UA Tri

We have been there, done that and got the t-shirt.

So we can understand the training involved and the angst when you have a schedule to keep and you’re managing niggles just trying to make it to the event!

Due to the training needed, most triathlon injuries we treat are associated with overloading/overuse.

Constant training, especially heavy loading distance work repetitively stresses muscles, tendons, and the tissues around joints and bones. This continuous stress produces repetitive microtrauma in those tissues. When you keep training on these tissues that are already irritated the body is unable to repair the damage in time and uh oh…..

These irritated tissues are then unable to cope with the training and become painful, swollen, weaker and tender to touch.

Having an understanding of the type and stage of injury is vital to get the right advice and treatment to know whether it’s just one of those niggles that will go away, or whether it’s a little more serious and requires a little more help and dare I even say it to a triathlete…..the dreaded R word- REST….. (don’t worry though, this is our last resort)

Poorly diagnosed and mismanaged injuries can ultimately interrupt your ongoing training and event schedule. So don’t dilly dally, get it assessed properly!

Not that we like stereotyping, but your long distance triathlete is sometimes…..how do we say this, a little driven and sometimes obsessive……….

Triathletes love analysis, stats, figures, training power, times, distances so no better chance to roll out some research to a captive audience of triathletes!

Does the research identify and specific factors which predispose you to injury?

 

Time to bust some myths:

There is no association between sex, age, and physical characteristics (such as height, weight, and body mass index) and injury incidence. There was no association between competitive distance or difference between recreational or elite athletes and injury incidence. So if you’re doing triathlon, it doesn’t matter whether you’re a beginner or pro, the injury risks are the same.

Truths:

Significant increases in training load too quickly predisposes you to higher injury rates. Overuse injuries in the Ironman distance athletes were found to correlate with the amount of time spent on speed training. Low back injury also was associated with time spent on speed cycling. Achilles tendon injuries were liked with the distance covered running hills. Long constant runs reduce Achilles injury rates 😊

Running injuries are linked to your with total run training time (especially when doing speed work) in the week before starting to taper for your event i.e really pushing and rushing last minute intense training before you taper predisposes you to getting injured (this was a found over a 5 year study!).

Sweet spot:

On interesting paper comprised of 258 triathletes of all levels found a ‘sweet spot’ of training hours:
Athletes training 8 to 10 hours per week on average over 3 yr were found to have the lowest percentage of injuries. Athletes training less than 8 or more than 15 hours per week had a statistically significantly increased injury risk.

Recommendations:

Our top tips: (also insert some of the running injury prevention tips in here)

Limit your limit speed work close to a race and instead focus on distance at a more moderate pace

Take care with:

Your total run training time in the week BEFORE you start your taper (especially with speed work).

The total amount of time spent speed training (linked with overuse injury for Ironman distances).

Lots of hill work when running- this increases the risk of Achilles tendon injuries.

The time spent doing SPEED WORK when cycling (correlated with low back injury).

However, time spent on long runs may be protective against Achilles tendon injuries.

What do we commonly deal with clinically?

 

Our hit list of most commonly injured areas are:

The lower limb, especially injuries to the calves, Achilles, ankle/foot, shins, knees and the lower back would rank as most commonly treated.

The scientific literature: rate of injury amongst triathletes

In a nut shell, most of you get injured- it’s extremely common unfortunately.

A review of research papers studied (1) looked at the rate of injury amongst triathletes found these findings from various papers:

The lowest injury rate found in a study was just 37% of athletes competing in all distances (these took place over only a 8-week training period).

For those doing longer training programs (i.e half or full ironman’s) the rest of the studies don’t make such good reading from this review of research papers (1)

These range from 87% of triathletes suffering from some form of overuse injury over a 26-wk training period.

In a retrospective study of 656 participants in Ironman Europe, almost 75% reported at least one injury since starting triathlons

For those crazy enough to qualify and attempt KONA- you can look forward to many types of pain, not just the hurt locker pain either.

91% self-reported an injury during the year, and most had an average of 3 injuries during the course of training for Kona…….

Where do triathletes get injured?

 

This previously mentioned review paper also looked at where triathletes get injured the most.

These findings not surprisingly mirror what we have seen clinically over the years. The most common site of injury was in the lower limb with ankle, calf/Achilles and foot problems slightly edging out the knee. Back was also extremely common (bike positioning and loading mainly for this one).

Which discipline (swim, bike, run) causes more injury?

Any guesses before you read on?

 

In an effort to better understand injury patterns in triathletes studies have looked at which of the three individual triathlon disciplines (swim, bike, run) athletes reported sustaining the most injuries from.

Swimming, not surprising carries the least number of injuries with just 7% of triathletes carrying swimming injuries. These are mainly shoulder and neck injuries. Overalll, there are very low loads in the water and you generally spend the least time training as a ratio out of the 3 disciplines.

Cycling (43%) and running (50%) are pretty close, clinically though, we definitely see more running injuries than cycling.

Why is cycling so close to running? Well, pretty simple really, you spend the most collective time on the bike training. It’s brutal on your lower back, hips, knees and the back of your neck.

Runners hit the ground with anything between 5 and 9 times their body weight on each stride. Over a typical 10km run, and especially up to marathon lengths, the cumulative effect of those impacts is immense.

A group of researchers found that most injuries (especially knee injuries) were reported during running both in preseason and in competition season among a group of Australian athletes. Weakness and muscle imbalance plays a big part especially over the longer distances where these imbalances get supercharged as you fatigue. Poor technique and especially weak gluts play a major role in this.

Also, as you transition off the bike, your body has to change from a repetitive flexion pattern on the bike to then working in an extended movement pattern for efficient running.

Main injury culprits - knees and ITBs (iliotibial band), and calves, shins, ankles, feet and achilles tendons.

Prevention time!

 

Our specific Triathlon screening:

Preventing injury is much better than trying to manage injuries, so we have designed a tri specific screening assessment to identify any predisposing biomechanical issues (tight bits and weak bits) to help prevent your injuries and come up with a tailored rehab plan to make you more efficient.

This involves us putting you through your paces, testing your strength, mobility and functional movements to identify not only current injuries, but areas at risk.

Then we rip into it, we’ll be able to settle any current niggles or problems wit some hands on treatment, and provide a rehab plan to address any underlying problematic areas so you can continue to splashing in the pool, donning the lycra and pounding the pavement to prepare for your next event.

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Triathlon Injuries: Transitioning from Prevalence to Prediction and Prevention. Kienstra, Carolyn M. MD1; Asken, Tristen R. PT, DPT, CSCS2; Garcia, Jennifer D. PT, DPT, MTC2; Lara, Vanessa MS, ATC, LAT3; Best, Thomas M. MD, PhD4. Current Sports Medicine Reports: November/December 2017 – Volume 16 – Issue 6 – p 397–403

  1. Shaw T, Howat P, Trainor M, Maycock B. Training patterns and sports injuries in triathletes. J. Sci. Med. Sport. 2004; 7:446Y50.

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