Injury prevention post - Liam @ Sligo Advanced Physio

General Injury Prevention post from Liam @ sligo advanced physio on the mall. The first in a series of posts.

Hopefully everybody is enjoying the training in the off season. Here are a few pointers to keep in mind to try and cut down your chances of picking up an injury to ruin your base training.

1. Previous Injury – The biggest predictor of a future injury is a past injury. If you had a back problem 2 years ago or a knee injury 6 months ago then these are the areas you really need to concentrate on in the off season as part of your strength and conditioning programme. Just because you don’t get pain in those areas now does not mean that they have returned to “normal” function after the injury. Pain reduced muscle function and proprioception therefore if you had knee pain you would likely find that some muscles around your knee would be functioning poorly increasing your chance of re-injury. The off season is a great time to commit to structured rehab programme to maximise the endurance, control strength and proprioception in the region of the old injury. Maybe in future posts we can look at specific injuries and rehab plans for them if people are interested

2. Load Management – This is a massive contributor to injuries. It is always a tricky one trying to match the demand you want to place on your cardiovascular system to improve aerobic fitness with the effect this load may have on your musculoskeletal system.

Think of this example:You are a keen club swimmer who up to know runs 5 miles once a week just for fun at 9 min mile pace. You decide that this year you fancy having a go at your first triathlon. You decide that you will run 7 miles 3 times/week and increase your pace to 8 minutes miles. The likelihood it that cardiovascularly you will tolerate this quite well given your strong swimming background. The problem is that good aerobic fitness gained from one sport (such as swimming) is not going to protect your musculoskeletal system from coming under pressure and maybe breaking down when your increase your running mileage. A few good rules to always consider to give your musculoskeletal system a chance to adapt and not break down are the following:

a. Be sensible with your mileage increases. 10% a week is often thrown out as a guide but obviously this is very general. It works well if you are doing 60 miles a week but if you are doing 5 miles a week this will be too conservative. So if you start with low mileage a week don’t increase by any more than 30% a week and as your mileage increases drop your percentage increases closer to the 10% region.

b. Watch out for how your body feels as part of your training diary keep a record of any areas of your body that feels sorer than others. Keep a record of your sleep pattern and your general tiredness as an early sign of overtraining. Record where you feel more tired after a run, is it your calves, quads or glutes. This can help you identify when you might need to reduce your mileage or look at your running technique.

c. Remember how important periodisation is, try to aim for a lighter mileage and pace week every four weeks to allow some recovery time to reduce the risk of overreaching and musculoskeletal injury.

d. Try not to increase 2 variables of your training at any time. If you increase your mileage by 20% don’t reduce your mile pace in the same week. If you normally run the flat then don’t increase your mileage and add in a substantial hill section in your runs in the same week.

e. Think of the surface you run on; compacted sand and grass are likely to place less load on your joints than constant road running but running on sand dunes will significantly increase the load on your Achilles tendon and might be best avoided if you have a previous history of Achilles injury.

f. Include strength and balance training in your weekly training programme especially for your pelvis and lower limbs. When you run you only have 1 leg on the ground at any 1 time therefore attempt to include lots of single leg strength and balance work. Maybe in a future post we could discuss a few exercise ideas to work on specific issues.

g. Footwear/Technique – 10 years ago this seemed easy use good motion control running shoes and run with heels striking the ground first and pushing of through your big toe. Easy! Now things are now much more complicated. Chi running, pose running and bare foot running are all concepts that most runners are well aware of. The problem is how can you identify what running style or running shoe (or no shoe!) works for you? Unfortunately that is a massive discussion in its own right with very few conclusions from research to help us make a decision. Maybe that’s a subject for a future post if people are interested.

I hope some of the above is helpful or interesting and might even be worthy of a bit of debate!. If anyone has feedback or different ideas it would be great to hear them. If anyone has any topics they would like a post on in the general injury/performance sphere let me know. Enjoy your training!