Therapy for Endurance Athletes
From a therapist who runs ultras
I know what it feels like to toe the start line of a 50K with your heart pounding and your mind spinning. I know the particular exhaustion of mile 25 when your legs are done but something deeper keeps you moving. I know the grief of an injury that pulls you off the trail, and the quiet identity crisis that follows when running — your anchor, your therapy, your community — is suddenly taken away.
I'm Andrea Javorkova Adams, a Licensed Marriage and Family Therapist and ultrarunner based in the East Bay. I work with endurance athletes — runners, cyclists, triathletes, CrossFitters, and anyone who has made physical challenge a central part of who they are — because I understand this world from the inside. You won't have to explain why a DNS feels devastating, why you wake up at 4am for a long run, or why your training schedule sometimes takes priority over everything else. I already get it.
Therapy with me is a space where your athletic identity is understood, respected, and explored — not pathologized or minimized.
The Unique Psychology of Endurance Sport
Endurance sport is as much a mental game as a physical one. You already know this. What you may not realize is how deeply your athletic life and your emotional life are intertwined — and how much each affects the other.
Endurance athletes are often high achievers with a remarkable capacity for discipline, delayed gratification, and pushing through discomfort. These are extraordinary strengths. But they can also mask — or amplify — some very human struggles:
The same perfectionism that makes you a disciplined trainer can make it impossible to rest, recover, or feel good enough
The ability to push through pain can make it hard to recognize when you genuinely need to stop
The identity and community built around sport can make injury feel like losing yourself
The solitude of long training runs can be deeply meditative — or a way of avoiding difficult emotions
The drive that gets you to the finish line can tip into overtraining, burnout, and resentment
Understanding this intersection — between athletic performance and emotional wellbeing — is what I do.
What I Can Help You With
Injury and Return to Sport
Injury is one of the most emotionally devastating experiences an endurance athlete can face. When running is your stress relief, your community, your identity, and your joy — losing it, even temporarily, can trigger grief, anxiety, depression, and a profound sense of lost self. I help athletes navigate the emotional side of injury and build a psychological foundation that supports — rather than hinders — physical recovery.
Performance Anxiety and Race Nerves
Pre-race anxiety is normal. Debilitating anxiety that affects your training, your sleep, and your enjoyment of the sport is something we can work on together. Using CBT and mindfulness techniques, we'll identify the thought patterns fueling your anxiety and develop practical tools to help you show up to the start line grounded, focused, and ready.
Burnout and Overtraining
When passion becomes obligation, and training feels like something you have to do rather than something you love, burnout is close. I help athletes reconnect with their intrinsic motivation, rebuild sustainable training relationships, and address the underlying perfectionism or anxiety that often drives overtraining.
Identity and Life Beyond Sport
What happens when the race is over — not just today's race, but the season, the career, the chapter? Athletes who retire, who age out of their peak performance, or who are forced to step back by injury or life circumstances often experience a profound identity crisis. I help athletes explore who they are beyond their sport and build a richer, more resilient sense of self.
Relationship Strain from Training Demands
Training for endurance events takes time, energy, money, and emotional bandwidth — and it doesn't always leave much for the people you love. I work with athletes and their partners to navigate the very real tensions that arise when one person's sport takes up significant space in a relationship, using Emotionally Focused Therapy to rebuild connection and communication.
The Positive Power of Endurance Sport
Not everything that brings you here is a struggle. Many of my athlete clients come to therapy wanting to deepen their relationship with their sport — to run more mindfully, to understand what draws them to the trails, to use the lessons of endurance sport to build a more resilient and purposeful life off the trail too. The mental skills that make a great ultrarunner — presence, resilience, embracing discomfort, playing the long game — are the same skills that make a great life. We can work on both together.
Why Walk-and-Talk Therapy is a Natural Fit
For endurance athletes, sitting still in a therapy office doesn't always feel natural. That's why I offer walk-and-talk therapy — sessions conducted outdoors, moving through the trails and parks of the East Bay. Research shows that movement enhances emotional processing, reduces anxiety, and makes it easier to access difficult emotions. For athletes who think more clearly when they're moving, walk-and-talk therapy can be a game changer.
Walk-and-talk sessions are available for clients in the Bay Area and Corte Madera. Online therapy is available for endurance athletes anywhere in California.
My Story
I came to ultra running the way many people do — looking for a challenge that would push me beyond what I thought I was capable of. What I found was a community, a practice, and a teacher. The trails have shown me things about myself that no amount of sitting still ever could — about resilience, about suffering, about the difference between pain that means stop and pain that means keep going.
As a therapist, I bring that same orientation to my work. I believe in pushing toward growth, not just comfort. I believe in the long game. And I believe that the people who are drawn to endurance sport — with all their drive, their discipline, and their complexity — deserve a therapist who truly understands the world they live in.
