Injury Prevention for Elite Athletes

Injuries are common in recreational and elite athletes training for endurance events.

Injuries can be roughly classified as acute, such as rolling the ankle while trail running or overuse.  Overuse injuries can be caused by a sudden increase in training or the injured tissue can no longer cope with the demands placed upon it.

PREVENTION

Active Recovery
An active recovery of cool down is very important after hard workouts to help flush out lactic acid; it should consist of 15-20 minutes of gentle movement.

Differentiate Muscles soreness from Injury soreness
Delayed onset muscle soreness is common a day or two after a strenuous session, other than putting up with the soreness there is no harm done in continuing to exercise.  Joint soreness is an indication that the joint itself has been stressed and requires more rest.  Signs would include swelling or a ‘puffy’ joint and tenderness.  If other areas continue to ache or are painful, longer than 1-2 weeks should be assessed.

Correct Training
A gradual increase in training in necessary, a 10% increase seems to be a good rule of thumb.  Remember that while it is important to gradually increase training volume and intensity, adequate recovery allows the body to build up stronger.  High intensity training requires around 36-48 hours of recovery before another high intensity session should be undertaken.  A good rule of thumb is the higher intensity the session the longer that recovery.  Knowing your body is key for any athlete, knowing when to push and when to rest.

Cadence
Stride rate 180-200 strides per minute for runners, 90-100 RPM for cyclists

Technique
Runners should consider softer landing (midfoot/forefoot), slight lean forwards at the ankle, tall chest.  A proper bike fit is important for cyclists and triathletes.  A coach should be employed for swim technique analysis.

Strong Core
A strong stable core provided a good base to propel and transfer energy.  This allows an athlete to maintain good form and technique even when fatigued.

Adequate Flexibility
Adequate flexibility for the demands place on the individual ie. Hip mobility for runners, hamstring flexibility for cyclists, shoulder and thoracic mobility for swimmers.  This is probably more important as we age.  Static stretching should not be performed prior to a work out, dynamic stretching and a good warm up is better.   Static stretching prior to a work out has been shown to be detrimental to performance.  Static stretching (20-30 second hold) should be performed after a workout.

Old Injuries
Deal with those old injuries in the off-season that linger after your competitive season.  With an increased training load they will most likely reappear.

Adequate Sleep
There is some research that ongoing sleep deprivation, longer than 1-2 nights, interferes with our hormonal balance that regulates recovery.

Nutrition Replacement
A great resource is the coach.ca website, that has a sport nutrition section found at http://www.coach.ca/sport-nutrition-tips-p138189. Eating properly is important on a routine basis but a post workout combination of carbohydrates and protein is critical for recovery.  Good information can be found at http://www.coach.ca/recharge-and-replenish-recovery-nutrition-p144453.

Compression
Compression socks have become quite popular, with some claims of improved athletic performance.  Best scientific evidence is that they assist with lactate acid clearance post exercise and decrease swelling.

Cold Baths
Cold baths have become popular and are theorized to reduce the inflammation that has occurred with a strenuous workout. Cold water may help recovery, and can be used for around 10 minutes. It is not necessary to have an ice bath; cold water of 24 Celsius is okay.  Standing in our lake after a workout is also recommended.  Contrast baths of cold and warm water may also be beneficial though not very practical 1 minute cold 10-15 Celcius then 1 minute warm  (37-40 Celcius) for 7 cycles was advocated.

Footwear
Consider changing running shoes every 1000 km or so.  It is also wise to have two different pairs of shoes that you can rotate.  Make sure you have your footwear checked by a store with knowledgeable staff that can help you pick the right shoe.