Running Injuries: Can Anxiety Make My Physical Symptoms Worse?

Reviewed by Dr. Haley Perlus: Right now, I am returning to running with two health issues going on: a strange illness and a recovering torn hip labrum. I am a ball of nerves and it’s making me wonder if my anxiety is making my symptoms worse. Or, at least feel worse?

The answer is yes—anxiety can make your symptoms worse.

I’ve had three major running injuries the past few years and have dealt with anxiety upon each return to running.

How my anxiety is making my symptoms worse

Ok, it is too soon to say whether anxiety is making my symptoms worse, but I can tell you—it’s not helping. I am hyper-focused on how I am feeling and over-thinking everything, and then telling myself to not think, just do. Everything is going to be okay. But it’s not helping.

Have you been there? Keep reading.

I’ve been out from running completely for more than 4 months with a torn hip labrum. This is one of many setbacks since I started The Mother Runners in 2019 (torn hamstring, pleurisy, long COVID, torn plantar fascia, torn hip labrum, and now what they think is a post-viral reaction).

Each return to running has been a similar story. I’m so excited to be back out there. I think I am being patient and staying within the lines, but then a symptom or ache pops up and I freak out. This kickstarts a firestorm of inner conflict: “You’re fine, you’re healing. This is normal,” versus “You are setting yourself back, re-tearing your injury, or running yourself down.”

Frankly, this internal battle is exhausting. And I just want to trust myself, trust my body, and trust the process.

Related: 9 Steps to Return to Running After Injury

We grow stronger from the setbacks

As a running coach, I have seen my athletes overcome so much including running injuries and chronic diseases that are sometimes debilitating, to go on to run marathons and set PRs. They inspire me, and they show me that our bodies are amazing and can do amazing things.

I need to believe that my body is no different. But after being kicked so while down so many times these past several years, it can be hard to stop the spiral of doubt and negativity.

So, I reached out to my favorite sports psychologist, Dr. Haley Perlus, to find out what’s in my head, what’s not, and how to cope. Because, guess what? Your mind plays an instrumental role in your healing process for your running injury—and/or illness. If you don’t believe you are healing, if you think running is wrecking your healing process, it could very well be doing that.

In this article, Dr. Perlus shares:

  • How anxiety can make our physical symptoms worse
  • How anxiety can affect our recovery from sports injuries or illness
  • Plus, 3 coping mechanisms to stop anxiety from making your symptoms worse and how to shift your
    how anxiety can make your symptoms worse pin
    Pin these tips on how how to stop anxiety from making your symptoms worse for later!

    mindset to set you up for success!

Be sure to check out my article on injury anxiety (aka Injury PTSD or fear or reinjury): How to Overcome Fear of Reinjury

Ok, let’s get to how to stop your anxiety from making your symptoms worse, according to Dr. Perlus.

Related: 9 Mental Training Tips from Sports Psychologists

Does anxiety make physical symptoms worse?

Yes, anxiety can make your physical symptoms worse, including a running injury sports injury, and illness, says Dr. Perlus.

“Every thought has an emotional reaction which then has a response physiological and biological response,” she explains. “Your heart rate goes up, your muscle tension increases, your skin conductivity alters along with the neurotransmitters, chemicals, and hormones that are released in our bodies.

This means that thinking bad things like worrying about whether you are reinjuring yourself, fear, frustration, and feeling hopeless, all emotions can lead to more muscle tension or release chemicals and hormones like cortisol which can affect our bodies’ ability to heal, explains Dr. Perlus.

Anxiety around running injuries can make your symptoms worse!

In effect, anxiety can trigger your autonomic nervous system to go into overdrive. Your autonomic nervous system regulates things like your heart rate and breathing and produces your fight-or-flight response when under stress. When stressed or anxious, this system kicks in causing physical symptoms.

As Dr. Arthur Barsky, professor of psychiatry at Harvard Medical School, in the Harvard Business Review, describes, “Anxiety and stress themselves produce these physical symptoms, and on top of that your reaction to those symptoms can make them worse. The more you focus on them, the more alarmed you become, and the more intense your symptoms become,” says Dr. Barsky. “It can get really out of control and become so uncomfortable that you might not be able to do much more than sit and worry.”

Talk about a vicious cycle I think we all know very well—especially injured runners or runners coming back from having a baby, for example.

Related: Free Return to Running Plan

How does anxiety affect our recovery from running injuries or illness?

Anxiety can inhibit your recovery from running injuries or illness by making them feel worse—and even inhibiting your body from actually healing.

Recent research in the Journal of the American Academy of Orthopaedic Surgeons reinforced that injury and healing involve both the body and the mind: Certain psychological responses can complicate the healing process while others can boost recovery.

We want our thoughts to influence the appropriate emotional state to help our biology to help our body to heal. But it’s much easier said than done, let me tell you…because I have tried!As much as I have told my brain to turn off and just let my body do its thing, those fears and negative emotions come back.

Here are 3 coping mechanisms to stop anxiety from making your symptoms worse and interrupting your healing, according to Dr. Perlus.

Related: How Overcome Race Day Anxiety

How to Stop Anxiety from Making Your Physical Symptoms Worse, according to a Sports Psychologist

If you fear that you won’t recover from your running injury or that you won’t get back to where you were or where you want to be, here are 3 coping strategies to make your mind help your body.  

1. Be a problem solver.

If you are in a time-out due to illness or rehab from a sports injury, then focus on where you are in that moment,” says Dr. Perlus, who has helped countless injured athletes return to sport. Don’t think too far ahead or too far behind.

Focus on what you CAN do to build strength (mentally and physically) and slowly increase from there.

how anxiety can make your symptoms worse pin 2
Pin these tips on how how to stop anxiety from making your symptoms worse for later!

Remember that our bodies do ADAPT! That is science! “They want to return to that state you’re dreaming about. “So, trust that they will do that. Trust that your body will work with you to get back to that level,” she says.

This was very powerful for me—and I think for anyone dealing with a running injury or illness because you feel like you are at war with your body like your body betrayed you. But it wants to return to the status quo too, so give it the tools to do so with positive thoughts and trust—a MINDSET SHIFT. You pave the way with your mind for your body to heal and strengthen.

“With cooperation from our mind, patience, and discipline, you can get back,” says. Dr. Perlus.

2. Look to the past to create a better future.

I know I said not to look too far behind you because this can lead you to rush your fitness and end up getting reinjured or dealing with a new injury (I have been there!).

But “if you are struggling to trust that your body wants to heal, think of a time your body has overcome a running injury or illness,” says Dr. Perlus. Go back to where you felt scared or full of doubt and think about the strength that arose for you to overcome your setbacks.

For me, I think about how I was injured or sidelined from running for almost 3 years to return and run a 2:58 marathon at CIM after only 4+ months or running, and then trim 4 more minutes off my time four months later at Carmel last spring.

Related: How I Fueled My 2:54 Marathon

If you can’t think of a time you’ve overcome obstacles victoriously or your return was a bad experience for you, think about the knowledge you have currently. Have you rested? Have you worked hard on your PT? Does imaging or the doctors say your injury is healing or the illness is getting better? Think of all that has gone into your recovery. Focus on that evidence.

3. Be still.

Finally, you’ve heard time and again that meditation can help calm anxiety—even just 8 weeks of practice. Well, here is another time.

Dr. Perlus says the stillness that can come from meditation decreases the amygdala, which is a part of our brain that increases in response to our anxiety, making physical symptoms worse. And instead, it increases our prefrontal cortex which promotes more logical thinking. This can still the mind and allow our bodies to do what they need to do to heal without our emotions interfering with our recovery process, says Dr. Perlus.

Some meditation resources are apps like Calm (I love Jay Shetty’s Daily Calm) and Headspace, and my friend Sara Hayes’s Mindful Miles Movement.

Research shows that even just 5 minutes of meditation can help calm anxiety and stop anxiety from making our physical symptoms worse.

“Our minds influence our emotions which can wreak havoc on our bodies and interrupt our healing process,” explains Dr. Perlus.

“We need to create a mindset to help us. We need to look at the knowledge we have, that our bodies WANT to get back to where they were but they need grace, discipline, and patience to do so. So, let’s get it to them,” she says.

I hope this article helps you in your return to running after injury or illness!      

If you need guidance with your training and going after your goals in the winter months, check out my run coaching services. Also, be sure to check out my free training plans:


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