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Friday, 10 May 2013

10 Tips to Training with an Injury

Four weeks ago it was a nice morning so I decided to go for a run.  It wasnt a tempo run or an interval run - just a nice run to enjoy the sunshine and the beach.  About 2km into the run BANG - a searing pain my  right foot.  By the end of the day I couldnt even put weight on the foot.

Surely my life was over, my fitness would evaporate and I would be morbidly obese by the end of the week (this seems to be the thinking whenever an athlete gets an injury..)

The next day I went to get it checked out - I went to see Astrid at Brighton Podiatry.  I like Astrid - if you want warm and fuzzy buy a kitten - if you want to know the facts go see Astrid.  A ultrasound scan revealed a 17mm tear and inflammation  in a tendon in my foot.

Tip 1.  Find out quickly from a professional what the problem is.  Dont go see a GP, dont see a physio, dont spend hours checking out Doctor Google - find out the real issue fast.

According to Astrid I couldnt run for 6 weeks.  Weight bearing was out - even swimming was to be avoided (due to plantar flexing)  Astrid's partner is a runner - she understands the mindset.  Rather than focussing on what I cant do I asked Astrid what I could do.  There is an important difference between pain and damage.  For example riding a bicycle in a carbon soled shoe was painful but, according to Astrid, wasnt going to cause further damage.  Riding up hills (additional stress on foot) was out but flat riding was fine.

Tip 2.  Find a professional you can work with.  Find out what you can do rather than just what is off limits.

For most of the day I wear an airboot.  One of the keys to healing is to make sure you dont create a situation that will cause you to re-injure ie healing in a shortened state.  This is an important one for things like Achilles etc.  Simply having a cortisone injection would mask the problem (pain) but would not allow for proper healing.  The boot keeps the foot flexed which means the tendon doesn't heal in a shortened state.  I also roll the foot on a hockey ball to facilitate blood flow.

Note I avoid Anti-inflammatories due to the direct link to gut issues (Cox-2 Inhibitors)

Tip 3.  Heal the injury - dont just mask the pain.  Would you just take pain killers for a broken arm or have it re-set in place ?

So far the first 3 tips have been fairly obvious - now we get lateral.

Most injuries cause inflammation.  If we are introducing other inflammation into our body we slow the healing processes.  My diet is pretty good but after the injury I decided to not work against my body and focussed on cutting out inflammatory foods even more.  Wheat (even hidden wheat in gravies, hamburgers, crumbs etc), refined sugars - I focussed on cutting these out completely.

Tip 4.  Dont work against your body.  Dont 'distract' the healing by creating other problems.  Be stricter on an anti-inflammatory diet.

There are several supplements that can aid with healing.  Colostrum and Lacto Ferrin are two I use to help the body heal faster.

Tip 5  Look at supplements that can help you body recover from injury.  Look specifically at the injury type eg tissue, bone etc.

Now for the fitness side (and read on for an interesting stat on the efficacy).

Fitness can be simply broken down into two factors.  1.  Bloods ability to carry oxygen and
2. Strength.

1. Blood
The bloods ability to carry oxygen is measured by the red blood cell count (hematocrit).  Studies, such as this one here have shown that high intensity, anaerobic intervals causes an increase in red blood cell count (even more efficiently than long boring miles) but surely you need to run or ride to do intervals.  Enter the Krank Cycle.  This allows me to do high intensity intervals with zero impact on my foot.  My protocol was 30 sec HARD / 3 min recovery times 10.

I also kept on top of my iron intake so as to not 'waste' the intervals.  The net result is my red blood cell count has gone from 40 up to 44 in 4 weeks.  Pro cyclists aim for a count of 50 often using artificial means to get there.  In essence I have actually got fitter whilst injured.

Tip 6.  Use High Intensity Intervals to maintain/increase base fitness.

Tip 7.  Do what you can to get that heart pumping.  Krank Cycles, Single Leg Riding - whatever gets it done without loading the injured area.

2.  Strength
Obviously it is hard to do strength work for the legs without... well, using the legs.  Or is it.

Here's an interesting one.  In a number of studies such as this one here it was found that when working a single leg that growth was also shown in the other (unused leg).  It wasn't as much but your body does like to try and balance itself.  Single leg squats, leg extension, lunges etc can all be used to build and maintain strength

Tip 8.  Work the uninjured leg - you will still get an increase in strength in the other leg and also reduce atrophy.

The other tool I use is the Compex Electrostim.  These have some a long way since the old days of simply placing the electrodes on your chest and hitting a button.  Modern units have variable levels - even specific programs.  For example the unit I use has an endurance program which uses shorter duration 'shocks'.  I use this to build strength but also to fatigue my legs before a flat ride to solicit greater fiber recruitment.

BTW - It's also good justification to keep shaving my legs.  Pulling the electrodes off hairy legs is not a highlight of the day..

Tip 9.  Consider using alternate tools such as electrostim, aqua jogging to create muscle contractions without loading the injured area.

As you can see dealing with an injury is holistic.  You should look at diet, look at alternate 'tools', work with a professional etc.  Trying to do this on your own (from my martial arts days my injury list is long so have spent years looking at this :)) is difficult and time consuming especially with the amount of mis-information out there so this leads me to the final and most important point.

Tip 10.  TELL YOUR COACH.  They wont (or shouldn't) think you are soft but will work with you.

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