10 tips to stay injury-free
Top injury prevention advice for triathletes from sports physio Alison Rose, who's worked with Olympian Jess Ennis and the Brownlee brothers
She kept Jess Ennis fit for the Olympics and has guided the Brownlees on run technique since 2005. But what injury prevention tips does Alison Rose have for us mere mortals? Read on to find out…
1. Running off the bike
For triathletes, 65% of injuries come from running, with overuse injuries dominating. Running after biking throws up a multitude of challenges, with tiredness carrying over into run technique and making you more prone to triathlon-type injuries, like lower back issues because your glutes aren’t strong enough, and hamstring issues because you’re not using your feet properly.
There’s can also be a lack of rotation when you come off the bike because you’re rock-solid. Your upper is really stiff, which decreases your breathing capacity, so you’re going to get tired. Being stuck will make you start rotating your foot or your knee – and that’s where the problems come in.
So being aware of your run technique can only help you come off the bike. Instantly start swinging your arms when you run and your body will start moving properly.
2. Counter rotate your upper
The ability to counter rotate your upper and lower back (that is, upper back rotate left, lower back rotate right) is a vital component of normal movement that’s often lost in endurance athletes, and has many adverse effects on performance, technique, breathing and muscle function. The upper back is frequently stiff in endurance athletes, so try this drill to help prevent that:
A) Sitting with feet on the floor, relaxed posture, hands on lap.
B) Keep head still, and rotate through lower rib cage.
C) Your shoulders will move as your ribs move. They shouldn’t be pulling you into rotation.
D) Do x 20 little and often in front of mirror and for a warm-up.
3. Instil patterns at a young age
When you look at younger athletes, the wobblier ones with less efficient movement patterns often don’t make it as professional athletes.
The Brownlees would have started to pick up injuries if they’d reached their late teens without having done the run technique in their mid-teens. I think Jonny suffers fewer injuries as he started the stability work earlier, although there also must be subtle differences in biomechanics between him and his brother Ali. And Ali has become less and less injury-prone as he’s got older, which is a testament to the injury and strength work that he’s done with his drills.
There’s an optimum age for looking at running gait. In the whole group of Kelly Holmes’ 60 athletes, there were only two (one being Britain’s latest tri star Non Stanford) without strength or flexibility issues. But within two years, the injury rates had dropped right down, flexibility was good and knees weren’t falling in.
If you can get to people at that age, you can instil the patterns straight away. But obviously you need the parents and coach to buy into it as well.
4. Find the root
It may be that the root cause of your injury is a long way from the area that’s sore. My role with Jess Ennis is more about prevention than correction. We check everything once a week by observing Jess run, walk and throw. It’s a puzzle of connecting parts. If one part is misaligned, it can throw out everything else. If the ankles aren’t right it can affect somewhere else in the body.
5. Become flexible
These ‘fast feet roll-throughs’ maintain ankle mobility while promoting the foot and calf strength function. They’re also good for the prevention and rehabilitation of calf and shin problems, as well as Achilles injuries. This drill also encourages you to take off from the ball of your foot when running. They can be done as a warm-up for your ankles, round the house while waiting for the kettle to boil, or as a warm-down after run sessions.
A) Start with both knees bent before rolling through each foot from just off the heel to toe.
B) Make sure you push through the big toe, before lifting the foot off the floor.
C) When bringing the foot through for the next step, ensure the toes are pulled up towards the shin (that is, ankle at 90°). Make the movement a definite rolling through the ankle joint, from heel to toe, feeling the muscles in the calf and foot working, as the plantar fascia is prone to tightness after high run volumes.
D) Knees should remain bent at all times. Hips shouldn’t go up and down. They should remain parallel with the floor from the initial start position. All movement should come from the ankle joint itself.
E) Maintain perfect posture and relaxed running arms.
6. Beware of trends
People are really good at looking for the quick fix. I see people coming in with minimal shoes but it takes time to learn to run in them. And I don’t think that Caucasian feet, so used to wearing shoes on tarmac, are now, evolutionally-speaking, designed for that.
But it’s still great to do drills and balance doing exercises barefoot and maybe jogging on grass – albeit for a limited amount of time, unless you’ve got very, very strong feet.
You just have to remember that there are physiological differences – the African and Jamaican foot type is very flat, while their muscle types are different. Caucasian calf muscles come quite low down, but if you look at those of African runners there’s a lot more tendon there. And those physiological differences do make a difference.
7. Increase strength and posture
Many injuries, whether new or long term, are due to poor postural alignment, so you need to do strength work as well. Alistair Brownlee has said that the most important thing with run technique is “keeping tall, with your hips straight up and forward”.
This ‘high knee walking, front knee bent’ drill promotes and trains postural control, stability and balance. It encourages strengthening of glutes, hamstrings and calf muscles, while also helping to prevent loss of technique. Initially, perfect your timing doing one leg first and then the other. Your knee and arm swing should be coordinated:
A) To start this drill, stand on your right leg, with the left knee at hip height and the thigh parallel with the floor. The left knee is bent, with knee at 90°, ankle at 90° and toes pulled up towards the shin. The knee of the standing leg should be straight and you should feel the glutes working.
B) Walk through onto your left foot and repeat, taking the right knee to hip height, the thigh parallel with the floor, the right knee bent 90°, the ankle at 90° and the toes pulled up toward the shin. Again, you should have perfect posture and relaxed running arms. When your confidence is increased, then you can go onto your toes.
8. Prevention is definitely better than cure
GPs are fantastic in many ways, but for sporting injuries in particular the NHS can take a long time and isn’t specific enough. Seeing a private physio for two or three sessions should be enough to deal with the problem if you catch it soon enough.
If the right things are being done you should start to see progression. I see athletes who just come for a full body check, which looks at things like stiff ankles or tight quads. It’s better to have one session than six or eight to correct a problem.
9. Keep on training
Never rest unless you have to, as resting the area rarely works long term. Although it will allow inflammation to settle, when you start to exercise again, the alignment issues will still be there – and, with time, the injury will frequently reappear. A full and functional rehabilitation is the key to performance and treating injuries in the long term, so that they don’t recur.
10. Analyse run technique
An in-depth analysis by a qualified sports physio of your running technique can help by examining the way you move and the efficiency with which you move. For example, if you’re suffering from chronic knee pain then they can help offload the knees and reduce or even remove this pain, which in turn will improve your performance.
(Images: Jason Newsome)
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