What’s The Damage?

Unless you’re a very lucky or very resilient triathlete you will suffer an injury at some point. The question is how to deal with it when it happens.


Posted: 9 August 2010
by Roy Stevenson

Hands up if you've never been injured. If your hand is in the air, you're in the lucky minority of triathletes who have never had to take time off training to recover from a sore calf, aching shoulder or throbbing knee.

Triathlon is a great sport for total-body conditioning, but it also offers many opportunities for injury if you're not careful - and even if you are. Club-level triathletes have a 56 per cent chance of being injured in any given five-year period and many ignore a problem, hoping it
will magically heal on its own, rather than doing the sensible thing by treating the injury immediately.

Treat yourself

If you become injured, your top priority should be to start treating the injury straight away. This is where many triathletes make the aforementioned mistake of resting and hoping the injury will heal by itself. The injury does usually improve with complete rest, but this can lead to a buildup of scar tissue in the affected area. This can cause problems later - research suggests there is a 50 per cent chance an injury will recur, which suggests athletes in general are not treating their injuries properly.

Next time you become injured, or even feel a twinge, act quickly. Start off by resting - and yes, that does mean not racing. Ice the area for 10-15 minutes at least twice a day (and preferably several times) for the first three days. Never apply heat to a new injury. Firmly compress the area using a bandage or compression material. If you're using
a bandage, make sure it isn't so tight that it cuts off blood flow. When you're sleeping elevate the injured area above the level of your heart. Reducing the blood flow to the area minimises inflammation and swelling. Gently stretch the affected area if there is no pain.

Change is good

If the injury is not severe enough to stop you running or cycling, now's the time
to modify your training. By taking the following steps, there's a good chance
your injury will improve within a week or two, so you can gradually start to increase your training again.

A key element of this strategy is developing a sense of your limits by listening closely to what your body is telling you. If, for example, you have a running injury that becomes sore around three miles into a run, limit your running to two miles. You alone can determine how much running is safe for you, but it's a good idea to cut back on the frequency, duration and intensity of your training. That might mean restricting your running or cycling to every second day (or cutting your frequency of exercise days per week by 50 per cent), and avoiding running on consecutive days.

Warm up very slowly for 10 minutes and cut back the pace you train at by one to two minutes per mile. Changing the surface you run on could also help. Avoid gradients and run on soft, level surfaces like grass or trails.

Always ice the affected area after you run or cycle. Gently stretch the affected area with one or two stretches. Hold each stretch for 15 to 30 seconds. And check your running shoes for excessive wear. Even the newest, most expensive shoes will not prevent an injury but old, worn shoes will make one more likely.

A good indicator that you are recovering from your injury is how the affected area feels in the morning. If there is no pain when you wake up or during your training you can slowly rebuild your training to pre-injury levels. However, if the injured area is stiff and sore and you're still hobbling around in the mornings, it may be time to take the next - painful - step.

Get a second opinion

If pain and swelling have not receded after a week of self-treatment and training modifications, you should visit your GP, who will diagnose your injury and advise you on whether you need to stop training and start taking anti-inflammatory medications. Your physician may also decide you need physiotherapy treatment.

Physiotherapists will have seen your injury before so listen closely to the advice and when they prescribe home exercises, do them. Your physio may also use ice, heat, electric stimulation, ultrasound, massage and mobilisation exercises to hasten your recovery.

Support system

You might also want to see a podiatrist to find out if you need orthotics to address any biomechanical idiosyncrasies in your running style. They may be just what you need to stay injury-free.

You may feel frustrated if you have to stop training. This is not surprising: if you stop training completely you will probably notice a reduction in your VO2 maximum (your ability to process oxygen) and so you may need weeks of effort to regain your fitness.

However, it's not all grim news. Many studies have found that a reduction in training shows almost no decrease in fitness for injury periods up to 15 weeks, but only if your training is done the right way. One study found that when intensity of training remains unchanged, VO2 max is maintained for 15 weeks, even when the frequency and duration of training are reduced by as much as two thirds. This means that you may experience no loss of fitness if you can exercise intensely in an activity that doesn't aggravate your injury.
If you've been instructed not to run or cycle, you need to find alternative cardio-respiratory exercises. This is a good time to do some cross-training. Performing other exercises will also develop parts of your body that are neglected by running, cycling or swimming.

Unless your injury is swimming-related (this usually means the shoulders) now's the time to develop your training in this area - there's no impact involved and you can still do high-intensity swimming to maintain your fitness. Non-impact equipment in the gym, such as the elliptical trainer, stationary bike or rowing machine, is also a good alternative, providing the motion does not aggravate the injury. While trying these other exercises, monitor your pain levels to make sure the injury is not flaring up.
If you feel pain, try a different activity.

Aim high

To maintain your fitness you'll need to exercise at a high intensity, so aim to get your heart working above 80 per cent of your maximum rate. This is difficult with stationary cycling as you will probably experience muscle fatigue in your legs before you can get your heart rate close to your normal running heart rate. This is to be expected. You'll still get a great workout from cycling.

You can continue with your strength-training programme while injured as long as you avoid exercising the affected area. And if you haven't done any resistance training, this is a great time to start strengthening the rest of your body.

Hit the pool

If you can't run on land, try aqua running in the pool. It simulates running but is also a great alternative if you've picked up a stress fracture, since most other activities aggravate the symptoms. Aqua running is done wearing a flotation vest - it works your legs, trunk, arms and cardiovascular system. With deep-water running you can simulate interval workouts, long workouts and everything in between.

Several studies have shown that aqua running can be used to maintain fitness. In a study in Florida State University one group of well-trained male runners switched to aqua running for six weeks, while another group continued with their regular running programme for the same period. The deep-water running group maintained their VO2 max, lactate threshold and running economy.

Another study, at Brigham Young University, in Utah, found that two-mile run times were maintained after six weeks of aqua running. This was confirmed by another study at the University of Toledo, Ohio, in which trained runners saw no change in their 5K times, VO2 max, lactate threshold and running economy after five to six sessions per week of aqua running over four weeks.

You will not be able to get your heart rate up as high as you can when running. Research from the Karolinska Institute in Stockholm concluded that heart rate during aqua running is about 10 per cent lower than when running on dry land. So to get the full benefits of this technique, you'll need to work hard in the pool.

Return smarter

A common mistake is to rush back into your training programme after an injury, trying to make up for the missed sessions. Never try to catch up on lost days; you'll probably aggravate the injury again.

Your body is composed of many different systems. Ideally they act as a smoothly functioning unit, but when you are returning to training after injury, some systems will be more out of condition than others. You may notice, for example, your breathing (respiratory system) returns to optimum condition faster than your leg muscles (muscular system). When this happens, be patient and wait for the slower systems to catch up.

Rehabilitation is an important part of coming back from an injury, but treat it with disrespect and you'll be back on the injury list faster than you can say "That really hurt." If you're smart, you'll listen to your body and adjust your workouts accordingly. Pain sends a message that a part of the body has temporarily reached its limit. Heed the messages, take it slowly and you'll be on the road to recovery.


Take The Plunge: Aqua Running Explained

Wearing your flotation belt around your waist, get in the deep end of the swimming pool. Simulate your running style in the water. It'll take time to establish your correct posture and learn a new skill, so be patient.

If you lean forward slightly you can run forward, while if you remain upright you'll run on the spot. Either works. Some runners like to do laps so they can measure progress.

It will come as no surprise that your leg turnover is not nearly as fast as when running on dry land, because the water slows your movements.

Interval workouts seem to be particularly effective with deep-water running. Here
are two sample interval workouts you can try:

Workout 1

5-minute warm-up
1 minute hard, 1 minute easy
2 minutes hard, 1 minute easy
3 minutes hard, 1 minute easy
4 minutes hard, 1 minute easy
3 minutes hard, 1 minute easy
2 minutes hard, 1 minute easy
1 minute hard, 1 minute easy

Workout 2

6 x 3 minutes hard with 1-minute recovery between each effort. Do two sets.


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