Ask The Coach:Simple Injury Prevention
By LifeSport Coach Marci Gray
Tri Season is in full swing, most of you have done several events by this point and are looking forward to bigger and better things or are in the midst of serious training. Continuous repetitive movements by the body can lead to injury and we are all guilty of the “no warm up” or “I don’t have time for the cooldown” mentality. Staying in one position for too long, doing the same thing over and over again and not warming up/cooling down are the biggest factors in getting injured.
Let’s go through a typical day of the average age group athlete. Most of us have jobs that require sitting at computers or in cars or meetings most of the day. Typical workout times are early in the morning (fresh out of bed) or evenings right after work, where we are rushed from one thing to the next with no time to stretch or warm up prior.
The main key in preventing injury, honestly, is to proactively stretch. Stretching routines can be extremely simple, take just a couple of minutes out of your day and save you from days, weeks or more of dealing with an injury if you get one. Typically the best way to stretch, is the movements in the opposite direction of what you do most thru the day (sit).
Looking at sitting posture from the top down:
Neck/shoulders- forward and rounded
Thoracic and Lumbar spine- rounded and flexed
Ankles-Slight Plantar flexion (pointed)
If only for a couple of minutes a few times a day we stand up and reverse these positions, the body has an opportunity to elongate shortened tissues and stretch joints that remain “locked down” for too long. Our bodies are meant to move, not be still, and as triathletes, we are generally not a “still bunch” but work stations and cubicles force that upon us.
Say, you show up at Intervals one morning, it is really early and you had woken up late with really no opportunity to stretch other than the bending over it took you to slip on the running shoes. Warming up on the track consists of 4-8 lengths around and the legs are tight from the group ride the night before, which, once done, you loaded the bike and sat in the car for a 25-30 min drive home or more and then a quick shower and dinner and bed. As you line up on the start line for the upcoming interval and the group leader yells go, you take 3 steps and feel a pull in the calf. An immediate searing pain and it shoots down the leg, no longer can you run, barely hobble off the track. We all have seen this before whether it was us or a friend..
Other problems that I commonly see in the running/triathlete community involve joints rather than soft tissue- hips, knees, backs, necks, shoulders, elbows- whether it be from the prolonged sitting we do commonly at the office or the postures we adopt when we run/bike/swim. I commonly see referred conditions as well that involve nerve roots and nerves, often misdiagnosed as IT Band/Piriformis/Plantar Facsitis/Meniscal tears/Bone spurs/degenerative changes/ trigger points/carpal tunnel.
Many times I commonly see mechanical problems easily fixed by just moving and loading the joint in the right direction. Often, in the hips/knees and ankles we get “junk” caught in between the joints- pieces of fat pads (bursae) or bits of articular cartilage that just get stuck from all of the movement we do when we exercise. In the shoulder and elbow it is the same. However, in the spine there are similar mechanical issues involving the intervertebral discs or facet joints that can result in an impingement in the nerve root causing referred or radicular pain, which is often mistaken as trigger point, or IT band syndrome (depending where in the spine it occurs.)
If you have pain, and are worried it is an injury, think about the possibilities first- is it constant or intermittent, was there trauma (fall/crash), sudden onset or gradual, can you move and change your position and be pain free?
Most of the time, I generally see reducible mechanical pain that responds to very simple movements, if you know what to look for, there are, however, some instances where the pain is due to more involved conditions, such as a stress fracture or a tear in a tendon/muscle. The good news is, if you have the proper diagnostician, these answers can be much quicker to come by. This doesn’t always mean x-ray or MRIs are necessary, but might be used later if mechanical evaluation does not fix the problem.
Marci Gray is a licensed Physical Therapist and owner of her own outpatient private practice. She is McKenzie Certified and a USAT All American. Marci has competed in races from sprint distance to Ultraman and has been a USAT Team USA qualifier 3x for Olympic distance.