I vividly remember the first time I did a movement evaluation with an elite-level athlete years ago.
“It hurts [here] when I run more than 12 miles” he told me.
Wondering if any other of his “normal” activities provoked his symptoms, I asked “when else throughout your day or week does this pain kick in?”.
His response: “only after mile 12…seriously- that’s it”.
The Doctoral studies I went through to become a physical therapist didn’t really prepare me to handle this situation… Clinically speaking, when you take an athlete of this level through a thorough movement evaluation, often times it is incredibly difficult to find “deficits” (something wrong or lacking)--whether strength, mobility, or otherwise.
Nevertheless, as a performance physical therapy practice owner, it’s my job to help athletes like this triathlete to come up with a game plan for getting back to competition form as soon as possible.
On the surface it seemed like there was nothing wrong with this triathlete. Peeling back the layers, however, we found what we often see these days with our athletes. The “other” factors involved in his training most likely were playing into his injury more than anyone had realized…
His training volume (in this client’s case, running mileage per week) had gone through some huge spikes in total distance, mostly due to a later-than-anticipated registration for a Full Ironman competition (a continuous effort of a 2.4 mile swim, 112 mile bike ride, and a 26.2 mile run/full marathon). He hadn’t started his training cycle far enough in advance compared to what he normally would have.
Sleep & stress management had been crap over the past couple of weeks. In fact, he had recently just had a child move out of his home and go to college, and work had been especially busy.
He had never consulted a nutritional professional about how to amp up his nutrition game going from an Ironman 70.3 to a FULL Ironman. The influence of this nutritional fact can’t be overstated.
I have learned a lot over time and lots of studying and experience working with hundreds of athletes across the spectrum of sport participation. One of the most important lessons I have learned in my Sports Medicine career is this:
Sudden or repetitively large spikes in TRAINING VOLUME (across the spectrum of sports) represent the largest risk for injury for athletes...
Sudden or repetitively large spikes in MOVEMENT VOLUME OR TYPE (across the spectrum of any movement for that matter for sedentary individuals, adults who don’t play sports, and adolescents) represent the largest risk for injury for humans...
These spikes can be magnified across the amount of repetition we experience during the sports we love playing...For example:
Running: several thousand repetitions of single leg stance
Cycling: tens of thousands of repetitions of a pedal stroke
Weightlifting: Several thousand pounds of weight lifted over a training session
Soccer: several hundred QUICK different direction changes and single leg maneuvers
CrossFit: Thrusters, Clusters, Rope Climbs and more x ? + fatigue
What Probably Doesn’t Matter (As Much)
I am convinced that things like Biomechanics (your glutes aren’t “firing” or your kneecap shifts to the right or left of center) and Pathoanatomy (one of your legs is longer than the other, your hips are not in perfect “alignment”, or your MRI says you have “Degenerative Disc Disease”) matter far less than what we have previously thought.
Don’t get me wrong — there are nuances to the human body and human movement which we have yet to understand. And there are plenty of injuries that need a biomechanical or pathoanatomical treatment approach.
But the fact is, there are already a majority of clinicians out there who work hard to treat those things.
And chances are...if you have found your way to this Blog, you’ve already tried those approaches.
And they probably aren’t working out as well as advertised...
So let’s dive into 4” other” things you can do to directly reduce your risk of injury (regardless of sport)
(1) Follow a Plan
That’s probably one of my favorite quotes by the late Zig Ziglar.
The fact is, many athletes across the spectrum of sport don’t approach their training intentionally, but rather accidentally.
We have a huge portion of scientific literature that shows us how the body craves gradual overload in order to allow our tissues to adapt in healthy ways (by that I mean getting stronger muscles, thicker tendons, higher tolerance to physical stress). So setting some goals, and having a plan is perhaps one of the best things you can do to prevent injury — even if that means hiring a running coach, performance physical therapist, or trainer!
(2) Focus on Recovery
Recovery is the new cool kid in town.
From the insanely fast rise of the Hypervolt & other percussions massagers to the enthusiasm surrounding Heart Rate Variability and sleep quality, people who take their fitness seriously are starting to catch on to the incredible importance of rest & recovery.
This is perhaps the most under-appreciated and abused way to improve performance and reduce injury risk.
Heart Rate Variability (HRV) is one metric that objectively measures how “recovered” our bodies are and therefore how prepared we are to handle physical (and other) stress. As more research continues to pour in about HRV, there are a few standout things from the current research that you can do right away to prioritize your recovery:
Prioritize your sleep habits
No screentime before bed
Keep your bedroom cold
Be consistent with your bedtime
Shoot to drink half of your body weight (drink that in ounces — so if you weigh 200#, your goal could be 100 ounces daily)
The physical, psychological, neurological (insert any other -ical here) benefits of mindfulness continues to be well documented in medical literature these days. If you take your recovery serious, some sort of mindfulness or meditation daily can be a huge boost.
(3) Pace Yourself / Use the 10% Rule
If I lost you at “pace yourself”, please don’t stop reading just yet…
It’s not in our nature to tap the brakes on a good thing.
The 10 Percent Rule is a time-tested principle that I first learned from my work with some of the endurance athlete crowd of Detroit Metro.
The 10 % Rule…
This rule encourages athletes to not increase total training volume by more than 10% of the previous week. To my knowledge, this was first introduced in the running community as a concept to adopt while training for a race. But it has applications across the spectrum of sport participation in my experience.
This is my absolute favorite way to strategically controlling the amount of training volume we put ourselves through in order to allow our body and its tissues to gradually adapt and strengthen over time WITHOUT INJURY.
A 10 percent increase may not seem like enough to you. But I assure you that it builds over time, and in some cases is even rather generous…
Here is a common example:
-A runner starting at 10 miles per week of total running time only increases to 11 miles for the following week — but grows to 28.5 miles per week by 3 months time (nearly triples).
(4) Cross Train!
When it comes to injury prevention, cross training is a must.
The importance of cross training doesn’t have as much to do with the specific demands of the cross training exercise/movements.
It has everything to do with feeding your body some movement variety.
Specifically in adolescent athletes, we know that single sport specialization can pose a huge risk for injury. In developing and matured bodies alike, human tissues crave recovery and variety.
It’s NOT about triathletes NEEDING to weight train to gain a lot of muscular strength for their sport.
It’s about triathletes NEEDING to give their muscles a break from the long-duration, high-repetition challenges of triathlon training.
It’s NOT about CrossFit athletes NEEDING to learn the nuances of running form to be able run a sub 18:00 5K.
It’s about CrossFit athletes NEEDING to realize the value to their aerobic fitness and tissue health of improving running form and efficiency, even though they’d rather be doing back squats and power cleans.
It’s NOT about high school soccer players NEEDING to be good at basketball or cross country.
It’s about high school soccer players NEEDING to have a few months out of their year where they are not challenging their bodies with the physical and mental demands of only one sport (read more about the risks of single sport specialization in adolescent athletes here).
So there you have it — 4 “other” ways of preventing injury that you need to focus on as an athlete.
Have any others you’d like to add to the list? Drop a comment or connect with us on any of our social channels!
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