INJURY PREVENTION ESSENTIALS
01 Strengthen your body
Triathletes understand the concept of body ‘overuse’ leading to overuse injuries, however many ‘overuse’ injuries are actually due to ‘under preparation’. This is where the triathlete’s body was not prepared for a given training load and, as a result, injury develops. The best defence against this is to get your body strong through strength and conditioning exercises. This can take the form of mini home circuits or fully-fledged gym programmes. Not only will strength work reduce injury risk but it’s also been scientifically shown to have significant positive effects on performance.
02 Dial down the stretching
Don’t overemphasise the importance of stretching or foam rolling. Flexibility is not as important for triathletes as might be assumed. Tight muscles (e.g. calves, hamstrings, glutes) are in fact typically weak muscles. When the focus is put on strengthening, e.g. calf raises vs calf stretching or foam rolling, interestingly the calf or muscle tightness tends to reduce.
03 Avoid the messy middle
In terms of training intensity, research has shown that best performances and reduction in injury risk are achieved with a training balance of approximately 20% high intensity and 80% slow and low intensity. The ‘danger zone’, which isn’t conducive to performance gains and heightens injury risk, is logging miles at mid-intensity, where it’s neither high nor low, but rather in the middle.
04 Avoid making training errors
Errors made in training largely contribute to the onset of most tri-related overuse injuries. Training errors can include doing too much, too soon, at too high an intensity. The most common training error being to ‘spike’ training loads in an attempt to cram a training base in for an upcoming event on a short timeline. Research shows that increasing training load by x 1.5 more than the average of the prior four weeks can increase injury risk by 38%.
05 Train harder and smarter
Triathletes recognise the need to train smart, however it’s interesting to note that training harder is actually a form of training smarter. This might seem like a contradiction (see tip 4), but building a large, incrementally-increased chronic training load over time has been shown to reduce injury risk for both team and individual athletes.
06 Give sit-ups a miss
Sit-ups are a common inclusion in many triathlete’s core workout, because it seems logical to include sit-ups and crunches. The problem, however, is that the spine is exposed to excessive and dangerous levels of compressive force through the sit-up/crunch motion. A better and safer alternative is planking, including front and side planks.
07 Maintain energy through diet
Maintain energy availability through a well-balanced diet that provides sufficient calories. The term ‘RED-S’ (Relative Energy Deficiency Syndrome) describes a state of an athlete who has low energy availability due to a calorie deficit. The result can be poor bone health and heightened stress-fracture risk, as well as various endocrinological health disturbances.
HOW TO AVOID SWIM INJURIES
08 Strengthen your shoulders
Strength and endurance of the rotator cuff musculature is of paramount importance in the quest to deter swim-related shoulder injury. Shoulder exercises involving dumbbells, for example side- lying shoulder external rotations, tend to be most effective.
09 Use cords and bands correctly
Don’t mistake cord work and theraband work as strengthening your shoulders. Rather cord work and dry-land band drills tend to work on muscle patterning as opposed to muscle strengthening. Strength gains through strength training are of greater importance and should not be neglected in favour of band or cord work.
10 Look after your thoracic spine mobility
The thoracic spine (middle part of the spine between the shoulder blades) can get stiff in triathletes. Time spent in a ‘stooped’ or round back position on the bike can be a key driver for reducing thoracic spine mobility. Spinal mobility work can assist by counteracting the flexion-based stiffness that triathletes develop. This can be achieved by lying over a half foam roller regularly. The greater mobility in essence assists with decreasing loading at the shoulders and can also facilitate a better recovery phase of the swim stroke.
11 Stretch the hips
Perhaps the only muscle ‘tightness’ pattern that should concern a triathlete is that of the anterior (front) of the hips. When the musculature at the front of the hips gets tight (hip flexors, quadriceps), the result in terms of swimming can be reduced stroke length, elevated shoulder joint loads, and a poorer streamlined position. But the only stretch I would endorse for triathletes is a good sustained hip flexor stretch to lengthen the front of the hips. Hold for 1-2mins and perform several times per week.
12 Mix up your strokes in training
Mixing up swim training with a variety of strokes, especially some backstroke, can help distribute load around the shoulders, balance strength and control, and reduce possible ‘overload’ of the shoulders through freestyle-only based swimming.
HOW TO AVOID BIKE_RELATED INJURIES
13 Avoid excessive neck strain
Work on thoracic spine mobility (see tip 8) as well as building upper trapezius and shoulder muscle strength through exercises. Combined, this can reduce the aching and strain often experienced both during and after cycling.
14 Get a professional bike fit
A pro bike fit can assist with not only performance and comfort, but also reduce injury risk. Common sites of cycling injuries are the lower back, knees, and neck. Each of these sites can be assisted by an appropriate bike set-up that takes into your account your unique needs and body dimensions.
15 Work on your hamstring strength
A common triathlete injury site is the upper hamstring tendon/insertion. This is often observed in triathletes who have just started riding a TT bike. Because of the greater downward angulation at
the pelvis when riding a TT bike, the proximal hamstring muscle tendon unit can experience high tensile and compressive loads. These loads can, in the presence of weak hamstrings and sudden increases in the time spent riding a TT bike, result in the onset of painful proximal hamstring tendinopathy. Proximal hamstring tendinopathy is
best treated through progressive hamstring strengthening exercises.
16 Work on lower back endurance
By having good strength and endurance in the lower back extensor muscles, there’s less chance of developing cycling-related lower back pain. Some of the best ways to develop lower back extensor muscle strength include deadlifts and back extensions.
17 Don’t make big changes in body position rapidly
Just like with running or swimming technique alterations, if you’re looking to change your bike set-up, consider doing it in incrementally (e.g. progressive saddle height changes) as opposed to large and sometimes injury-provoking bike-fit changes.
HOW TO AVOID RUN RELATED INJURIES
18 Don’t switch shoes too quickly
The perils of transitioning too rapidly to minimalist shoes are increased Achilles tendon and calf loads. Recent evidence also found that the reverse is true, with transition to maximalist shoes also increasing injury risk for the runner. If transitioning to either style of shoe, be sure to do it over time and incrementally.
19 Keep running in all weathers
Our tendons, in particular the Achilles, respond positively to incremental and progressive changes in loading and use. Tendons however can be thrust into acute overload by the triathlete who has, for example, taken 3-4 weeks off at the end of the season. A return to running after the time off can represent a large spike in loading of the Achilles and associated elevated injury risk.
20 Be mindful of bone health
Bone health is often overlooked by triathletes. To support your bone health in training, build in times of sun exposure, as well as time for heavy bone-loading exercises (e.g. squats, strict press, deadlifts). Monitor bone mineral density levels through intermittent DEXA scans that can be organised through your GP.
21 Don’t overthink your running technique
The key is to avoid overstriding (defined as the foot landing ahead of the knee at impact). Aim to run with a quick cadence to decrease knee joint loading, don’t worry about foot placement (heel-striking is not necessarily ‘bad’), and run relaxed as smiling has been shown to improve running efficiency.
22 Shoes are not the be all!
Current research indicates that the only scientifically-valid guiding principle when choosing run shoes that will decrease injury risk is to select your shoes based on comfort. Simply put, if it feels good it probably will be good at reducing your injury risk.
23 Strengthen the running kinetic chain
The kinetic chain (gluteals, hamstrings, quadriceps, gastrocnemius, and soleus muscle groups) needs to be strong in order to counteract adverse joint loading forces. It’s interesting to note that the muscle that produces the most power is the soleus, sitting deep to the gastrocnemius muscles, which has been found to generate forces of 6.5-8 times your body weight when running. The best way to strengthen the soleus is with heavy seated calf raises, e.g. in a smith rack in a gym.
24 Perform plyometrics
A plyometric action involves rapid muscle lengthening followed by a shortening, which occurs with every run stride. Plyometric training can involve hopping, bounding, and jumping-based exercises and drills. The benefits are enhanced nervous system function, improved tendon energy storage, and improved time to exhaustion and running economy. For triathletes new to plyometric training, the volume and intensity should start low with focus on correct technique.
25 Build volume before speed
To minimise lower limb running-related injury, build volume (high chronic training loads) before adding speedwork. Once the onset of speedwork (e.g. track sessions, fartlek or interval runs) is well-tolerated, adding terrain changes (e.g. hills) into the training cycle can assist with adverse load minimisation and associated reduced injury risk