For 26 years as a plastic surgeon, I have given my patients the same advice after surgery: Listen to your body. Pain, fatigue, and swelling are not inconveniences. They are signals. They are the body’s language, guiding us toward healing or warning us when we have gone too far. What I have learned this year, at 65, is how difficult that advice can be to follow.

In January, I was training on my Peloton treadmill, preparing for three races scheduled at the start of the year. Running has been a constant in my life for over 15 years. It clears my mind after long days in the operating room. When I travel, it allows me to experience a city before it wakes up. That morning, midway through a routine run, I felt something unusual in my Achilles tendon. There was no dramatic moment. No sharp pain, no rupture. Just a subtle shift. My stride felt off. I slowed, walked, and finished training. Like many physicians, I rationalized. Perhaps it was tight. Perhaps it would resolve on its own.

Over the next week, I modified my routine and avoided running, but something was not right. My gait had changed, and I was limping even at a walk. When I tried running outside the following weekend, I made it one block. An orthopedic evaluation confirmed Achilles tendinopathy, one of the most common overuse injuries in active adults, particularly in runners over 40. Studies estimate that up to 10 percent of recreational runners will experience Achilles tendon injuries during their lifetime, with risk increasing as the tendon loses elasticity and blood supply declines with age. What struck me most was not the pain, but the dysfunction. I was not injured in a dramatic way, but my body was clearly telling me something had changed.

Even then, I kept negotiating with reality. I withdrew from my first two races but held onto the possibility of running the Atlanta Half Marathon, a race I have completed nearly every year for the past decade. The week before the race, I tested it. Seven miles in, the limp returned. That was the moment I stopped.

Achilles injuries are uniquely humbling. The tendon is the strongest in the human body, capable of absorbing forces many times our body weight with each step. Yet the portion most prone to injury has a limited blood supply, which significantly slows healing. Recovery is not dictated by motivation or discipline, but by biology. As physicians, we understand this intellectually. What we struggle with is accepting it personally.

Surgeons are trained to override discomfort. In the operating room, endurance is expected. We push through fatigue, ignore physical tension, and focus on the task in front of us. Those habits serve us well professionally, but they can work against us when we are a patient. Research has shown that physicians are often less likely to seek care early and more likely to delay treatment, a pattern driven by both culture and training.

Now I find myself doing exactly what I have advised my patients to do for decades. I am committed to physical therapy, recovery protocols, and exploring options that may support healing. But the hardest part is not the work. It is waiting. Time is often the least appreciated treatment in medicine, yet it is the one we cannot accelerate.

Running has been more than exercise for me. It has been a place for reflection, a way to process the emotional demands of caring for patients, and a source of both strength and stillness. The idea of losing that part of my life is difficult. But injury, like aging, forces a different kind of reflection. What does it mean to listen when your body is no longer negotiable? What does it mean to adapt when willpower is no longer enough?

If I return to running, I will be deeply grateful. If I do not, I will find other ways forward. Cycling, hiking, swimming, strength-training, different forms but the same purpose. Turning 65 has prompted many to ask if I am thinking about retirement. I am not. I am thinking about expansion.

Listening to the body is about recalibrating. It is about respecting limits while continuing to move forward with intention. For 26 years, I have asked my patients to listen to their bodies. Now, as I age, I understand what that truly requires.

Diane Alexander is a plastic surgeon.