This post is for the recreational to very serious endurance athlete that is committed to their sport year after year and who finds themselves dealing with annoying injuries.
After being a competitive road racer myself (runner) for 27 years, (retired at 40) I do understand that there is a common denominator that binds endurance athletes together! You’re willing to push yourself to your limits, and no overuse injury is going to have “its” way with you when it comes to taking you out of your sport (running, road cycling, mountain biking, triathlon, Tough Mudder, or Cross-Fit competitions.) You’ll train through pain if you have to, but you’ll also try to not let your training buddies see that painful grimace when your injury is “giving you the business”. Deep down you realize that you’re not 100 percent, and its messing with your focus and attitude towards training. I remember training for the Ottawa Half-marathon in 2005. My girlfriend and I at the time would diligently train to get our mileage in, however when it came to getting in some intervals or stepping it up beyond a “cruising gear” I usually found myself alone. Which was fine because I usually found training with others who weren’t as motivated as myself, distracting. So, I put in my time to train properly as I knew the Ottawa race was going to very competitive in my age group (at the time is was 35-39 yrs). One day I set out to do some longer intervals at tempo on a sort of county road that wasn’t too far from my girlfriend’s home. About 20 minutes into the hills I started noticing an ache or pain on the side of my left knee which intensified going up hills only. The more I persisted to push through the pain, the worse it got. So, having the halo of being an athletic therapist didn’t help me one bit. I needed to conced that I sustained a repetitive/overuse injury and I needed to manage this fast. We had 6 or 7 weeks to go before the race which was the critical time to ramp up one’s intervals and anaerobic threshold tolerance. It was a hard pill to swallow, but I realized I had to shift into “shut-down” mode and take care of this nagging injury. This injury management took about 10 days of not doing any speedy running, and focusing on letting the inflammation at my knee settle down, while I diligently stretched the tight muscles that I had apparently been flogging for too long.
I was back at doing my intervals at day 14 as well as religiously getting in my stretching after my training sessions. Luckily, that was really all it took to get over this little “speed bump” in my training. I realize that my injury could’ve been much worse and that I might have not even competed in the Ottawa Half-marathon and achieved a personal best time of 1:21.
The point of my little story is to address one’s mindset and attitude while you’re “under the gun” (pressure of training for competition) as they say. What to do when the pressure is on and you’ve got two competing priorities on your plate. Caring for your injury and getting better and achieving your training or competitive goals. I’m here to tell you that you can do both, 100 percent! This preemptive strategy incorporates the old saying “a ton of prevention is worth a ton of cure”. Incorporate injury prevention into your training and lifestyle as an endurance athlete. This might change the way you train, compete, eat, sleep, and think. All of which is what I’m hoping for. Now, as we carry on to addressing your injury or someone you know with an injury, I’d like to explain to you a little bit about how I work with athletes who are compromised in a way that prevents them from training at their current level.
With most injuries that have no traumatic event or mechanism associated to the injury, there still is a cause for the injury. One method of detection of injuries before they even occur lies in a good assessment of the individual. Our bodies can be riddled with muscle imbalances that can increase our chances of sustaining an overuse injury. Good observation of your standing posture will provide us with some good information, but you and I both know that your posture and muscles need to be moving dynamically to give us more relevant information. I use a movement based assessment protocol called the Functional Movement Screening. This assessment tool allows us to take a “snap-shot” of seven different movement patterns so we can observe the quality rather than the quantity of your movements.
The Functional Movement Screening is a system that can help detect your potential for sustaining an injury as well as your potential for injury. When we move, our bodies and nervous system must carefully calibrate and adjust to our movements based on the tension in our muscles, tissue, fascia, joints, etc which is then matched by our ability to maintain an upright posture of our stabilizers. In general, most athletes have flexibility and mobility issues that stand in their way of their performance. The challenges that inflexibility imposes on our movements, muscles, joints, ligaments, tendons, etc is a major stressor to the body. These stressors are discussed more below.
Sorry, (Geek Alert) , this is where we get a little sciency (bear with me)
Endurance sports such as distance running, cycling, swimming and triathlons create prolonged repetitive stressors to the body. The joints, tendons, muscles and fascia all go through repetitive moments of frictions, compressions, shearing and rotational or torque–like stresses to name a few.
These stressors are part of the performance of your sport and depending on the duration of the event or training session, how intense the body parts are working (climbing a steep hill while cycling, or climbing a vertical rope) add in your current muscle imbalances and this can determine how severe your potential symptoms or injury can be.
Below is a summary of reported as well as clinically-verified injuries that can be caused by the internal stressors discussed above. Again, most of these stressors are caused by increased tissue, muscle, and fascial tension that inhibits free and fluid range of motion and economical, movement mechanics. Maybe you can relate to one of these injuries based on your research or assessment you’ve already had done.
- Lateral knee pain (i.e. Runner’s knee, IT Band Friction Syndrome)
- Hip strain, Hip bursitis, Trochanteric bursitis
- Knee pain caused by running or Patella-femoral syndrome
- Plantar fasciitis due to overpronation with flat feet
- Achilles tendonitis-and its secondary complications
- Shin splints, anterior compartment syndrome, Tibialis- anterior strain
- First toe joint pain and dysfunction
- Hip pain and dysfunction
- Sacro-iliac joint pain and dysfunction (Piriformis syndrome)
- Associated lumbar spine dysfunction and nerve impingement
- Hamstring muscle strain
- Quadriceps muscle strain
Cycling related injuries
- Hamstring muscle strain
- Ilial-tibial band syndrome (lateral knee pain)
- Lower back pain and postural dysfunction
- Thoracic spine dysfunction and postural muscle pain
- Calf muscle strain (gastrochnemius and soleus pain)
- Wrist joint pain and dysfunction
- Sacro-iliac joint and ligament dysfunction and imbalance
- Associated postural dysfunction and adaptation to cycling
Swimming related injuries
- Shoulder pain and related injuries: Biceps tendon, rotator cuff tendonitis
- Neck pain,joint and muscle dysfunction
- Associated muscle strain and dysfunction (deltoids, latissimus dorsi, pectoralis major and minor, quadriceps muscles, lateral rotators of the shoulder, infraspinatus and teres minor)
- Abdominal muscle strain and dysfunction
- Groin muscle strain
- Pelvic joint dysfunction and weakness or the core musculature
Current self-maintenance practices such as myofascial foam-rolling are recommended and can help improve the stress of being inflexible. This particular method of targeting your specific “tight regions” of tissue where the density of the muscle tissue is clearly creating problems ( too short and tight) is a very effective treatment and should be a regular maintenance practice for you in your training routine.
Stay tuned in for another post where I will address the techniques and practices of self-myofascial “rolling” treatments for injury prevention.
If you have any questions about the contents of this post, feel free to email me at: firstname.lastname@example.org .
Yours in health and fitness,