If you have been swimming, cycling or running for a while, no doubt at some point you have had an annoying niggle that has either reduced or stopped your training altogether. Whether it’s a sore knee, shin splits, shoulder impingement, a dreaded stress fracture, achilles tendonitis – it happens to the best of us. And now, right as the season starts to kick off, it’s something we triathletes dread.
But how do you manage an injury without a. losing all your fitness and b. losing your mind? The process of recovering from an injury is a bit like grief and its 5 stages: Denial (ignoring the pain), Anger (“this is so unfair!”), Bargaining (with your physio), Depression (“I’ll never race again”) and finally Acceptance (“I am out just now but I won’t be forever”).
Here are our top tips for surviving the dreaded i-word:
Don’t panic. First and foremost, if something is flaring up, follow the RICE protocol: Rest, Ice, Compression, Elevation. If you’re lucky, it will calm down in a few days. This is not the end of the world and we all get injured from time to time. Yes, it is frustrating but, in the end, most of us are not getting paid to do this so we have to accept this is just a blip in the road.
There are lots of things we can do in the meantime to maintain our fitness, including swimming, pilates, weights in the gym – a quick You Tube search will bring up loads of exercises that you can do, and a good Personal Trainer will be able to put together a month of exercises for you to do until you are fully healed. You can also use this opportunity for a bit of rest, recovery, and healthy eating.
Seek professional advice – find a great physio, a great coach, and set aside a budget for that because, sadly, our health can cost actual money. But isn’t the investment worth it? No one ever said triathlon was a cheap sport. If you are really close to one of your races, a good sports physio or therapist may be able to strap you up enough so that you can get through it, before going back for your main rehab programme.
Ignore the naysayers. People love to tell you running or intense exercise is bad for you. Try to drown those voices out with positive thinking. There is a wealth of scientific evidence to show runners are at no more risk of knee osteoarthritis than anyone else, yet we have all been told by someone at some point that we are wrecking our joints. The science just doesn’t back that up. We can overcome most injuries that triathlon throws at us, and that’s made easier if we block out the negative voices.
Trust yourself, your instincts and your body. If you’re in pain, that’s your brain sending you a message that something’s not working right. It doesn’t mean it won’t work again, it just merits more investigation and correction. If something isn’t making sense to you, ask your physio to explain it. If you’ve read stuff online, even though it’s a slippery slope to nonsense self-diagnosis, it’s worth at least bringing it up with a professional to make the necessary checks or ease your mind.
Pills are often not the answer. Well, sometimes they are, but be prepared to accept that long-term hard work, strength and mobility exercises may be what’s really needed. Cortisone injections or anti-inflammatories can help manage your pain but they can mask the underlying issues causing you pain in the first place. And remember, taking anti-inflammatories before or during an endurance event can cause muscle soreness, delayed recovery, as well as disrupting the lining cells of the colon, leading to a leakage of bacteria into the bloodstream. This can cause a condition called endotoxemia, which can lead to septic shock in extreme cases, so DON’T be tempted!
DO YOUR REHAB. The people who improve most quickly from injury tend to be the ones that do their rehab consistently and keep progressing over weeks and months, not just stopping as soon as they feel ok to run again. This has to be combined with a phased and systematic return to sport. Don’t expect to have 6 weeks off and then dive back in at full speed or you risk having even longer off.
If you’re not improving, go somewhere else. Ask your GP for a second opinion, a new physio, an MRI, an arthrogram. Our wonderful NHS doesn’t always have the resources to deal with sports-related injuries but keep pushing and make sure you mention how important it is for your mental health to keep active.
Prevention is better than cure. There is a wealth of information that shows resistance training with weights is one of the very best ways to prevent injury in athletes. You can do all the stretching, foam rolling and yoga you want, but ultimately you are going to need to lift weights if you want to remain strong and in the game for a long time. According to research of 25 trials, that included 26,610 individuals, there was no beneficial effect for stretching in reducing injury risk for athletes, whereas studies with multiple exposures, proprioception training, and strength training showed tendency towards a beneficial effect for injury risk reduction. Strength training reduced sports injuries by 69% and halved over-use injuries. Another recent study showed that those who included plyometrics (ie jumping) in their programmes reduced their chances of injury by 55%!
Follow the Endurance Physio on Facebook – Mike James is a walking thesaurus and chances are he has made a video on managing whatever injury you have!
In conclusion – don’t panic, seek expert help and find as much to do as you can to keep ticking over until you’re back in action. Injuries – and races – come and go, but most of us are in this for the long haul so we need to do what we can to ensure our longevity!