Training Injuries

There are many reasons why we end up with training injuries. Click the previous link or here to discover important factors to help you to train safely and avoid training injuries wherever possible.

The following is a list of common training injuries caused when the body is tired, under-nourished, unwell or not warmed up. Unsafe equipment or clothing too can cause training injuries.

COMMON TRAINING INJURIES

Most injuries associated with training arise from the repetitive nature of training, and the prolonged strains on the body. Even acute injuries, however, such as a sprained ankle, do not happen arbitrarily, but may be attributable to a fault in technique or equipment. For some injuries, basic first aid and a period of rest may be all that are needed; others may require the attention of a doctor or physiotherapist.

Infections

Repeated illnesses, such as colds and chest infections, may not be readily recognized as training-related, but they can result from the sudden and excessive demands made on the body by a poorly planned training programme. Recurrent infections are a sign that over-activity is taking its toll on the immune system, which has the task of fighting off the micro-organisms that cause disease. Rest is the best treatment, and attention to diet is also important; to meet the demands of exercise the body needs a steady supply of nutritious food. Eating plenty of fresh fruit and vegetables, which contain vital nutrients such as the antioxidant vitamins C, E and beta-carotene, boosts the immune system and helps the body to ward off disease.

Muscle soreness and strains

It is normal to experience a little soreness in the muscles (known as delayed onset muscular soreness) the day after exercise, particularly when training harder than usual. This is caused by microscopic tears in the muscle fibres or connective tissues. If a person works too hard or fails to stretch after training, the pain can be severe. Gentle stretching and massage relieve soreness, which should ease within one to two days.

common training injuriesMost exercisers occasionally suffer from muscle strain or a ‘pulled muscle’. This is a more severe form of muscle soreness, in which the tears in the tissues are bad enough to impair muscle function, causing loss in power or range of movement. The pain is sharper and more localized than with muscle soreness. The area can be massaged using topical anti-inflammatory creams or gels; alternatively, ice can be applied and the individual should rest. If the pain is severe, a doctor should be consulted. She may prescribe anti-inflammatory drugs such as aspirin, if necessary. The muscle may take anything from a week to a couple of months to heal. When resuming exercise, care should be taken to avoid placing any further strain on the pulled muscle. It may therefore be necessary to temporarily modify the training programme.

Muscle cramp

Cramp occurs when a muscle contracts involuntarily and does not relax, causing intense pain. This may happen when a prolonged session of anaerobic exercise leads to a build-up of lactic acid in the muscles. Recurrent attacks of cramp may be the result of insufficient fluid; insufficient dietary sodium (found in salt) or calcium (found in dark green vegetables, dairy produce, seeds and tinned fish, such as sardines and anchovies); or not warming up and cooling down properly. Stretching and massaging the affected muscle brings instant relief, and the exercise session may be continued. Apart from slight dietary modifications, no further treatment is necessary.

Blisters

Painful friction burns or blisters are most commonly caused by chafing from shoes.

They can be prevented by wearing well-fitting shoes and cotton socks and applying petroleum jelly to vulnerable areas, such as the back of the heel, to reduce friction. Once a blister has developed, all that can be done is to cover it with a thick, clean dressing and try to carry on. The fluid in large blisters can be released with a needle that has been sterilized; this can be done by putting the point of the needle in a flame until it is red hot or rinsing it in alcohol. The area should be washed and a small hole made. The clear fluid can then be gently squeezed out (if the fluid inside a blister is white or yellow, it has become infected and medical attention is required). The area should be treated with an antiseptic and covered with a dry, sterile dressing. The dead skin from a blister should not be removed because this protects the new skin underneath.

Shinsplints

Any pain in the front part of the shin is known as shinsplints. This pain – which may be experienced as pins and needles – can be caused by a range of mechanical problems, such as flat feet, muscle imbalance, damage to the muscle at the front of the shin (tibialis anterior), inflammation of the outer layer of bone (caused by repeated muscle stress), or even hairline fractures of the bone. The pain can be treated with ice, compression, elevation, rest and massage. Anti-inflammatory drugs such as aspirin can also bring some relief. A sports physiotherapist can recommend ways in which a training programme can be adapted. Suggestions may include the development of an exercise programme that allows a gradual build-up to more strenuous activities; changes to the way the feet strike the ground when running; or running on soft, rather than hard, surfaces. Surgery is occasionally necessary to relieve internal pressure within the different muscle compartments.

Knee problems

The knee, which is one of the largest joints in the human body, is vulnerable both to the repeated impact of running and jumping, and to wrenching from sudden movements. Knee problems are therefore extremely common among people who exercise, particularly footballers, skiers, runners, rowers and cyclists. The most common symptom is pain in the front part of the knee, just behind or around the knee cap. This complaint is called ilio-tibial band syndrome (ITBS): the ilio-tibial band is an area of fibrous tissue on the outer thigh into which many of the most important muscles are inserted. People particularly vulnerable to ITBS include distance runners and cyclists, many of whom have to cut back their training or even stop altogether.

The cause of this nagging and often constant pain is thought to be bio-mechanical – that is, a result of the way the body functions while moving. People who have legs of different lengths, people with back problems, people whose feet roll inwards when they strike the ground and people who constantly run in the same direction (clockwise or anticlockwise) around a circular track are all at risk of developing ITBS. However, the specific cause is sometimes difficult to identify without advice from a sports physiotherapist.

Self-help measures include well-fitting shoes, ideally ones designed specifically for the particular sport, with insoles or arch or heel supports if necessary; plenty of leg stretches, particularly hamstring stretches; and building up the muscles around the knee (thigh and calf muscles) with basic leg exercises and the use of resistance machines. Runners should avoid running on hard surfaces and be sure to take rest days. For cyclists, achieving the perfect fit between bicycle and body may be the key, so specialist advice should be sought.

If the pain continues, an individual may need to switch to an alternative form of exercise that does not stress the joints – swimming, for example. Aspirin or other prescribed non-steroidal anti-inflammatory drugs may reduce pain and allow an individual to remain active. If the problem is serious, a doctor may recommend anti-inflammatory injections or surgery.

Ankle sprain

Injuries to the ankle can sometimes occur as a result of wearing low-cut sports shoes with inflexible soles, especially in games that involve a lot of sudden stops and changes of direction, such as squash or basketball. Supportive shoes should be worn. The immediate treatment for a sprained ankle is to apply ice packs to the affected area or to immerse the entire foot in a bucket of iced water. The joint can then be wrapped with a compression bandage. A serious sprain requires medical attention.

Achilles tendon problems

The Achilles tendon connects the calf muscle to the heel. It can become detached during sudden movement. This dramatic and painful injury is quite common, particularly in sprinters. A damaged Achilles tendon re-quires surgery, so prevention is the best policy. A person who is prone to tendon injuries should warm up thoroughly before exercising and avoid abrupt stops and starts. A more common problem is bursitis: an inflammation of the bursae found near the joint (a bursa is a small sac of tissue containing synovial fluid to cushion the body’s pressure points). Chafing from high-backed sports shoes can sometimes be the cause of bursitis. When bursitis occurs, several weeks of rest may be necessary to allow the inflammation to subside. Changing to a more suitable sports shoe can help to avoid the problem.

Heel pain

Pain in the heel can be caused by inflammation of the long plantar ligament, which runs along the sole of the foot from heel to toes. Applying ice provides immediate pain relief, but a sports physiotherapist should be consulted to identify the cause and recommend remedial exercise. Friction from ill-fitting shoes is the most common cause of heel pain.

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