about four to six out of 10, and it should resolve within

48 hours. So if something is within that element, we would say that's uncomfortable. If something goes beyond six out of ten, it's a very new pain. It's a new pain experience. And it's affecting the way you walk or sleep. Those are things that we look to get a diagnosis for. And if it's longer than 48 hours, just seek some medical advice. And start with your GP if you're really concerned.

And if it's a muscle or tendon or something you've had before, a physiotherapist can give you some advice. But that's just a really quick guide on how I would speak to people in terms of deciphering discomfort and pain. And I'd say that element you talked of at the beginning about guilt, we see that so much in amateurs and elites, that rest feels like you're cheating and you're not determined enough and you're not focused enough. So I really try to remind people that rest and recovery is when we get stronger.

We don't get stronger when we're running. We get stronger when we're resting and we're recovering from it. And if you can repeat that to yourself a lot and almost use it as a mantra, that helps to take away a little bit of that guilt. Oh, brilliant. Well, thank you both so much for coming on. Thanks for having us. Thank you for having me.

I hope you enjoyed that. And if you are struggling with a sports injury, I hope that your journey has a satisfying upward arc like chess is. As ever, if you want to comment on anything that we've raised in this episode, get in touch, in the show notes. Now, we know that you lot love when we do episodes of the pod focus on things like body image and self-confidence. So if you're into that stuff and you want to learn more, keep an ear out because we're going to be dropping a four-part mini series sponsored by Phillips

aimed at helping you improve your confidence. It's part of our Project Body Love initiative. And if you want more things, body confidence, you can register for the Project Body Love event that's running from the 15th and 16th of May. The link is in the show notes. That's all from going for goal this week. We'll be back next Tuesday. Bye.