In the thick of the season, amid constant juggling of job, family and exercise, the body’s aches and pains are often ignored or patched up, left to the off-season. These chronic overuse injuries often limit the ability to fully train however, and can have a big effect on speedwork and interval training.
While almost every triathlete is used to the occasional sore kneecap after a long run or an aching shoulder after a hard pool workout, chronic injuries to the hamstring in particular are a common source of pain and dysfunction in runners and triathletes, and can be harder to fix.
Overworked and overloaded
Defined quad muscles look nice in the mirror and toned glutes look great in skinny jeans, but it’s the three hamstring muscles that are largely responsible for pulling the body forward with each running step. Since the three muscles share a common origin on the “sit” bone, the hamstring tendon bears the brunt of hard and long running workouts.
For those training for performance, hill repeats and track intervals can tax the hamstring muscles and the tendon can become overworked and overloaded. The first inkling of this is usually soreness after a run in the upper portion of the back of the leg, even progressing to pain during exercise and difficulty with simple daily tasks like sitting and walking.
Dr John Ball of Maximum Mobility in Arizona, a chiropractor and the man tasked with rehabilitating Leanda Cave from her high hamstring injury, says: "Clinically it seems triathletes with a higher running emphasis tend to develop high hamstring problems more often than the rest."
He includes two categories of triathlete at increased risk: those that have had hamstring injuries in the past, and those with issues such as strength imbalances, poor glute control, poor running mechanics and improper bike positioning.
As with any overuse injury, taking care of the injury means modifying activity to allow the injured area to heal. San Francisco-based physiotherapist Lisa Giannone, who has treated elite and Olympic runners with the problem, has seen many triathletes make the problem worse by stubbornly refusing to stop training, and warns that in extreme cases they risk rupture of the tendon.
As the aero position on a tri-bike can stress the hamstring tendon, use the off-season to work on your bike handling skills on the more relaxed geometry of a mountain or cyclocross bike. What’s more, the gloomy winter months are a great time to hit the gym for the strength training needed to rebuild after injury.
Tailor your exercise plan
Since the body will compensate for sore or injured areas over time, long-term hamstring injuries are likely to cause a greater degree of hamstring and leg muscle weakness. Also, athletes who have struggled with high hamstring tendon pain for a while are more likely to have their running and cycling mechanics affected.
Dr. Ball recommends tailoring their exercise regime to train the dysfunction, and focusing on strengthening the weak and uncoordinated muscles, as it is likely that they led to the problem in the first place.
Giannone focuses her initial programme on strengthening the muscles of the quads, hips and core, and only indirectly involves the hamstring muscles to avoid aggravating the hamstring tendon. Later exercise can address the hamstring when the area is ready for more direct strengthening.
Add volume and intensity gradually
Once the soreness has abated and the leg has regained strength, running volume and intensity can be added in a progressive fashion. If you haven’t already done so, consider getting a sports medicine specialist or coach to analyse running and cycling mechanics.
Bear in mind that overdoing your training probably led to the injury in the first place, so trying to step right back into last season’s training schedule is likely to cause the problem to return.
As a rule, triathletes are used to going hard day after day and would rather go hard than take a day off, but recovery time is always needed to rebuild after a hard season. Train hard and recover harder.
For more advice on recovering from injury, head to our Triathlon training section here