Q - Why do you think so many athletes get injured?
Dalia - From my own personal experience of working with athletes, the most common reasons I see for people getting niggles are usually ramps up in training, over training but also sticking to one discipline, i.e. just running and no mobility work/cross training/strength training. I also feel that our general modern lifestyles play a part too. We sit at desks for several hours a day, we then sit in cars or public transport and then we sit again at home. Therefore we don’t spend as much time exercising our range of movement in different ways.
Chris - There are many reasons for injury to strike but increased training load is often a factor. This might be an acute load from a single session or a more chronic issue where total training load over time leads to breakdown. Athletes love their sport and always want to do more. Sometimes the hardest part of coaching is convincing people to do less! If people paid as much attention to their recovery as they do their training then we’d definitely see fewer injuries.
Q - What techniques can athletes use to keep their body in top shape?
Dalia - Cross training is great for athletes! Perhaps there is a weights class you can do at the gym. Not only does this provide you with extra power for your sport, stronger muscles will help injury prevention. Swimming is a great low impact exercise that can help work on our breathing but also a sport that can be done on rest days (we are talking easy here). Range of movement is great for athletes so a yoga class is perfect, it doesn’t have to be high impact either or even an hour long. Sometimes just a 20 minute yoga video in the morning before work is fine. Sleep is really important, something many of us struggle with but it’s important not only for our health but for our performance and recovery.
Chris - I agree that cross training is great advice, particularly for runners. Participation in other sports has been shown to reduce injury risk and can be used to provide aerobic conditioning without the pounding of running. On the flip side, cyclists can suffer from very low bone density unless they supplement their training with activities that place a mechanical load on the skeleton, like running or lifting weights.
Another important issue is diet. Many athletes undereat because they are trying to reduce body fat, thinking that this will improve performance. This can lead to a condition called Relative Energy Deficiency in Sport or RED-S. This is characterised by low-energy availability and low bone mineral density. In women, it typically results in menstrual dysfunction, including loss of period. It may not be as obvious in men, but results in low testosterone and can lead to long term health issues. To stay healthy, athletes need to fuel the work they do!
Q - Athletes love their foam rollers! How should foam rolling be used?
Dalia - I’m not a big fan of foam rolling personally. If I do it then I do it quite lightly. It’s rather superficial and I would just rather have a massage! I get why it can feel good and *feels* like it’s releasing muscle. Most people do it wrong though! People often believe that foam rolling has to be painful but this could be doing more damage than good. Foam roll to level that’s comfortable, like a deep massage. If in pain, muscles could tense up and we put our body through unnecessary stress.
Here are a couple of articles that are worth a look:
What foam rolling is actually doing when it hurts so good
Your IT band is not the enemy but maybe your foam roller is
Q - What advice do you have for self coached athletes?
Chris - Concentrate energy on getting the basics right and be patient. When you start training or increase your training load, your aerobic fitness can increase very quickly. All that exercise capacity is like a new toy that you just want to play with all the time. Ride further! Run faster! Unfortunately, our musculoskeletal system (bones, muscles, cartilage, tendons and ligaments) takes a bit longer to catch up. One possible reason for this is that connective tissue only adapts to the first 5-10 minutes of each activity. As we become capable of training sessions much longer than this we increase the gap between our capacity to do work and our body’s ability to withstand the load. The result is often a disappointing and frustrating battle with injury.
To avoid this, I prefer to work on exercise frequency before extending duration and intensity. Light to moderate exercise 4-6 days a week is a safer way to build fitness than two monster training sessions at the weekend.
There are some popular guidelines out there, like increasing your mileage by no more than 10% a week, but these are far too generic and can quickly lead to a greater load than athletes can handle. Increase your training slowly and then hold at that new volume. See how your body responds and then decide whether it’s safe to add more. Long term development comes from consistency over weeks, months and years so don’t rush it!
Think about your equipment but don’t overcomplicate it - fit and comfort are the most important factors.
For runners, the choice of running shoes can be bewildering. Look online and you’ll get evangelical insistence that there is only one true path to running shoes enlightenment - cushioned, minimalist, barefoot, maximalist! Forget all that and just wear shoes that feel comfortable, rotate through several pairs of different shoes and replace them when they’re worn out. Simple.
For cyclists, a bike fit isn’t just for the pros! A bike fit from an experienced practitioner can help keep you pain free. Something as simple as an incorrectly set seat height has been shown to increase the risk of knee injury.
Finally, don’t wait for injury to strike before you take action. A history of injury is consistently the biggest risk factor for future injury so the best thing you can do is stay injury free to start with!
Q - What should athletes do if they develop a niggle?
Dalia - Don’t google it! Or ask on Facebook! See a physio/medical professional. Very often we feel a pain in our knee and just assume it’s the knee, we may foam roll, book in a massage, google our symptoms, ask on Facebook but my advice is to always see a professional who can take a look at your biomechanics, like a good sports physio. Very often people lack strength in core, glutes and ankles, range of movement is limited, muscles compensate. So whilst you think you may have a knee problem, it could be coming from other areas. With some injuries or niggles rest is advised, others can sometimes benefit from continuing our sports (but steady) and/or loading exercises. A good sports physio can advise you on this.
Chris - Firstly, stop doing things that hurt! A niggle is often the first clear sign that something isn’t right. Next, assess your training leading up to this point. Have you had a particularly hard session? Has your overall training load increased? How about rest and nutrition? Has equipment changed or is it worn out? If a short period of rest or reduced training doesn’t resolve the situation, definitely go and see a professional for advice.
Q - How can a massage therapist help?
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