Ep. 51: Heidi Armstrong – Engaging the Parasympathetic Nervous System to Enhance Your Healing

Injury recovery can be even more painful if you’re an active person or athlete.

It’s true that no matter the level of activity, every person who is injured suffers. This is because it’s not only our physical body that gets affected but our emotional and mental ones as well.

And when it comes to athletes (or just very active people), sometimes we might think “They’re fine,” right? Because they already know how to deal with difficult situations, for example when hitting a ceiling with their progress or how to find motivation to keep going.  Even though this might be true to a degree, and it might help a bit, in my experience any type of injury gets us unprepared and even though we think we knew how to get through this, there are nuances that we just didn’t expect.

So, yes, perhaps your body might be in better shape overall, but when you get hurt, being unable to move like you’re used to can lead to mental and emotional suffering. Period.

And on the other hand, pushing too hard so you can get back to your active lifestyle can turn out to not be so beneficial.

Heidi Armstrong, the founder of Injured Athlete’s Toolbox, was drawn into injury recovery coaching the same way I was – through her own injury, and the realization that there are better ways of supporting injured people than what she herself received, especially when it comes to the mind-body connection and creating the best possible conditions for healing.

In this interview, you’ll discover:

  • How to choose the right team of health practitioners to support your recovery.
  • What to do to start engaging your parasympathetic nervous system to help you heal better and faster.
  • How your negative emotions affect your recovery and what to do to change them.
  • Why ‘taking it easy’ during recovery can be stressful, especially for active people, and how to address the underlying reasons.

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Show notes & links

The show notes are written in chronological order.

  • Heidi Armstrong’s website: http://www.injuredathletestoolbox.com/
  • Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Frontiers in psychiatry9, 44. [read it here]
  • How the Parasympathetic Nervous System Can Lower Stress [read it here]
  • Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories (Shapiro, 1989a, 1989b)
    • Episode 18: Dr. Esly Carvalho – Exploring the EMDR Method for Healing Trauma
  • The Internal Family System is a transformative tool that conceives every human being as a system of protective and wounded inner parts lead by a core Self.
  • Hämmig O. (2019). Health risks associated with social isolation in general and in young, middle and old age. PloS one14(7), e0219663. [read it here]

00:00 – excerpt from the episode
00:57 – intro (listen to discover a little more about your host. Martin will tell you a new lesser-known fact about Dr. Maya)

01:35
Dr. Maya Novak:
It’s true that no matter the level of activity, every person who is injured suffers. This is because it’s not only our physical body that gets affected but our emotional and mental ones as well.
And when it comes to athletes (or just very active people), sometimes we might think “They’re fine,” right? Because they already know how to deal with difficult situations, for example when hitting a ceiling with their progress or how to find motivation to keep going. Even though this might be true to a degree, and it might help a bit, in my experience any type of injury gets us unprepared and even though we think we knew how to get through this, there are nuances that we just didn’t expect.
So, yes, perhaps your body might be in better shape overall, but when you get hurt, being unable to move like you’re used to can lead to mental and emotional suffering. Period. And on the other hand, pushing too hard so you can get back to your active lifestyle can turn out to not be so beneficial.
In 2020, I sat down with Heidi Armstrong for our second deep conversation about healing physical trauma, and since she has more than 10 years’ experience recovering from her own injuries, she’s a wealth of knowledge and tools that can help you out. Enjoy.

03:07
Dr. Maya Novak:
In this interview, I’m joined by Heidi Armstrong who is an Injury Recovery Coach and founder of Injured Athlete’s Toolbox. She’s one of a few experts in the world who helps athletes overcome the mental and emotional fallout of injury. Heidi coaches injured athletes to refocus their intensity from physical to mental training, thus stopping the emotional roller coaster because the body follows the mind and positivity means faster healing. Heidi, thank you for being here.

03:38
Heidi Armstrong:
It’s my pleasure, Maya.

03:40
Dr. Maya Novak:
I’m so very excited about our interview. You’ve been a guest speaker on the previous Summit and so many participants really enjoyed what you were saying and what you were sharing. So, I know that this one is going to be amazing as well. Now, for those who don’t know you get, can you share a bit about yourself, about your story. How did you actually become an injury recovery coach?

04:04
Heidi Armstrong:
Yes, it was actually quite by accident and it was by doing injury the complete and totally wrong way. So, in the early 2000s, I was a professional mountain bike racer. I had a crash, injured my knee, ended up having one surgery, and didn’t get better from that. I had another one and then just had an identity crisis, a total meltdown. Thanks to an invention from my best friends who told me you cannot do this this way anymore you’ve got to get help, I put together a care team. And I had nobody to speak with and no idea what to do, but the first thing I did was I got a psychotherapist, and then I got a different physical therapist, a different orthopedic surgeon, acupuncturist – so, I put together this whole care team. It was actually my physical therapist that said, Heidi, you’ve got to start using your brain in different ways, and if you don’t do that, your body is not going to heal. And so he actually told me to go get a camera, and he said you’re a chemist, and he said you like science, go learn about the physics of light and lenses. Put your camera on manual and learn how to use it. And so I started doing that and I realized when I was looking through the lens of the camera I could not focus on my loss of identity, my pain, and all of that fallout from my injury. I actually had a place of peace. I began to do other things in that same vein. Like specific types of therapeutic journaling, and yoga on the floor. I did these things every single day and then my attitude started to change and then my care team noticed. And so the first call I got was from my orthopedic surgeon and he said, hey Heidi, I have this patient who’s an injured athlete and he doesn’t need a psychotherapist at this point, but he needs to talk to someone else who’s been the hole. Because something we all go through when we’re suffering or in pain is, I must be the only one going through this. And so he said can I give him your number, and I said sure. And so he did and I worked with this guy informally for a few months, and then started working with other injured athletes informally. At any given time, I had maybe two or three of them that I was speaking with and helping guide them through the mental and emotional fallout of injury. And then in November 2010, I had a second injury that completely changed my life and I had to quit my career. It turned my life totally upside down, and so I thought, you know, I’ve been doing this for more than 10 years and it’s something I really love, and so I want to first do some research and then I want to do this fulltime. I want to help injured athletes overcome the mental and emotional fallout of what happens after they get hurt. So, that was a brief – even though it doesn’t seem brief, it actually is – but a brief description of how I got into it.

07:07
Dr. Maya Novak:
Well, thank you for sharing this. I think that a lot of people can identify with struggles when you are injured and when you have a serious injury because it’s not just like a flu type of thing, let wait for two weeks and then I’m completely okay. It’s a completely different story. So, let me ask you this, what was the most difficult for you emotionally, mentally, and physically? What was the most difficult thing when you were injured?

07:38
Heidi Armstrong:
Physically, my second injury that I had in 2010 resulted in a very, very rare condition in my knee called arthrofibrosis, so it’s a scarring of my knee joint. It’s exceedingly rare, as I mentioned. There are about four doctors in the world who really know what they’re doing with it. And so, physically, finding the right doctor and then learning about this condition that’s rare, and then having six surgeries – a total of eight too – the first two were botched. The last six I had to travel to Colorado. I live in Texas, so I traveled there more than 20 times for six surgeries. And so just having something that is so rare and that is chronic. It will never go away. I’m functional now, but extensive limitations. I spent – I call 2012 the year I spent on my back because I did. I had four surgeries in a very short period of time. So that’s the physical challenge, and that was the hardest thing that I had to go through physically. Mentally and emotionally, this one completely bushwhacked me. As I started to get better physically and really turn a corner and think maybe I don’t need more surgery, I remember the specific day. I was lying on the couch and I had to put my leg in this machine that – most people that have torn their ACL, they know this, it’s called a constant passive motion machine or I also call it the constant party machine. You put your leg in it and it slowly bends your leg back and forth. I was lying there and this intense wave of anxiety came over me, and what I realized in therapy was that it was all from trauma that I had experienced in the past. It was because of abuse and neglect as a child, and it was completely overwhelming suffocating anxiety, to the point that I was suicidal. I didn’t want to be here anymore and went through months and months and months like that. That was because I realized that I had used movement in my sport, and my achievement in sport, to stuff down all of the emotions from things that happened in my past. What I’ve come to realize in my practice is that so many of the people with whom I work have the same exact story.

10:17
Dr. Maya Novak:
Let’s talk a bit more about this because this is such an important topic, what you just explained because I’m seeing this very often as well. While you are able to move, and while you are able to be like normal and everything is fine, but then with an accident, and then with an injury, and especially with more a more serious injury or with a recovery that just takes longer, months or perhaps years, sometimes is different. Something changes inside and we don’t have that outlet for that stress. So, can we talk a bit more about this? Why do you think that this is actually happening? Is this connected to something that we did not resolve in the past and now it’s just come to the surface? Or what is your view on this?

11:07
Heidi Armstrong:
Yes. So, we all know people who, for instance, run and they say oh, I’ve become insufferable and nobody wants to be around me when I can’t run, or I can’t stand to be around myself when I can’t run, or I feel stressed out when I can’t run. That’s because running becomes a tool to push down emotions that that person doesn’t want to feel. And so for me, it was riding my bike. If I felt stressed out or just had this low level of anxiety, I could go ride my bike. I would say oh, it’s like meditation, it makes me feel good, and it’s healthy to move. So, I sort of hid behind this construct of the cycling is actually helping me heal. Really, what it was doing was creating a space for me to not feel all of the things that I had experienced in the past. So it just becomes like – imagine when you were a kid and you were playing in the pool and you have a beach ball and you shove that beach ball under water. You can only hold it down for so long before it just comes right back up and hits you in the face. That’s what the injury does. It lets all those emotions come back up and hit us in the face. While some people may say I don’t want that to ever happen, for me, I would say it was one of the best things that ever happened to me because I got to process that trauma and go to therapy and deal with the real feelings that kept driving me to move and move. And that helped me as a person.

12:44
Dr. Maya Novak:
Mm, this is a really great point and what you said with this ball under the water. I think it – as I see it – if someone is letting all the stress and everything out through the movement, then this is a mechanism that they try to do and they try to push aside all those feelings and everything. So, in this situation it’s really stressful, a different situation, it is harder to push aside. What, in your experience, happens if we still try to push, don’t look, I’m going to ignore this, and I’m not going to do anything about this. Can this potentially affect also how we heal, how our bodies physically heal?

13:31
Heidi Armstrong:
Yes, and this is a very interesting and good question. So, I’ve noticed several things. One is that if we have a strong drive to get back to our sport or the way that we moved that helped us destress, that leads to really bad decisions in the recovery process. So, it leads to not paying attention to the feelings that are coming into it. And it leads to not paying attention to restrictions. It leads to overdoing doing things. And then it can also lead to people not wanting to do their home physical therapy or their exercises they’ve been assigned by their physician. And so all of that is because they just want to push aside the injury, and what is, to return to the sport. So it leads to bad outcomes physically. Then it also leads to bad outcomes mentally and emotionally, which then feeds the physical. So it becomes this huge cycle. And if athletes are injured and they’re just focusing on getting back to their sport and feeling that stress, that’s a part of the brain, the sympathetic nervous system, that’s just constantly stressed out. When that part of the nervous system is activated we release stress hormones, and those stress hormones interfere with healing. As you say, and I say, the body follows the mind. It’s not the other way around. If the mind is in this ditch of despair and woe is me, then the body just doesn’t get better for multiple reasons.

15:14
Dr. Maya Novak:
Yeah. This is really, really, really good. Now, you are talking about athletes and I know that a lot of people that you work with are athletes, but does this word athlete also include people who just love to work out or just love being active? Or is this like there is a lady or a guy with a $10 million contract in a sport?

15:42
Heidi Armstrong:
This is everybody. I should back up and mention a little bit of the research that I did. I talked about the year I spent on my back. In that year, I did research with more than 200 injured athletes and more than 100 clinicians. I wanted to discover a couple of things. One is what words were people using to describe their suffering, and then I also wanted to discover – the people that seemed to learn from their injury and gain more resilience, what habits did they have in common. And then from the clinicians, I wanted to find out what their biggest challenges were working with injured athletes. So, right away I had to redefine the word athlete because I realized that everybody that’s injured goes through the same thing. To me, an athlete is anybody who enjoys movement. The people with whom I did research were people who were avid dog walkers, people who gardened, people who did jazzercise or some other form of exercise with their girlfriends at the YMCA. These were not high-level athletes, the majority of them. I did have some professional athletes in there. But what I discovered is that it doesn’t matter – somebody’s age, sex, sport, or level within the sport. They all experienced the same thing. So, it doesn’t matter whether someone has a $10 million contract or they like to walk their dog. They all experience the same thing, and you’ve probably seen that in your practice too, yeah?

17:14
Dr. Maya Novak:
Absolutely. We are wired similarly, so it doesn’t matter who we are or what we have. When something happens when we are in this type of situation, very often we act and react in a similar way. Now, what we do with that is the most important thing.

17:34
Heidi Armstrong:
That’s exactly right.

17:34
Dr. Maya Novak:
Pushing it aside and trying to ignore it is not the best strategy, also because the potential, and what you explained before, what can happen because of our decisions and how this can affect our physical bodies. It’s one of the reasons of why it’s not really a good thing to push things aside and let me just ignore it.

17:54
Heidi Armstrong:
Mhm.

17:54
Dr. Maya Novak:
So, in your research or just in general in your experience, what are some of the most common negative emotions that injured athletes, injured people have that they feel?

18:09
Heidi Armstrong:
This came right out of my research and it was absolutely undeniable that the suffering is universal. So, the four words that came up most commonly were frustration, impatience, anger, and sadness. Women tended to use the word sad more than angry, and men tended to use the word angry more than sad. And then also disconnection - people would say that they feel disconnected from their own body. Like my body that I use to connect with this world and be outside and be in nature, it doesn’t work the same anymore, or it’s broken, or it’s never going to work the way that it used to. And also disconnection from their social network, like their teammates, their walking partners, the people they used to meet at the gym or at the pool. So, they’ve lost their community.

19:02
Dr. Maya Novak:
Yes, it makes sense, absolutely. So, I just want to touch on something else that you mentioned at the beginning, and that is that when you were recovering, you were changing your medical team – or you were looking for another doctor and so on. Now, very often, what happens is that when we get injured, we go to the doctor and that’s actually it. Whatever we hear there, we sort of accept that. Can we talk a bit about how important it is to find someone who we feel good with, and if that means looking for a second, third, fifth, tenth opinion, that we are not actually afraid of going there.

19:54
Heidi Armstrong:
Yes. Amen. So, what I would say first to everybody watching and listening to this - you matter and you are important and you need to find somebody who makes you comfortable. What I hear often from people is, oh, well, he was a really good doctor or he is a really good doctor, and he’s the team doctor for such and such a sports team and he’s really good, and he’s doing his best. And then I also hear, well, I don’t know about switching doctors because I don’t want to let my doctor down or I don’t want to insult my doctor – when that person isn’t even getting better. And so I think it would be time to take a step back and say why are you putting how your doctor’s going to feel about this in front of how you actually feel and your progression after your injury. It’s very, very important to find a medical team, a doctor or a physical therapist or a massage therapist – whoever you want to be on that team. That team needs to include people who will be present to you, will hear you, will listen to you, and will not tell you that you need to go see a psychiatrist or the pain is in your head but will help you find the tools you need to get better. Even if they don’t have the tools right there, they know to say okay, you should see this person or you should see this person. The other thing I want to say is I work with a lot of people who have chronic and life-changing injuries and by and large, physicians who become orthopedic surgeons are wired to fix things that are broken, and that’s wonderful, fantastic, and great, and we need that. And also, there are people who end up in one section of the bell curve who have conditions – like I’m one of them – that won’t ever get better, that become chronic. And so when somebody who is wired to fix something that’s broken encounters a problem that’s chronic and really can’t be fixed but needs to be managed, there’s a cognitive dissonance there. So, when people are looking for a medical team and they have something that’s chronic, difficult, or not healing properly, they need to make sure that that physician has the mentality and the brain wiring to be able to work with a situation that doesn’t have an obvious solution.

22:41
Dr. Maya Novak:
Yes, and this is very much connected to what we talked about before with negative emotions. Because if you are just sticking with someone because you don’t want to offend them or because you are afraid to speak up or something, then what is happening inside of you – it can be fear, it can be frustration, it can be then anger or resentment, everything, and then this affects your physical healing as well. Now, can we talk a bit about how our negative emotions affect our healing a bit more?

23:10
Heidi Armstrong:
Yes. So, I touched on the sympathetic nervous system earlier, and I think it’s very important for people who are injured to understand a little bit about how their nervous system works. What I tell people is understand this so that you can work your – let me back up – let’s talk a little bit about how our nervous system is wired and how it’s broken up into two parts. I think it’s really important that people who are injured understand this because that way they learn to work with their nervous system instead of their nervous system working against them. Our nervous system is divided into two parts. There’s the sympathetic nervous system, which is the one that all of us are very, unfortunately, familiar with. This is the one that increases our heart rate, makes us feel nauseous, sometimes gives us a headache, and sweaty palms. If there’s a hungry tiger chasing us, we run from it. The stress of injury, like oh poor me, I can’t believe this happened to me, or just the stress like the frustration and the anger and all of that is the sympathetic nervous system. It’s like the gas pedal of our nervous system. The opposite side is the parasympathetic side and that, thank goodness, is responsible for things like our heart rate, our digestion, and a lot of involuntary things that happen in our body. It’s also the brakes of our nervous system, so it can help calm us down. When we’re engaging in things like yoga and meditation and therapeutic journaling and any creative practice, we start to feel that calm and that oh, I realize I didn’t think about my knee for the last half hour I was so engaged in whatever it was I was doing. That’s the parasympathetic nervous system. There are research-documented specific ways that we can engage that. The more that we can engage our parasympathetic nervous system, the less we’re engaging our sympathetic nervous system and the more that creates an environment mentally and biochemically for us to heal physically.

25:35
Dr. Maya Novak:
Oh, I love your explanation. One thing that you mentioned at the beginning was ‘poor me’, why did this happen to me. Can we talk a bit about this? Because this is connected to a victim mentality and something happening to me and poor me and I don’t have any power over this. We’ve all been there. I mean it’s not like no one has ever experienced that, something happened to me and poor me. Can we talk a bit about victim mentality, and how this also affects healing and the whole process?

26:16
Heidi Armstrong:
Yes. Victim mentality is a really good example of something that engages our sympathetic nervous system.

26:26
Dr. Maya Novak:
We'll continue in just a moment. I wanted to quickly jump in for two things. First, thank you for tuning in. And second, I’m sure you have at least one friend, colleague, or family member who would very much appreciate this episode. So share it with them and help us spread the word. Now let’s continue…

26:47
Heidi Armstrong:
After we get injured, we all go through a grieving process and we go through each step of the grieving process. In one hour, you could feel acceptance, in the next hour you could feel angry, and you go back and forth at the beginning. What I tell my clients is to take a piece of paper and write down a date by which you feel like you can begin to pick up the pieces and move forward. Is it two weeks from now? Like how much space do you need to process this emotionally because that has to happen, we have to move through that. Then hang it on your refrigerator and if you don’t honestly feel by that date that things have begun to turn around, then get help. So that means to get help with somebody like you or somebody like myself. Or if you’re noticing a lot of things are coming up from the past, a psychotherapist. But get out of your own head to get help to move forward from that because a victim mentality is equal to someone sitting around and saying this happened to me, why did this happen to me, why did that person cut me off on the bike and I crashed, or blaming somebody else instead of accepting the situation. We cannot move forward if we are the victims. It also takes away all of our power and it takes away all of our motivation to do anything to get better. So, a lot of people need help moving from feeling like a victim to feeling empowered. And then realizing that, okay, this injury happened for me and in this space of not being able to run out and do all the things I used to be able to do, I’m going to learn something about myself and the world and how I relate to the world instead of just sitting here and feeling sorry for myself. It takes a lot of work to get out of that mentality. It’s not like a light switch or something you can just willfully choose. It’s a work in progress and it’s a course of action. Often when we’re kind of floating around just untethered, we need somebody to bring us back down to earth and give us that accountability.

29:12
Dr. Maya Novak:
Absolutely, and I don’t what your experience is with that, but I’ve had quite a few clients who are medical professionals or some who should know how to also help themselves. But when we are injured, when this is us and not somebody else, it’s harder to help ourselves with the knowledge that have because we are looking from these glasses that we have on. What is your experience? And what kind of clients or patients, the people who have – professionals who should have or who have all this knowledge – what is your experience with these types of clients? Or is it a good thing to get help even though you have – I don’t know a Ph.D. in Psychology, for example.

30:10
Heidi Armstrong:
Yes. Interestingly, the majority of my clients are healthcare professionals or people who have PhDs. I think injury is a great equalizer. At the end of the day, we all – or I should say at the beginning of the day with this – we all put our pants on one leg at a time and we are all human beings. Because of that, we all suffer in the same way, and when we’re suffering, I say we’re stuck in a bottle and we can’t read the label on that bottle. It doesn’t matter how much knowledge we have about the situation, we’re human first. So, when we’re stuck in that bottle, or when we can’t move past being a victim or we can’t find the motivation to do mental training exercises, or we’re sitting around feeling angry and frustrated all the time, it’s because when we’re stuck in there we can’t read the label on the outside. That’s where working with somebody like you or myself in cases of depression, anxiety, trauma, self-harm – working with a therapist too. And I think what you and do, the work we do complements the work of a therapist really well. When I explain to people how we work together, I say a therapist helps you remove barriers from the past that are keeping you from moving forward with me today. And so I want to help you forward and give you – teach you the tools you need to evolve and create resilience and become a stronger human being physically and emotionally. But sometimes stuff from the past keeps us from doing that. That’s what I believe one of the biggest of injury is, is it allows that stuff from the past to come up and it is incredibly painful and super, super uncomfortable, but it allows us to process that so that we can basically like fall apart and then come back together.

32:18
Dr. Maya Novak:
Yes, absolutely, and it’s what you said, it’s complementary. It’s not like oh, I’m going to the doctor, I don’t need this type of help. Or if I take this type of help, I shouldn’t be going to the doctor’s office, for example, or an appointment. It’s not one or the other. It’s one and the other thing.

32:40
Heidi Armstrong:
Yes.

32:40
Dr. Maya Novak:
Because healing and injury recovery, it’s not just a physical matter.

32:47
Heidi Armstrong:
Mhm.

32:47
Dr. Maya Novak:
As we are discussing here, it’s everything. It’s mental healing, emotional healing, spiritual healing, physical healing. It’s every type of healing and many times, it’s not enough just to go to – I don’t know – a doctor’s appointment, or just to go to the physiotherapy, but for healing, that you have all the tools necessary in every single area.

33:14
Heidi Armstrong:
It takes a team, it really does. And I’d also like to mention – because I’ve talked a few times about therapy and the importance of going to therapy if you’re in a position where you need it. The types of therapy that are very, very helpful for people who are injured are EMDR – so it stands for Eye Movement Desensitization and Reprocessing. There’s a blog on my website, injuredathletestoolbox.com that I’ve written about EMDR that explains what it is. And then the other one is called Internal Family Systems, which is a bit of a misnomer because it’s not Family Therapy, but it deals with the fact that we are all made of parts. So, there’s a part of us that feels sad. There’s a part that feels happy. There’s a part that feels angry. There’s a part that feels frustrated. And getting to know each of those parts is a very mindful therapy. People who like to move who get injured, often are very resistant to going to therapy because they don’t want to sit on the couch and woe is me for a whole hour. But these two types of therapy help to rewire and change your brain.

34:33
Dr. Maya Novak:
You mentioned a few times also that sometimes injuries become chronic things. So, it’s not something that you get over in a few weeks or in a few months. When something is either very long – so the process is very long – or when we have a really serious injury, we find ourselves in situations where we are hopeless and we losing hope about healing. What would you say to someone who perhaps is right now in this situation? They don’t see the light, and they are losing hope about their healing.

35:22
Heidi Armstrong:
I would say change your perspective about hope. Most people think that hope is a noun – they have it or they don’t. To me, hope is a verb and it’s a practice and a course of action. You can’t have it if you don’t practice it. So, that looks like every day coming up with a list of things that you can do that give you some space from your injury so your injury doesn’t feel so suffocating. As I mentioned before, things like yoga on the floor – and there’s a wonderful new adaptive yoga book that’s very helpful. Most of it’s on the floor or in a chair. Things like getting into a cold shower, which helps engage your parasympathetic nervous system. Things like volunteering and even there are things that we can do volunteering on our phones. Things that involve us with our friends or having friends over. Finding a new sport. So, making a list of all of the things that we wanted to learn or do that we haven’t had time to do because we’ve been too busy. Do those things when you’re injured and those things will help give you hope and strength.

36:47
Dr. Maya Novak:
Very, very good. And I would like to add something else here, and this is because in the past, I was in difficult situations and I was also, in the past, depressed, like deeply, deeply depressed and sad. I know the conversations that I had in my head and one part of me was like I want to get better, but there was also a part of me who was like no, you know, I’m just going to stay here because I like to be the – you know – being a victim sort of. Now, what I would like to add here is you have to also decide that you want to get better and perhaps push aside that part who is like, well, you cannot do anything, and just sit here and wait and – I don’t know what.

37:37
Heidi Armstrong:
Watch the TV or something, yeah.

37:39
Dr. Maya Novak:
For example, yes. I love this practice and everything that you shared here. It’s very, very important. Now, in regards to healing and you mentioned quite a few times therapy and coaching.

38:02
Heidi Armstrong:
Mhm.

38:02
Dr. Maya Novak:
In your experience, when is the time for coaching and when is the time for the therapy? Because right now perhaps those who are listening – I’m absolutely sure that there are people who are like yeah, but what should I then choose? Is coaching enough, should I do the therapy, should I do a combination of everything? What is your advice in that regard?

38:27
Heidi Armstrong:
You’ve probably asked the wrong person because I believe that everybody should do everything! And I believe that because I believe that the time of being injured is such an opportunity – which I understand rearranges the furniture in most people’s heads because they’re thinking this is an opportunity for what? Like to hold down the couch? I can’t do anything. But really, it’s a time for self-exploration. And so I would say as a step one, to first get a coach and a good coach will help you identify if you need to go to therapy. Now, people who are feeling depressed, anxious, harming themselves, have a lot of trauma from the past, self-harm, could be suicidal – these are all things that should go to therapy as well as coaching. So, it’s not a really clear-cut answer, but my opinion is capture the opportunity when you’re injured. Capture all of it and do as much as you can to become a more resilient person and learn about yourself and your weaknesses and turn them into strengths, and those are opportunities. Often we will never have this opportunity again because life just goes and goes and goes. An injury is like a pause button and any time that somebody feels a pain about something, that’s like the universe shining a light on that pain and saying look here, look at this and pay attention to this because that will teach you tools that you need to cope with things for the rest of your life.

40:17
Dr. Maya Novak:
And it’s not like something is happening to me, it’s this is actually happening for me so that I can also move forward in my life because of this uncomfortable situation.

40:31
Heidi Armstrong:
Yeah.

40:32
Dr. Maya Novak:
What is your number one advice that you would give someone who is injured right now?

40:37
Heidi Armstrong:
Get help. Don’t try to manage the mental and emotional fallout of injury by yourself. Get help. So, if that looks like getting a coach, and that looks like asking your friends and your family for help, and goodness, people who are active are really, really stubborn about asking for help. They just want to do it all themselves. I have a good story about that. After one of my surgeries, one of my mother’s sister’s friends came over to bring Dan and me dinner, and I was on the couch – there’s a theme there! Anyway, I was lying on the couch and I was feeling really angry and resentful that I had to ask for help. She looked at me, and she said, do you like helping people? I said I do, I love helping my friends. She said, well, your friends enjoy helping you too and so if you don’t allow them to help you, you’re stealing their joy, so stop it. And I thought, wow, that was really profound. So, it was at that point that I realized that life is just a big circle and sometimes we need more and sometimes we can give more. And in asking for help, we are connecting ourselves with the larger fabric of life and humanity and getting rid of a lot of the isolation that happens when we’re injured.

42:07
Dr. Maya Novak:
Beautifully said. Yes, because my experience with clients is that they are more givers but they are pretty awful with receiving. Or in general, we are awful with receiving. It’s like yeah, it’s not a problem to give, to serve, to help. But when it’s our time, it’s like yeah, but no, I can do it myself, I can do it on my own.

42:34
Heidi Armstrong:
Yes, and there’s a well-known researcher who spent his life researching isolation – social isolation - and isolation is as dangerous to our health as smoking.

42:50
Dr. Maya Novak:
Heidi, I do have one last question for you, and it’s a bit of an out of the box question, a fun question.

42:59
Heidi Armstrong:
Okay.

42:59
Dr. Maya Novak:
This is imagine that you are injured right now and you know that the recovery is going to take you a while, you don’t know how long this is going to be, and you also know that it’s not going to be easy all the time. In this moment, you can choose one of two gifts that you’re going to get at the end of this journey. One is that you go through your recovery, doing all the necessary work that is going to help you to heal in the best possible way, and when you are done, you’re going to get this gift of preventing any future injuries. The other gift is that you can go back in time and prevent the accident that caused this injury, but here you actually take your chances. You can get lucky and never injured again, or perhaps the next moment you can have another accident that could be even worse than this one. What would you choose? I know that this is like an out of the box question, but which gift would you choose and why?

44:14
Heidi Armstrong:
I would choose one, because I’ve been at this present recovery for almost nine years, and I’m a much, much richer person because of it. Much more whole, much more accepting of all of the beauty and the pain that is life, and so much more connected to everybody that’s around me. I think that injury, in most circumstances – not all, can be a gift. And so to not have that opportunity to capture the gift, for me, it would be a tragedy.

45:02
Dr. Maya Novak:
Perfect. Heidi, I know that people would love to know more about you and perhaps get in touch with you. So, where can they get this information?

45:13
Heidi Armstrong:
Yes. My website is injuredathletestoolbox.com. You can reach me at heidi@injuredalthetestoolbox.com. You can also sign up for my newsletter at the bottom of my home page.

45:28
Dr. Maya Novak:
Fabulous. Heidi, thank you so much for being here and for sharing all the goodness.

45:34
Heidi Armstrong:
You’re welcome, Maya.

45:37
Dr. Maya Novak:
This wraps up today’s episode with Heidi Armstrong. If you haven’t done it yet, subscribe to the podcast on whatever platform you’re using to tune in, and share this episode with your loved ones – it really can change someone’s life. To access show notes, links, and transcript, of today’s talk go to mayanovak.com/podcast. To learn more about The Mindful Injury Recovery Method visit my website mayanovak.com and find my book Heal Beyond Expectations on Amazon. Until next time – keep evolving, blooming, and healing.

Love and gratitude xx
Dr. Maya

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