“I spent more years as a professional athlete, fighting injury, refusing to give in until I had achieved my dream of winning Olympic gold. It has been a long, hard struggle with moments from which I thought I’d never recover.”
– Kelly Holmes, 2 x Olympic gold medallist
One of the most – the most – frustrating eventualities an athlete, trainer, or sports enthusiast, can ever experience is succumbing to injury. Depending on the severity of the injury and how it is treated determines the duration factor: recover from a severe injury can be reasonably swift if the rehabilitation process is well managed; but what initially started as a minor injury, maybe mild soreness in the base of the calf, can develop into something much more sinister and sustained if it is ignored. Of course, prevention is better than the cure but, as any trainer will know, prevention is an illusion. The best we can hope for is to reduce the risk. Quality nutrition, warm-ups, cool downs and stretching regime will certainly help us in this endeavour. But there is much more we can do.
Below I have outlined ways in which injuries can arise. I’ve also included self-rehabilitation equipment that can aid exercise-induced fascial trauma and/or facilitate injury recovery.
The most common form of injury is caused by overuse. The overuse, or repetitive strain, injury occurs when we repeatedly over-use the body and don’t allow time for adequate rest. When we lift weights, go jogging or stretch we cause microscopic tears within the muscle. What makes us stronger, fitter and more flexible is when the body heals these tears by laying down additional muscle. If the trainer does not allow adequate time for this healing process to take place, muscles, tendons and ligaments (even bone) will become weaker until the inevitable happens – injury. Resting the body after exercise and sport is absolutely essential. One way we can speed-up post training recovery is by ‘rolling’ – otherwise known as myofascial release. The foam roller aids recovery by decompressing and relaxing the muscle whilst also increasing the blood flow. For the benefits conferred and how inexpensive they are the foam roller is an excellent piece of equipment and a must have for anyone who regularly exercises.
When an injury occurs the damaged tissues are weakened and their tensile strength is immediately reduced (the tensile strength is the tissues capacity to stretch). Throughout this phase the body lays down collagen tissue to bridge the tear. This area is more susceptible to re-tearing, which is why you should not stretch recently damaged tissue. For a minor injury at least one week should be given before you start to stretch that area, if the injury is more severe seek advice from a physio on time durations. Remember, stretching after injury must be performed with great care.
More severe injuries, such as ligament and tendon sprains, will also benefit from a good icing. However, ligaments and tendons, unlike muscles, have a much smaller supply of blood – they actually feed off the muscles – which makes the healing process slower. With any sports or training related injury, I would suggest that you seek the advice from a professional physiotherapist before a doctor. Doctors are usually not as knowledgeable of how to ascertain the extent of the injury and the best way to treat it. This is because they have to have a wide understanding of lots of different ailments. Whereas a physiotherapist, because they specialize on injuries and the body mechanics, can examine the injured area and accurately assess the nature and extent of the injury. From there they will be able to provide sound advice on how to help in the recovery process.
Snaps, twangs and breaks
If you experience any of the above my heart goes out to you. Truly, for the person who loves exercise and all things physical, there is nothing worse than being laid-up. After suffering a severe injury it is imperative to seek professional medical advice and support. But it’s not enough just to seek the advice, we must heed it. This is a common mistake made by the exercise enthusiast: ignoring the doctor’s orders and rushing back into training. You must maintain discipline and resist the temptation to rush the recovery process. Take your time and follow the physio’s advice. By doing this you stand a much better chance at reclaiming (or even surpassing) your previous performance.
Don’t be fooled
Quite often, after an injury, we feel good, there is no pain in and around the injured site and we feel fit, energetic and raring to go. This can be a false sense of security, a facade brought about by all the additional resting after the injury. An inexperienced individual will jump straight back into training where they left off and as a consequence, re-injure themselves. The body can, it seems, play tricks on us and when all appears well, we discover through more needless suffering, that this is not the case. It is for this reason why, even after a minor injury, it is so important to take your time when re-introducing the body back into physical exercise.
Peace of mind
A good sports masseur/therapist is literally worth their weight in gold and if you are a training/sports enthusiast, I strongly advise that you try and seek out reputable one in your local area. The job of the sports therapist is to relieve muscle tension, break-down and smooth-out knots and encourage blood flow. Depending on your training volume you should have at least one sports massage every month – at the very minimum.
Kick (or curb) the obsession
The importance of rest is highly underestimated and there are lots of trainers out there who are obsessed and are not resting enough, and think they can keep abusing their bodies without consequences. I know, because I was one of them. I used to train for four to five hours a day, six times per week. On average, totalled over a one week period, I would train for 25hrs. I maintained this work ethic for over three years. Throughout this time I was plagued with overuse injuries, but I was stubborn, obsessed and I did not know what I was doing. Now I have learnt my lesson, and I went about arriving at what now seems such an obvious conclusion the hard way. As a result of reducing my training out-put I feel fitter, my body looks better, I am much more enthusiastic about exercising because I am not always drained, and what’s more, I do not suffer a tenth of the injuries that I used to.
When Bruce Lee was asked during a T.V talk show if he thought he was over-training, Bruce replied ‘I’d rather be over-strained than under-trained’. To some degree I completely agree with him. However, although seemingly quite harmless, over-training is dangerous and can cause the trainer serious health problems. Severe aches and pains, injury, chronic fatigue and brittle bone are just some of the potential negative side-effects of excessive exercise. What we must do as physical fitness enthusiasts is find that middle ground where our training intensity and duration effectively meets our perceived goals.
Because over-training can easily disguise itself – or because the obsessive trainer has mastered the art of self-deception – I have compiled a list of signs and symptoms which can be directly related to over-training. Singularly they should not necessarily arouse too much concern, although two or three must be taken seriously. Have a read through the list and see how many you can identify and relate to.
Signs and symptoms of over-training:
Decrease in performance – when training for an event, such as a marathon, there should be a slow and steady improvement up until the race. It is common to have those ‘off days’ during the preparation stage and there is nothing to worry about if you are running set distances slightly slower than normal. What should cause concern is the frequency of these off-days increases or your performance begins to deteriorate. If you are or ever experience something similar then consider resting for a couple of days, reducing your overall training hours for a week or changing your training method.
Diminished enthusiasm – the thought of a training session should be a happy one that stirs our ambition to improve ourselves. However, when the thought of the gym or physical activity elicits prangs of loathing then this could be your body telling you it needs some rest. The diminished desire for physical training is a good indicator that you are currently doing too much.
Frequent minor injuries – constantly recurring niggles is a sign that the body needs more rest to help repair damaged tissue. Persisting to train when the body has reached this state is dangerous and more serious – long term – injuries could be just around the corner. Do your body a favour, if this sounds familiar, and give it a rest, maybe even treat it to a sports massage, you will feel great afterwards.
Lowered immune system – endurance athletes will experience diminished immune function because of the increase in inflammation. Lowered immunity makes us more susceptible to colds, infections and allergic reactions and it can slow the rate of recovery from any of these conditions.
Muscle mass reduction – there is a simple balance between rest and exercise, when the balance is maintained the athlete will enjoy augmented physicality and improvements in performance. But if the balance is upset and the volume of training exceeds that of the time it takes to recover, the athlete will then experience more breakdown (catabolism) of muscle tissue than build up (anabolism). Thus physical decline will ensue unless action is taken.
Loss of sex drive – it is well known that moderate to high intensity exercise increases libido. But what is not so well known is that over-training can deteriorate your sexual appetite leading to loss of libido.
Disturbed sleeping patterns – over-training or training too late at night can affect sleeping patterns. Sleep is a crucial time for the body to start the recovery and repair process. Interrupting this process can slow the repair of muscle tissues which may hinder performance. If you are struggling to sleep at night take a close look at your exercise output and at what time you exercise.
Points to take into consideration in the event of an injury:
As soon as you experience a twinge, twang or snap STOP immediately.
The first thing on your mind should be damage limitation, so do not put any more weight on or move the injured area.
Ice the area ASAP and continue applying the ice treatment for at least three days. When icing an injury try to aim for 10 minutes on (icing) then 2 hours off. This should be repeated as many times as possible throughout the day, for three days. The reason behind this method of icing is, if you apply ice for long durations the body triggers a defence mechanism to prevent that area becoming damaged by the cold, and sends more blood to the area which causes it to heat and swell up, which is exactly the opposite of what we want.
If the injury is in the arm or leg elevate whilst you ice.
Visit a physiotherapist to seek advice.
Rest, rest, rest and rest. Make sure you give the injury plenty of time to heal.
When you start back training, or participating in your sport, take your time. DO NOT think you can start at the same level as where you left off.
If you feel pain in the area after recovery STOP immediately. Go back to rehabilitating the injured area.
An injury to the head, neck or back will require immediate medical attention. If you feel as though you have an injury within one of these areas DO NOT WAIT, go to a physiotherapist immediately.
Prevent, Rest, Ice, Compression, Elevate
The acronym PRICE should be applied to all minor injuries – muscle pulls, sprains and bruises. PRICE can, of course, be applied to more severe injuries. However, I would only recommend this after you have spoken with a medical professional.
Prevention = When an injury first occurs Prevention/Protection should be the first thing on your mind. Prevention is about making sure you do not damage the injury further, as this can prolong the healing process. Protection of the injured area is essential because not only do you want to experience any more pain, but you do not want to make matters worse.
Rest = We all know that injury requires rest to allow healing to take place. If we do not rest we will prolong the recovery time and in some instances the injury could be made worse. Be sensible and REST.
Ice = Ice helps to reduce the swelling around the injured area, which aids in speeding recovery. The ice should be applied to the injured area for 10 minutes on 2 hours off for at least three days. It is advisable to ensure that there is a thin insulating layer under the ice pack, or you could burn the skin. Do not apply ice to an already numb area, or near the heart.
Compression = A compression bandage can reduce swelling within and around the afflicted area. When applying the bandage it is advisable to ensure not to wrap it over the injured area, it should go above and beyond the injured site.
Elevation = If an injury occurs within the arm or leg you should elevate the limb. By elevating the limb gravity works by drawing the swelling from the site of injury. When elevating a limb make sure that it is higher than the heart.
It is almost a certainty that a physically active person will experience an injury at some point. Few are fortunate enough to escape this eventuality. When we suffer an injury there are really only two options available to us. Option 1: We can wallow in self-pity and fall into despair as we watch others keep fit and enjoy sports whilst we don’t. Option 2: We can exercise our boundless capacity to accept misfortune and, in this state of equanimity, we can begin the process of recovery. Ultimately the choice is yours.
Adam Priest is a former Royal Marines Commando, professional personal trainer, lecturer and Thai boxing enthusiast