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Injury Prevention Workshop Cambridge Triathlon club. Mehmet Gem BSc (hons) MSc MCSP Musculoskeletal Physiotherapist. Overuse Injuries. Overuse injuries most frequently are a result of micro trauma.
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Injury Prevention Workshop Cambridge Triathlon club Mehmet Gem BSc (hons) MSc MCSP Musculoskeletal Physiotherapist
Overuse Injuries • Overuse injuries most frequently are a result of micro trauma. • This is where small amounts of stress imposed on the body over time are not given the suitable time to heal and progressively get worse any may become chronic. • They initially begin as a “niggle” but deteriorate over time and can become debilitating. • For each joint and structure there are a number of factors which may lead to an onset of injury or pain and this could be poor technique, muscle imbalance, poor training, or strength deficiency
Running • Studies have found that injured runners had significantly weaker hip stabilizers compared to healthy runners. • Anterior knee pain? The problem is not always at the knee! • Weak / inactive gluteus medius • Weak external rotators • Problems of an altered Q angle. • - Knee pain • - ITB Syndome
Illiotibial band syndrome • Constant flexion and extension of knee may cause the IT band to become irritated on the outside of the thigh and at times may cause lateral knee pain too. • Wearing shoes that are inappropriate based on the foot mechanics of the runner may exacerbate IT band tendonitis • Management • To prevent worsening of ITB syndrome and to assist with treatment a good stretching protocol for the ITB along with self myofascial release with a foam roll will reduce the stress on the muscle. • Soft tissue work will along reduce tension in the muscle and help prevent further irritation of the tendon.
Running Route and Surface • Hard surfaces increase the amount of stress on muscles and joints and increase the risk of tissue trauma. • Consistently running on one side of road to the other may cause injuries due to the road camber. • Average road slants 7-9 degrees • Always vary where you run
Running Technique • New research shows that running on your forefoot puts less stress on your knees!
Swimming • The rotator cuff is the set of muscles and tendons that stabilize the humerus and also stabilizes the scapula (shoulder blade). • Common injuries are around the shoulder area and usually arise as a result of poor technique or muscle imbalance / poor stability. • Poor technique - arms crossing over in front of your body and swinging the arms too wide in the swim stroke. If you swim all out in your workouts too often, the result can be shoulder strain. • Studies found that people who have weakness in their rotator cuffs and scapula stabilisers are more prone to having shoulder injuries.
Rotator cuff tendinopathy • Tendinopathy refers to degenerative changes within the tendons. This ranges from inflammation to microscopic tearing and resulting scar tissue. • Inflammation of the bursa which impinges more over head. “Painful arc” • Treatment would be to reduce inflammation, improve range of movement, find any muscle imbalances which were the cause and to increase muscle strength specifically.
Bike • A forward head, hunched shoulders, and a curved upper back produce bodily adaptations which decrease triathlon performance.
Cycling Posture • Athlete on the Right • Rounded back • Unnatural neck and head position • The only way to see where he is going is to lift his head high and curve the neck • Athlete on Left • Rolled hips forwards, (spilling water out of a bowl) • Optimum leg position for power • Optimal breathing position
Poor Cycling Posture affect • It may decrease endurance by increasing work of breathing • May make your breathing less efficient by decreasing your thoracic expansion • In turn shoulder range may be limited due to tight anterior deltoid which may limit stroke length and strength when swimming which may prevent efficient arm recovery.
Lower back pain • Lower spine curvature changes to compensate for the excessive forward curvature of the upper spine, which: • Weakens and overloads the lower back • Can cause chronic lower back pain • Worsens existing lower back problems • May alter pelvic position, which can reduce running efficiency • Posture assessed for optimal alignment, observe your resting posture and posture during training and ensure that you maintain the natural curvature of the spine .
Weight training – Strength and mobility • Usually 30 mins 2x a week • During triathlon your will fatigue and rely more on core, if this is poor, when technique decreases you are more prone to overuse injuries. • Although stretching can reduce muscle tension in the short term, there is always a cause as to why they are getting tight. • Commonly the result of increased muscle tension may be a result of overuse of this muscle in compensation for the weakness or restriction of another area
Core Exercises to add into training : • Scaption in standing • Side plank with external rotation • 3pt plank with shoulder extension • 3pt plank with shoulder row • Plank with hip extension