How injury can lead to insight and teach you to listen to your body

RIGHT AS TWO PEOPLE WERE about to jump on the other end of the teeter board to launch Dr. Monique Burton into a double back tuck, she could tell her positioning was slightly off. But since she was relatively new to the seesaw-style apparatus used by circus performers, she didn’t know in the moment precisely how to adjust.

As soon as she launched, the pain in her leg was excruciating.

Once she came down and took off her safety belt, she discovered something was terribly wrong — the force of the launch had fractured her tibia where the shin bone goes into the knee.

The fracture required immediate surgery. After that, she was on crutches for two months with no weight on her leg, and had many months of additional healing ahead.

As a sports medicine pediatrician at Seattle Children’s Hospital and volunteer physician for USA Track & Field at the Beijing, Tokyo and Paris Olympics, exposure to traumatic injury is not out of the ordinary for Burton.

But experiencing it herself — and the monumental effort it has taken to recover in the nine months since — gave her a new level of compassion and understanding for her young patients.

“To me, injury impacts somebody at all aspects of them,” from identity to daily function, she says. “If I heard at the beginning it was over a year to normal, I think that would have been really traumatic for me.”

An injury is jarring and disruptive, from forcing you to go slower on the stairs to preventing you from running on the weekends. It can be easy to fixate on the pain and how to make it go away. But when you take a deeper look at what your body is communicating through injury, it also can lead to a new perspective on your body (and life) that can point toward better health overall. 

Injuries and, more crucially, pain are an inevitable part of being human, says Betsy Rigsbee, lead physical therapist for Pacific Northwest Ballet. The main purpose for pain is self-preservation and protection; it’s your body’s way of reminding you something is not working.

The way your body generates pain depends on a complex interaction of your immune system, genetics, environment and other factors, Rigsbee says. 

Pain is also your body’s learning system, she says. 

While nobody wants to feel pain, it serves a function. It’s feeding you information such as slow down, reduce your stress, or it’s time to move more and get stronger. Even with chronic pain, your body is talking to you.

When you allow yourself to absorb the information that pain is providing, it can take the experience of injury and recovery to a profound place, with new insight into your body, your health, your habits, and even who you are. From there, it could become a new beginning, a time to see your health and ways to support your body with new eyes and actions. 

Four elements of wellness

If you’ve had a severe injury before, you might have learned about preventing future injury with more thorough warm-ups or intentional periods of rest to help your body repair and recover. But keeping your body healthy also requires a bigger-picture approach. 

PNB’s Rigsbee spends much of her time thinking about and helping professional dancers stay healthy. No one ever wants an injury, but when people’s livelihoods depend on how their bodies perform, the stakes are particularly high.

Injuries typically fall into two categories — the traumatic ones and the ones caused by overuse or repetitive use, she says. Either way, there’s no straight line to recovery. And that’s partly because every person approaches healing differently. 

Some people might think of injury as something you have to power through; they perhaps could be pretending nothing is wrong (maybe you know this person), maybe because they have a high tolerance for pain. 

Other folks look for support. That can look like going to the doctor for a diagnosis or enlisting physical therapists, chiropractors or massage therapists to assess how to get back to healthy movement patterns again. 

Rigsbee’s philosophy around injury and healing can be boiled down to four key components that apply to anyone, no matter where they fall on this continuum and how active they are. These elements are so basic and obvious you might bark with laughter when she names them. Ready? 

Sleep. Hydration. Fuel. Managing stress.

“These four things day in and day out I preach to my professional dancers,” she says. “It’s so universal. It’s so human.”

In some ways, the reality of a professional ballet dancer’s life is not so different from you and me. Some are married, some have kids. Some have pets. Some are passionate about their church or other organizations they work with on the side. They like to veg on the couch. They scroll social media. Some don’t sleep well. Like us, they get stressed about work.

But unlike us, they sometimes jump upward of 600 times on an intense day and call it their job.

While the basics of recovery apply to everyone, Rigsbee says, they’re especially essential for her dancers. Like other professional athletes, they contend with demanding schedules that stress their bodies in different ways that ramp up the potential for injuries. If they’re not getting enough sleep, or are dehydrated, or if they’re not giving their bodies nutrients to recover from dancing for six hours a day, they are at a much higher risk of overusing a tendon, muscle or a ligament, she says.

It’s been well established by research that your body can’t differentiate between a co-worker being upset with you and being chased by a bear. Repeated or chronic stress makes it much harder to recover, Rigsbee says, and managing stress is as difficult for dancers as for anyone else. 

“I would love to see more people spend time and money and effort and energy into those four things in terms of reducing their risk of injury and promoting their body’s ability to recover,” Rigsbee said. “Those are great things that will help you be a healthier, happier human in general.”

For anyone wondering the simplest way to prevent injury or to recover well from activity, Rigsbee likes an analogy she learned of thinking of yourself as a cup. What are you putting in there? Enough sleep? Good nutrition? Stress from a divorce? Weakness in the body? If the cup is overflowing with stressful things, you’re more likely to have pain or be at risk for it. In that case, modify the things in the cup, like getting more sleep or changing how you are eating. 

In some cases, you can build a more resilient cup, for instance by strength training to build more power and so your body can recover faster. 

“Sometimes you only have to change a little bit of one thing to tip the scales enough so you’re not having pain,” she said. 

Listening to the body

Injury can be a loaded word that brings up beliefs, attitudes and fears, says Greg Yasuda, associate professor of the School of Naturopathic Medicine at Bastyr University. It reflects how you think about health, and what it means to you, he says. How you think about your body at age 50 will be different from how you thought about it when you were 20, he says.

His father, for example, is experiencing heart failure at 89. He doesn’t care to do more, so Yasuda, a doctor of naturopathic medicine, doesn’t push him to take on new protocols. If his dad were panicked and upset, he would approach him differently.

When a patient comes to see Yasuda, he listens to what they want to share about the pain, how it’s affecting their daily life, and their concerns — and he looks for connections in what they say. 

In Chinese medicine, there’s a correlation between organs and emotions. Lungs are connected to grief, for example, he says, so if someone has an issue with their lungs, he might ask questions about grief. As a student, he didn’t give these connections much credence. But after being in practice for 26 years, he sees them all the time.

He tries to get his patients to see their pain from a new perspective, aiming to help them come back to balance in their body, whether through rest or finding ways to lower their stress.

“Health itself isn’t very motivating,” Yasuda said. “Most of us know what we should do, and we don’t do it. It’s this sort of distant payoff that we don’t measure.”

What he finds more motivating for people is often unexpected — he talks to his patients about what brings them joy.

As a young naturopath, one of his patients had severe eczema, and despite multiple approaches, nothing had worked to resolve it. He found out that she was stressed about her grandkids moving, so they came up with a plan for her to see them regularly after they moved. Later, he bumped into her, and she told him her eczema was 60% better, after nothing else helped.

“If we’re not enjoying our life, we don’t have a lot of incentive to make it better or make it longer,” Yasuda says. 

One of his patients, Ann Bradford, is an avid walker, who walks anywhere from 2 to 8 miles daily. But when she started having severe pain in her knee, she found herself going up and down the stairs one foot at a time.

Yasuda noticed her hamstring felt tight, so he suggested softening into the area that hurt. And then asked her if there was another purpose for the pain, a reason it was showing up right now and if there was something for her to learn from it, she recalls. 

Her mind went back to difficult childhood experiences. Making the connection to that time helped her see that experience in a deeper way. 

“It was so powerful and profound I literally burst into tears on the way out of his office,” Bradford tells me. Within a week, the 72-year-old was back on track with her regular walk routine.

Sara Bayer is the clinical director for acupuncture and East Asian medicine at Bastyr. When she thinks about injury or pain, she also considers how pain is a way for the body to communicate it is out of balance.

Sometimes, you don’t realize you’re doing it to yourself. Competitive sports, for example, can create imbalance because of the intense pursuit of a repetitive activity.

It’s possible for competitive athletes to have balance, though; Bayer points to ultramarathon runner Scott Jurek, who is famous for being one of the most dominant ultramarathon runners in the world.

“He did it with such equanimity and clearly had such a mental process that made him not hurt himself,” she says. 

But seeing physical symptoms, such as back or knee problems, and knowing in your body when you are out of balance is essential to helping prevent injury, a glaring sign of imbalance. People can struggle with this, Bayer says, and some patients dismiss symptoms for a long time.

But people can learn to listen to what their bodies are telling them. Practices like meditation, tai chi or qigong can help you notice what’s happening internally, so you can take steps toward balance and wellness.

“If you develop that inner vision, you’ll know if you go for a run if you’re exceeding the bounds of the ability to have equanimity,” she says.

Time and space to rest

After the surgery to repair her knee after her circus accident, Burton initially thought she would use her medical leave to get another board certification or build a gymnastics sports medicine program. 

Her body had another plan. 

She spent most of her time sleeping, and she was frustrated that she couldn’t stay awake for more than a couple hours at a time. She was experiencing pain so intense, it affected her ability to think; she could not function the way she normally did. About a month into her recovery, she realized her body was telling her something. 

“My learning in all this is centered around what do I need in my life to actually fully heal and let myself have the grace of, ‘I’m not going to get another medical degree during this time,’” she says.

She also needed space to process the injury itself and experience the grief and emotions around not being able to do what she wanted on a daily basis. There were other moments she didn’t anticipate, too, like getting emotional during a drop-off for her daughter at the gym where the injury happened about the idea of going in and seeing her circus friends. 

Burton recognized a lot of her patients might also feel emotional after an injury and now she talks to them about the process of returning to the place where they got injured and how it feels to not be able to participate in their life the same way.

But her lessons extend beyond the injury itself to how she was feeling in her life then. Around the time she got injured, she was feeling burned out.

“I remember walking to work and thinking, ‘I really need a break,’” she says. Fatigue is another major risk factor for injury; she got hurt at the end of class. 

Since her injury, Burton has become more intentional when she feels overwhelmed. She is more likely to listen to her body, then ask herself, “do I need a break or to change my schedule?”

Burton also realized she needed a lot of support taking care of her mental health during her recovery. Now, with her own patients, she spends time helping them see the lesson from an injury, like if it’s now time for them to take an art class. 

Several months after the injury, she’s still on the path to seeing everything there is to learn from it. But the key ones are in place.

“Listen to my body, slow down, and think about what’s important in my life, and emphasize those things that I was neglecting.”