marathon recovery header
Marcie Hopkins, University of Utah Health
resilience
If Covid-19 is a Marathon, How Do I Recover?
As our health care system continues to address pandemic-related employee burnout and fatigue, we can apply simple strategies to enhance our own recovery. Psychologist Megan Call and physical therapist Keith Roper return to a previous marathon analogy to share five recovery strategies for individuals and teams.
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year ago, we compared the pandemic to a marathon, with a clear finish line marking the return to normal life. Although the metaphor seemed appropriate at the time, we now recognize that we significantly underestimated where we were in the race. For many of us, the pandemic has been like running multiple marathons with limited reprieve.

Professional runners incorporate periods of recovery into their training to maximize improvement in speed, endurance, and strength. Rest is as crucial to success as physical exertion because it allows the body to recover and rebuild. This same practice is important for any job that requires dedication and performance, like patient care, teaching, research, and the multitude of positions that serve the well-being of our community.  

Here, we adapt the best practices professional runners use to recover during their training cycles and after a major marathon to keep ourselves engaging in meaningful action.  

1. Act with intention 

There are two primary ways runners become injured. The first is that runners are known for disregarding minor aches and pains. Their perception is that these little niggles will go away on their own and no extra attention or care is required. The second is that runners tend to push themselves when they are supposed to be recovering. Their pace is faster than it should be on slow run days, or they overexert themselves on cross-training or rest days. These tendencies are especially problematic when runners feel good. 

Many health care professionals take a similar approach to work and, like athletes, we can become injured, too. Some of us may take an extra shift, agree to sit on another committee, respond to email late at night or early in the morning, or ignore signs that it’s time to slow down.

At times, this ability to compartmentalize and push ourselves can be incredibly helpful and may save a patient, contribute to an important initiative, or help us achieve our goals, but it is not a sustainable, long-term strategy.  

Paying attention to how we are feeling and being intentional about our actions can help prevent injury. Runners who proactively address the early warning signs of an oncoming injury, usually by taking a couple of days off from running or re-engaging in physical therapy exercises, tend to be able to meet their training goals. Health care workers can do the same by recognizing and tending to the initial indicators of significant stress, fatigue, and burnout. This may entail emphasizing sleep, declining an opportunity, asking for help on a task, or turning our pace down a notch. It’s important to note that these preventive strategies can be applied even when we’re feeling good. 

2. Address the myths that get in the way of recovery 

Success in high-performance and helping professions is often based in productivity, making a difference, and working toward excellence. Many of us thrive in this type of environment because we want our actions to be impactful. Thus, it makes sense that recovery can feel counterintuitive. How can we take care of people and remain dedicated to our goals if we’re taking a break? 

The myths we tell ourselves about success often get in the way of our own rest and recovery. For marathoners, myths include comments like, “I’ll lose my fitness if I take time off” or “Running a little faster today won’t do any harm.” For health care workers, these myths may sound like, “I’ll hurt my team if I take time off” or “If I stop, then the work won’t get done” or “I have to keep up with everyone else.”  

Part of recovery is learning how to work with these myths and recognizing that sometimes actions that feel counterintuitive might be good for us. A simple way to address a myth is to acknowledge it with a statement like, “Here is the ‘I shouldn’t recover’ myth. This shows up when it’s actually time to take care of myself.” 

3. Move in more than one direction 

Running, especially on roads, is a repetitive motion in a forward direction. Over time, regularly moving in one plane can help marathoners become more efficient in their stride and performance, but it simultaneously contributes to the imbalance with other muscle groups that are needed to stay healthy. Health care workers can also engage in a similar pattern of repetitiveness and focus, particularly during times of challenge or stress. When a deadline is approaching or our schedules become especially busy, we often stop engaging in activities that are life-enhancing like exercise and social connection. This may be okay for a few days but can be problematic if we don’t make the time to reconnect to these important parts of ourselves. 

For runners, it’s important to move their bodies in different ways. Switching up their routine with activities like swimming, yoga, or light resistance training alleviates stress on overworked muscles, and strengthens other parts of the body. Health care workers can take a similar approach by engaging in meaningful activities that give problem-solving or helping part of ourselves a rest, like getting outside, playing music, having fun with family and friends, or learning something new. These activities don’t just make us well-rounded people–they give us a chance to fully recharge so when we return to work, we’re more ready for the next leg.  

4. Take care of your immune system 

For runners and health care workers alike, stress weakens our immune system. Whether we’re pushing through pain during a workout or taking on a little extra to help a patient or colleague, these actions impact our health. A depleted immune system reduces physical endurance and mental clarity, and heavily impacts performance in our respective fields. In health care, we understand how critical our immune system is and yet, many of us put off tending to our own well-being. Our culture is relearning how to incorporate self-care into our daily operations so we can better care for others.

Giving ourselves permission to address the basics like eating foods that nourish, staying hydrated, and regularly getting enough sleep, will help us have more reserves on race day or during times when we want to give 110%.  

5. Keep the big picture in mind 

During their months of training, marathoners focus solely on one, maybe two races. While the end goals differ, we see that same dedicated focus in health care workers. This approach can lead to incredible accomplishment and achievement, but we can lose ourselves along the way if we don’t keep the big picture in mind. We can flex our focus by regularly stepping back and reconnecting with our purpose. Questions like, “What are my actions in the service of?” or “A year from now, when I look back on this moment, what do I want to say I stood for?” can help us make small changes in our actions that allow us to stay on course and move toward a more meaningful finish line. 

“Logger Story"

The following is a story that I (Keith) frequently use with my physical therapy patients who need a little encouragement to engage in recovery. 

Two loggers set out to clear trees from a piece of land. As they work, one logger notices his partner sitting in the shade. Annoyed, he begins to work a little harder. The other man soon resumes his own task, but soon returns to the shade. As this continues throughout the day, the first logger becomes more and more irritated, and pushes himself harder and harder.  

As the day winds down, the first logger looks around and realizes his partner cut down just as many trees as he has. He goes to him and says, “I don’t understand. Every time I looked over here, you were sitting down. How did you cut all these trees?” The second man says, “Well, what you didn’t realize is that when I was sitting down, I was sharpening my saw.” 

Many of us believe that when we push ourselves to the limit, we’ll get more done, or we’ll get through the race faster. In reality, taking time to “sharpen our saws” and recover helps us rebuild our strength so that we don’t lose our edge and we can better engage in the work that matters to us most. 

Contributors

Megan Call

Licensed psychologist, Director of the Resiliency Center, University of Utah Health

Keith Roper

Physical Therapist, Orthopedic Center and Emergency Department, University of Utah Health

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