When an athlete suffers from an injury, one question that commonly arises is whether or not to continue training and if so, at what intensity. This is discussion is always a challenge because although it’s disappointing to see fitness numbers drop, it’s even worse to exacerbate the injury. Let’s dive into what happens when the body is overloaded and how we can discern the appropriate level of training for our injured athletes.
Let’s take a real-life example of a runner with a hamstring strain. A strain is a complete or partial tear of a muscle. What can we do as coaches to promote healing, sustain fitness, and prevent this athlete from becoming re-injured?
Step 1: Determine the appropriate volume of training.
First, we must examine the appropriate rest-to-activity ratio that allows the runner to heal. It’s not necessary to prescribe complete rest to all athletes who present with an injury. A simple rule to follow is to allow the athlete to perform activity that does not elicit pain during or after the activity has been completed. Maybe the runner can maintain 50% of their current training load? Possibly full volume can be achieved with the exception of speed work training? Or maybe he/she is a candidate for complete rest. Obviously, these criteria are determined on an individual basis.
Step 1: Explore alternative workouts that complement fitness goals.
It’s commonly accepted that the best way to get better at running is to run. However, when injury inhibits an athlete’s ability, they can shift focus to alternative workouts that still contribute central adaptations, such as sharpness in the neuromuscular system, circulation, oxygenation of tissues, etc.
When it comes to complementary training, we need to devise an exercise prescription with the intent to improve performance, and functionally reload the tissue. The obvious caveat is to not overdo the complimentary activity.
Perhaps strength training resonates well with your athlete’s recovery. Research shows excellent results in sport-specific strength training programs such as decreased injury rates, improved speed, agility, and ground contact times. This type of training can serve a dual purpose by both allowing the athlete to build complimentary fitness, and addressing the limitations that led to the injury in the first place.
When regular training volume is decreased due to injury, these strength sessions can be incorporated 3-4 times weekly. Try to emphasize form and slowly increase the duration of the workouts throughout the recovery process.
Other alternative workouts for runners include walk/runs and treadmill hikes. Walk/run sessions can be performed with low duration and high frequency throughout the week whereas treadmill hiking can be performed less frequently but with longer duration.
Step 3: Incorporate eccentric movements.
We need to appropriately load the tissue in a way that will promote healthy realignment to increase function and reduce pain. An eccentric movement causes your muscle to flex as it’s being lengthened or lowered. These movements include working your glutes as you’re lowering into a squat, or your biceps as you’re lowering a dumbbell after a curl. Incorporating eccentric training in an endurance athlete’s weight training program can prevent the chance of sustaining a strained muscle. These can be performed 2-3 days per week with high repetition and low load exercises.
Step 4: Determine an appropriate return to sport.
It’s now time to carefully test the waters while avoiding reinjury. Let’s go back to our injured runner with the hamstring strain. Our athlete is ready to return to running when they experience: 1. no increase in pain during or following activity and 2. their running gait normalizing with no limp.
There are plenty of things you can do as a coach to maintain and even maximize performance for an injured athlete. Be sure your adjusted training plan does not overload the tissues to the point of no return. Most importantly, allow the athlete’s pain to guide your flexible recovery plan.