In this weeks post, we’re going to be continuing our discussion on injury histories. Last week we started to talk about the types of injuries we have as endurance athletes and what that injury cycle looks like as they progress. The majority of our injuries fall into the overuse category, which means they build up over time. It’s that time that makes these injuries unique from other sports. It allows for symptoms to fly under the radar for weeks, months and even years, which keeps us from acting on them. More importantly, it allows the body to compensate by pulling more muscles/joints into the mix. That’s why when we deal with overuse injuries it is so important to look at an injury in two parts: 1) what broke and 2) what caused it.
My favorite way to visualize this concept is to look at the body as one big chain. Picture each muscle and joint as part of this chain from the ground all the way up into the core. The impact of our activity always starts at one end and is then absorbed and transferred up the chain. Efficient bodies/athletes are able to take that impact, absorb it and then send it all the way up the chain. In other words, they are able to use that energy to help propel themselves forward.
So what happens when we can’t absorb that impact properly? We stop using the whole chain the way it was intended to be used. In the beginning that chain is still strong, so we can keep going and start compensating. The problem is that instead of the whole chain sharing that impact, now only certain parts of it are getting beat up. It doesn’t matter how you twist that chain or change it to try and ease that workload. Eventually a link will break. Is it because that link was faulty? Or weak? No, it’s because that link wasn’t designed to work alone. It was designed to work as part of a chain. Simply swapping out that link for a new one won’t change what caused the problem and it won’t reverse how the chain has changed to compensate for that problem.
(Also here is last weeks blank injury history form to get started.)
What to look for in your injury history
1) The first thing to look at when you sit down to look at your history is what are the similarities? Are there patterns?
- Are all of the injuries on one side of the body?
- Are they all in one area but different sides? (for example: both knees, both hips, alternating ITB’s, etc)
- Is it the same injury over and over again?
2) In that first step we’re just looking at patterns. What do we notice on first glance? Did we forget anything? I’m constantly amazed at how much people forget to put on here or what they remember as they really start to write it out/remember. Not sure if it’s an “injury” put it on there anyway. Better to be too detailed than not detailed enough. The next step is to start thinking in terms of the chain. Here are some of the questions I would be asking if you walked into my clinic:
- Are any of the injuries traumatic? (bike crash, fall, etc). Was surgery required?
- If yes, did you recover 100% from them?
- If yes, how many injuries have you had on that arm/leg/area of the body since then? It’s easy to say that everything healed fine when you were able to train and race again, but if you’re looking at a history of injuries since then, it’s time to reconsider those answers. Remember- compensation doesn’t hurt. All it takes is a little bit of residual mobility and strength loss after a big injury to completely change how you move as an athlete.
- Are the injuries all “out of nowhere”? Do they persist even after treatment and rest? Did other problem areas pop up during the recovery? Did one injury start it all off and you’ve had a list of them since?
- Are they injuries that happened during a very specific event? Meaning was it during a race or big effort? While the majority of our injuries are overuse, that doesn’t mean we can’t fall victim to the bad luck kind of injuries. These are the ones where you are pushing hard through a combination of fatigue and incomplete recovery and something just gives because the muscles/joints can’t match the effort. Another example of this type of injury, is a sudden and unexpected change in effort. You move one way and accelerate and you’re body can’t keep up so it over/under shoots.
Putting it all together
The primary goal of looking at your injury history is to determine if you a have chain dysfunction or if your injuries are in isolation. My general criteria when reviewing injury histories are:
- 2+ injuries on the same extremity
- An injury persisting for over 6 months
- The same injury more than two times in your history
Using the worksheet, put an “x” next to the muscle regions in that chain. Blue boxes signify the upper extremity chain and red boxes represent the lower extremity chain. The low back box is purple and a part of both chains.
If you do not meet the chain criteria above, simply put an “x” next to the muscle regions where you have had an injury in the past two seasons. Also put an x in the box above and below that injury. If there is no below, go two above.
For some of you, this step will result in all of the regions having a box next to them. THIS IS OKAY! Seriously. Take a deep breath. It doesn’t mean that you’re a train wreck or that you’re program will be six miles long. It just means, your maintenance/recovery work needs to be a little more rounded. If you started off with isolated injuries and ended up with all the regions checked, that’s okay too. It just means you fell into that chain dysfunction category and didn’t realize it.
The lucky few of you will have no boxes marked. Congrats! That’s either a great track record or you are new to the world of endurance sports and looking for maintenance/recovery advice. In the following posts, we will help you fill in this chart based on your sport and work setup.
When we kicked off this series, I asked for volunteers to donate their histories. The response was huge so first off, THANK YOU. That being said, I couldn’t use all of them in this post/videos. Using only seven histories gave me 60 minutes worth of video. If you sent a history in, you will get feedback on it! I’ll be working on those over the weekend!
Here are some video reviews to help demonstrate the process and to give some thoughts on what I look for:
Where do we go from here
So right now you’re sitting there with a chart with boxes marked and the whole right side of the chart empty. In next weeks post we’re going to fine tune those boxes even more so by factoring in sport specific areas and your work history. From there we tackle the actual treatments and teach you how to use that chart when things feel great all the way to an actual injury.