Triathletes and Injury Prevention

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Having spent many years training for fitness, it wasn’t until the last few years I became aware of how delicate a balancing act it can be of knowing how and when to push yourself toward greater fitness and avoiding injury.

I have had many injuries and hope I’ve learned how to approach training with the long tern goal of staying healthy and injury free. I would often push myself too hard when I did not need to or it was not the right time to push. Maybe I did not give myself enough of a rest, either between intervals, sets, or laps. It absolutely is a science and the more I read and study, the more I am able to understand when and WHY I do the things I do.

With the idea of sharing that, I posed several questions to my physical therapy group that helps heal me, Elite Physical Therapy in Charlotte, NC. Kelly Floyd started this the group and Joe and Lesley have joined in the last year. They are immensely qualified and have vast sports experience themselves as well as treating patients of all ages and ailments.

I treasure their input and advice. Here’s some advice I hope you can learn from as well.

What are the training rules of thumb and why are they important to follow?

Always break a sweat before stretching. Think of your cold muscle as a piece of bacon out of the freezer. You bend it and it breaks! Heat it up and it bends much easier!

It all starts with the core, the area of your body from your diaphragm to your groin. When running, jumping, cycling, swimming, or weight training, sitting, standing, bending, you name it, keep your spinal alignment perfect. Your spine is made to be stabilized, not twisted and bent. That’s what our other joints are for.

When increasing your mileage/running time or weight lifting, especially if you have not trained in a while, live by the 10% rule. Don’t increase your training initially by more than 10% per week. For example if you have been running for 10 minutes 1 week, don’t increase to 20 minutes the next. Try up to 5 minute increases each week. We sometimes tell our patients that if they are running every other day up to 4 days per week, try adding 1-2 minutes onto each run for the week for a total of about 5 minute increase in time per week.

As for weight training, try to only increase your resistance if your form is perfect for 2-3 repetitions in addition to your planned repetition stopping point. For example, if you had planned to do 10 repetitions with 50 lbs, if you could perform 12 repetitions with 50 lbs with perfect form, you would be able to lift the next time with 10% more weight (55 lbs) at 10 repetitions.

As to not sound redundant, most of the overuse injuries can be prevented with a gradual training program and adequate rest. But for those athletes just starting out without knowledge of their own body, it’s best to see a sports medicine specialist (physical therapist, orthopedic surgeon, athletic trainer, some well-respected personal trainers, contact local triathalon clubs for information on these specialists). These specialists can assess your muscle imbalances and functional strength, assist with appropriate shoe-wear, nutritional requirements, and make necessary training corrections in mechanics to optimize your training.

Are there any training practices specific to triathlon athletes should adhere to?

Triathletes need to understand that the specificity of their training comes from performing 3 consecutive events sustaining a relatively high intensity. Therefore program optimization would be to carry this idea into your cross training as well. For example, Pick 3 consecutive exercises, (push ups, pull ups, squats) and maximize your effort on all 3 for a certain period of time. This type of training develops anaerobic power, or the ability to work through the burn, utilizing large muscle groups. Another example would be to get on a spin bike for a mile as fast as you can, then the treadmill for ¼ mile as fast as you can, then do 1 minute of step ups onto a 8-16 in. box as fast as you can.

Your practice sees many athletes after they have injured themselves. Given your experience, what are some things triathletes can do to prevent injury?

Hydrate! Your muscles need the correct electrolyte balance for optimal contraction. If you are lacking fluids pre- or post- training, your muscles lose efficiency to contract and then you may sacrifice proper technique, cramp, or strain a muscle.

Rest and Nutrition! Sleep is a triathlete’s best, but often unappreciated friend. Plan your training to allow for maximal rest the day or night after your hard training day. Also, periodizing your programs will permit proper work to rest training days working up to the event.

Shoe-wear! A lot easier to say than do, but a proper shoe-wear assessment by a physical therapist, podiatrist, or pedorthist can be a life-saver as your mileage and intensity increases. Also, make sure you have 2 pairs of shoes to rotate at least 48 hours between because the EVA rubber in the shoe heats up and needs time to cool down to regain its properties.

Professional Movement Assessment! Along the same lines as a shoewear assessment, a physical therapist can assess the entire body from heel strike to leg swing, from pedal stroke to breast stroke to determine faulty kinetic links in your triathlete body. Many times overuse strains and sprains can be prevented before heavy training begins by a full body athletic movement assessment.

What role does technique play in athletic performance and injury prevention?

Technique can affect efficiency and spinal control. Many overuse injuries come from your muscles’ inability to slow a body part down. This is called an eccentric contraction, and this type of contraction is where muscle strains show their ugly heads…usually right when you are pushing to the next level of training. The overuse injury can often be avoided by improving your efficiency of movement, in other words optimize your muscle’s overall ability to contract, especially eccentrically.

As for spinal control, excess spinal motion leads to uneven wear on your spine’s joints. It also leads to unwanted motion that your extremities need to control. Say you use your quadriceps muscles 10% more when cycling by leaning side to side vs. keep your spine still. You are already fatiguing yourself for the run portion, and the extra 10% muscle use can affect your technique in the last leg of the race

What are the most common injuries you see in triathletes and how can they help prevent them?

Overuse injuries- The “ itis’s “(tendonitis, bursitis) Usually at the foot, ankle, knee, hip, shoulder. Usually caused when training is increased too dramatically too soon, or when the body has not rested the necessary amount.

Stress Fractures- especially of the navicular in the foot and top of tibia in the leg. In women stress fractures may be more prominent, especially in the leaner female triathlete, where the body fat percentage is low.

Joint Pains/Muscle strains- Cause by muscle imbalances, overtraining, poor knee alignment, hip abductor weakness, incorrect shoe-wear, improper postural habits while cycling.

I wholeheartedly recommend them and if you have questions feel free to contact them at:

Elite Physical Therapy
2630 E. 7th Street, Suite 206 •Charlotte, NC 28204
Office: 704.333.1052 • Fax: 704.333.1054
Email: elitept1@bellsouth.net
Website: www.elitept1.com

Here’s alittle about them:

“Kelly Floyd, president and owner, graduated with a Masters in Physical Therapy from University of North Carolina at Chapel Hill. Kelly is an active triathlete and former collegiate basketball player as well.

Joe and Lesley Tedesco graduated with their Doctorates in Physical Therapy from Duke University and are also Certified Athletic Trainers. In addition, Joe is a Certified Strength and Conditioning Specialist. As former athletic trainers for the University of Florida, Joe cared for the men’s basketball team and Lesley worked with the women’s volleyball team. Both have experience initiating functional training programs to professional, collegiate, and high school athletes.

At Elite Physical Therapy, we emphasize a hands-on-approach to treatment of orthopedic dysfunction of the spine and extremities. Our services also include movement assessment rehabilitation, injury prevention programs, therapeutic massage and/or strength and conditioning consultation for all sports and fitness levels.

We believe in community outreach and promise dedication to excellence using effective programs to keep our community’s athletes healthy now and in the future!”