The Injuries You Can’t See: When Your Body Gives You the Break You Need

Within minutes of meeting professional trail runner Keely Henninger to talk about injuries, she’s shifted our conversation to mental health. She’s adamant that it’s our minds that are to blame for our injuries.

In 2018, at just 26-years-old, Henninger was dancing up hills and floating downhills on her way to victories at the Chuckanut 50K, the Lake Sonoma 50K, and the 50-mile national championship—and to top five finishes at the Ultra Trail Cape Town 100K, UA Mt. Bachelor 50, and Lavaredo 129K. From the outside looking in, Henninger was crushing it. But for Henninger, each podium finish added to her drive for perfection, and the mounting pressure became unbearable. Inside, Henninger was pleading with her body to break so that she could give herself permission to stop.

“I needed to completely break myself, to completely lose my sense of willpower to actually acknowledge that what I was doing to myself was wrong,” Henninger says. “Sometimes it takes something really big to realize you have to change how you’re treating yourself.”

Passion Turns Painful

Growing up, sports came naturally to Henninger. She planned to play basketball in college, but consecutive seasons of shoulder injuries derailed those plans. To de-stress, Henninger turned to running. During her senior year of college, she ran her first 50-miler, and the euphoria that came with pushing her body past what she thought was its limits stuck with her. 

As Henninger continued to train, she learned more about herself and her body, what worked well and what didn’t. Over time, her meticulous training transferred into success on the leaderboard. With each race, Henninger’s pure joy for running became tangled up with measuring her self-worth by how she performed. She pulled on her self-discipline levers, ratcheting up her control over how much she ate and how hard she trained, which was too little and too much, respectively. The knots only got tighter. 

“As an athlete experiences success in their sport, they receive positive feedback,” says Seth Swary, who has a PhD in Sport, Exercise, and Performance Psychology and an MA in Community Mental Health Counseling. “In addition to the reward pathways in the brain being strengthened, some individuals become wrapped up in their role as an athlete and perceive a dependence on running to meet other needs.”

A Wake-Up Call

In March 2019, Henninger started to feel tightness in her right glute. She pushed through the discomfort, but it wasn’t long before it morphed into jarring pain with each foot strike. When it didn’t improve with rest, Henninger knew something was wrong. An MRI confirmed her intuition: she had a sacral stress fracture. 

“The day I found out I had a stress fracture, I was relieved,” Henninger says. “A week after I was diagnosed, I was 50 percent happier just knowing that I didn’t have to run. I started to look back on my training and realize just how fucked up I had been doing everything.” 

According to Swary, athletes who highly identify with being an athlete are more willing to engage in maladaptive behaviors, such as disordered eating or performance enhancing drugs, because they perceive them to be acceptable and normal in the context of sports and in the hopes that it will improve performance. For Henninger, she was obsessing over—and judging herself for—how much and what she ate. If she had a rest day, she ate less. If she thought she ate too much, she ran more.   

“If someone is in a state of low energy availability, the most detrimental changes are likely to be seen in bone, cardiovascular, digestion, gastrointestinal, immune function, hormone production, cognition and psychological, and metabolic rate,” says Heidi Strickler, a registered sports dietician. “Adequate fueling is critical to minimize negative energy balance.” 

Starvation and Mental Health

Unfortunately, knowing this information isn’t always enough to override toxic and addictive thoughts. A landmark study dubbed the Minnesota Starvation Experiment studied the psychological and physiological effects of starvation and the results were remarkable: even on a semi-starvation diet, the men obsessed about food, reported fatigue, irritability, depression, emotional distress, and apathy. The men reported viewing others who ate normally with a fascinated, judgmental disgust. As they became socially withdrawn and isolated, they felt like their concentration and judgement were impaired. 

Just like the men in the Minnesota Starvation Experiment, Henninger’s mind went into overdrive when she wasn’t eating enough.  

“When I was in a poor mental space, I’d feel guilty for giving myself food if I didn’t work out, which is the most counterintuitive thing in the world. We still deserve to eat regardless of what we do,” Henninger says. “You get this ideal weight in your mind, but when you’re in that negative mindset, you always need to lose more weight. I’ve never obsessed about weight more than when I was at my lowest weight. It’s so messed up. Your body is pissed.”

As soon as Henninger received the results of her MRI, she went from relentlessly punishing her body to giving it the rest and recovery it deserved.  

“Your body doesn’t want to be starved. If you actually just eat a ton and treat your body well, your body will find its optimal weight,” Henninger pauses, and to bring it back to mental health she emphasizes, “How much mental space do you put toward putting food into your body? It shouldn’t be a lot.”

During her much needed break from running, Henninger was able to accept what she was doing to herself was wrong and to focus on healing herself mentally. In doing so, Henninger rediscovered that she runs because she loves the feeling of fresh air on her face, exploring beautiful places through movement, and pushing herself to unknown mental and physical limits. As she slowly but steadily returned to what brought her to running, she felt a renewed sense of excitement for her eventual return to running. 

“I wasn’t in a rush [to return to running],” Henninger says. “This was a very slow progress. I’d been trying to untangle unhealthy from healthy for a really long time.”

Today, when you ask Henninger about running, she hardly talks about the actual sport. Instead, she talks about her community who appreciate each other no matter what; the mountains that never judge; her passion for the unique physiological needs of female athletes; her four-legged best friend, Jade, running ahead of her, smiling the entire time. 

“The only way running can be a part of my life is if I don’t make it my life,” Henninger states. 

Henninger’s Tips For Staying Mentally Well

1. Feed yourself. “If you don’t have your eating in place, all the work in the world won’t lead to gains in other areas.”
2. Trust yourself. “If you don’t wake up every day stoked to be doing what you’re doing, that should be a red flag. When your body is trying to tell you to stop, things that normally bring you joy may instead bring a sense of dread. This is not a good sign. Listen to it.” 
3. Be more than a runner. “Before this injury, I would have picked winning races over my health because my mind was so narrowly focused on identifying as a runner. During this injury, I realized I’d rather be happy, enjoy life, push my body, and do things outside of running for the rest of my life than get this instant gratification and be defined by running for the rest of my life.”
4. Give yourself a break. “Normally, if I was injured, I would be antsy as heck after one week. This time, it was a very slow process. I wanted to let myself heal and figure out why I wanted to run. I was not lacking motivation to run; I was choosing not to run. I was so content with figuring myself out that I was respecting the process.”
5. Find your community. “I think that building a community of good friends and fellow female runners and investing yourself in the community really helps. I can’t say there was one person who helped me, but I think having a community of people helps you help yourself.”