Spring is around the corner and many athletes will finally get back to riding and running outside. With that comes a bump in motivation, but it can also lead to injuries. You get excited about your workouts, being outside again and you feel like a superhero. Then one day your knee is a little sore after a ride. You push through it for the next few days and now it’s hurting when you walk as well as when you ride. Finally someone notices you wince as you go down the stairs. “I’m fine,” you say, but in reality you’re suffering from an overuse injury.
What causes overuse injuries?
Overuse injuries are often caused by mechanical fatigue when tendons, ligaments, muscles and other soft tissues become excessively fatigued without adequate recovery. Frequently, endurance athletes experience overuse injuries such as IT-Band syndrome and patella or Achilles tendonitis due to abruptly increasing training volume or intensity with poor biomechanics and insufficient rest. Typically, it is not one training session that brings on an overuse injury; they typically result from repetitive trauma to tendons, bones and joints.
So, how can you take advantage of your early-season enthusiasm but still avoid an overuse injury?
Follow these 5 guidelines:
1. Increase training load gradually.
A general rule of thumb in endurance sport is to not increase training load more than 10% week over week and I tend to be conservative and recommend 8% to be on the safe side. For example, if you are riding a total of 6-hours this week a 10% increase would equal about 30 minutes, which means the following week training should be capped around 6.5-hours. By logging your training in TrainingPeaks® you can also track your training progression through Performance Management Chart (PMC). The Chronic Training Load (CTL) takes into consideration both volume and intensity of your training to measure the increased chronic stress of training over a period of time.
2. Pay attention to mechanics.
Improper technique is also a major factor in tendonitis types of injuries, especially in endurance sports that feature highly repetitive motions. If a cyclist has a poor bike fit and they ride for 1-hour at 85rpm, they are pedaling 5,100 revolutions with a cycling position that is potentially aggravating tendons in the ankle, knee, or hip! If you’re attentive and address the problem quickly you can often prevent it from becoming a chronic injury.
3. Include sufficient rest.
Your body is amazing at adapting to training stress and even adapting to changes in your biomechanics. But adaptation takes time and recovery. Ideally, athletes should include at least 1 day of complete rest for every 7 to 10 days of training.
4. Identify good pain versus bad pain.
Good pain is a result of overload from a training program that features progression. If you’re adapting well to the training, soreness or pain will be absent the next day and you’ll have the energy for a high-quality workout. Pain that remains present and relatively constant throughout a workout, even if it lessens a bit after a good warmup, is an indication that you’re pushing beyond your body’s ability to recover.
5. Warm up properly.
A proper warm up may last 10-20 minutes depending on the length and intensity of your training session. A more intense training session may require a slightly longer warm-up period. The jury is still out on whether stretching– dynamic or static– reduces the likelihood of tendonitis, but you can’t go wrong by increasing blood flow to working muscles through a warm-up routine.
Treating an existing injury
If you suspect you might have an overuse injury, the first step in early treatment should be the tried and true R.I.C.E. protocol:
- R. Rest, determine the necessary amount of rest. Typically 1-3 days of complete rest may be best at first for you to assess how severe your overuse injury may be.
- I. Ice, apply ice to the tender area a couple of times a day for 10-15 minute periods; specifically after your training session.
- C. Compress, if there is excessive swelling apply compression after icing. If excessive swelling continues for multiple days seek a medical professional for advice.
- E. Elevate, elevate your injured area above the heart while recovering/resting.
If you’re an endurance athlete with training or competition goals that are important to you, visit a physical therapist if you’re experiencing symptoms of an overuse injury. There may be treatments and specific exercises you can do to accelerate your recovery. When you’re ready to get back to training work with a certified coach or biomechanics expert to assess your cycling position, running form and/or swimming technique to ensure you are incorporating appropriate technique. Of course in the future you will want to utilize the 5 guidelines above to avoid an overuse injury in the first place. Rember, an ounce of prevention is worth a pound of cure.
A very import step upon returning to active training is to make sure you are re-conditioning your body to operate with proper biomechanics. This may mean taking a step back in the intensity of your training so you can focus on technique for a while, and then begin increasing training load by a conservative 5-8% per week for the first 2-3 weeks back to training.