It’s that time of year again when you dust your boots off and prepare for the season ahead. That dreaded text from your coach is sent into the WhatsApp group and you can’t help but think the inevitable: ‘how am I going to make it through another winter without picking up an injury’?
Unfortunately, injury is a part of sport. Whether it’s an acute injury (e.g. ankle sprain) or a chronic injury from a rapid increase in mileage over the last couple of weeks/months (e.g. Achilles tendinopathy), avoiding injury is no guarantee. In saying that, there are several injury prevention strategies that can be put in place to help reduce your likelihood of injury.
How can I reduce the risk of getting injured?
A lot of these you can do yourself:
Warm up extensively before exercising: Increase the heart rate and challenge the body using different mobility, strength and sport-specific exercises.
Prioritise rest and recovery: Alternate exercises and training every other day to allow muscle groups to recover (particularly after heavy lifting sessions). Avoiding going into match days with muscle soreness from heavy gym sessions.
Manage lifestyle: Ensure you are adequately fuelling before and after exercise, staying hydrated and prioritising sleep. Research shows that reduced sleep (<8 hours) can have negative impacts on recovery and increase injury risks by 1.7 times (1).
Other strategies may require assistance and input from a professional (e.g. Athletic Therapist or Physio):
1. Pre-screening: Undergoing a pre-season assessment has proven to be helpful in identifying health status and the individual risk factors for injury (2). Screening can also be useful for measuring baseline muscular strength and power. This is useful to have as a baseline if you do get injured to know what point you need to get back to, or even to just track performance improvements.
2. Load management: Monitoring the training and physical stress/load on your body is important, and can be effective for managing overuse related injuries such as Achilles/patellar tendinopathy, patellofemoral knee pain, shin splits etc.
If you are interested in learning more about how to manage your training load heading into the new season, get in touch with us through our socials or email!
From zero to hero
During this time of year, we often see a spike in chronic overload injuries, which makes sense given that training loads and intensity tend to peak, and many athletes are returning to their sport for the first time since off season. Following a significant period of rest or de-load, it is important to prepare the body through appropriate physical conditioning and increase the load gradually. It is probably not a good idea to start your first session back with a 5km time trial having done zero conditioning and prep work for a month beforehand. Ultimately, you are setting yourself up for a long and potentially painful period ahead.
No pain no gain!
Pushing through the barrier of pain in order to achieve results is not the ideal way forward. Pain is one of the body’s warning signals and it can act as a protective mechanism against further injury or harm. Whether it’s sharp, dull, aching, burning or tingling. Do not ignore it!
In my experience of working with athletes (particularly team sport athletes) there seems to be a common trend when reporting pain related to chronic injuries such as tendinopathies: they often wait until the pain is unbearable. Understandably, there are internal and external pressures to perform, and athletes may not want to tell you they are injured in fear of jeopardising their place on the team. At the same time, there’s a chance that some athletes are unaware of the early warning signs related to tendinopathy and so, fail to report this until it’s too late. Is there any way to solve this?
Figure 1. Overview of tendinopathy continuum
Get to know the flow: The tendinopathy continuum
Understanding how tendinopathies develop and their early warning signs may be the difference in returning to play in a couple of weeks vs months. When loading is optimal and there is time to rest and adapt, tendons become stronger and remain intact and healthy. This positive cycle continues when load is managed appropriately. On the other hand, when load on a normal tendon is excessive or there is sudden load placed on an unloaded tendon, you can develop what we call a reactive tendinopathy. Often this can lead to stiffness in the morning along with some mild pain and discomfort when walking, running or jumping. Pain can be pinpointed along the tendon or at the heel where it inserts into the bone.
Athletes may report that once they start moving the pain goes away – this is because tendons have a warm up effect once blood flow increases. However, this is where things can progressively worsen (leading to tendon disrepair and/or degeneration). An athlete may think that they are not doing any further harm or are by some miracle, ‘healed’ because their pain and discomfort have ‘disappeared’. Of course, that is until they have stopped exercising, the body has cooled down and their pain and stiffness quickly return. Overtime, if load is not managed, this can progress from mild pain and stiffness to constant pain that is worse both during and after exercise.
Top tips for managing load
1. Remain open and honest with your coach/trainer
Athletes may not have total control over their training sessions which can make it difficult when trying to manage load. However, maintaining communication with your coach/trainer may allow you to adapt and modify training where necessary. Now that you know some of the early warning signs, don’t be afraid to speak up if you are concerned!
2. Think outside of your training environment
Perhaps you work a full-time job that requires you to be on your feet most of the day, or maybe you have taken on extra shifts in the restaurant at the weekend. Whatever it may be, it’s worth considering (and managing) the physical activity/load on your body outside of your training environment.
3. Prioritise rest and recovery
Rest and recover between sessions to ensure that your body is ready to take on the next session. This is a key component of the tendinopathy continuum and is necessary for tendon adaptation.
4. Consider professional advice
Are you experiencing pain and/or noticing stiffness? Struggling to manage the load yourself? Get in contact with a medical professional who can design an individualised rehab programme for you and guide you on your road to recovery. Don’t wait until the pain is unbearable!
If there is anything we can do to help, make sure to get in touch!
References:
1. Vermeir P, Leye MD, Grymonprez R, Goethals A, Vermeir R, Bossche LV, et al. 456 The impact of sleep on the recovery of sport injuries. Br J Sports Med. 2021 Nov 1;55(Suppl 1):A173–4.
2. De Michelis Mendonça L. To Do or Not to Do? - The Value of the Preseason Assessment in Sport Injury Prevention. Int J Sports Phys Ther. 17(2):111–3.