Getting injured is something that all of us want to avoid at all times. It sucks and makes you realize how much is taken for granted every day. Injuries are, however, a part of the deal we make with ourselves when we train our bodies and play sports. There’s really no way to avoid hurting ourselves at some point, but we can take the proper steps to minimize the severity and reduce the frequency of injuries.
The most common reasons injuries occur are: 1) incomplete healing from prior injury, 2) demands outweigh capacity, 3) overtraining. Below, these three are broken down into greater detail.
Incomplete healing
History of an injury is the most common predictor of a future injury. This correlation exists for several reasons, such as impaired tissue integrity, altered nervous system patterning, or overreliance on compensatory mechanisms for function. The best way to combat these effects is to restore your physical condition beyond the pre-injury level. As busy adults with a million other things to juggle, the easiest thing to do is wait until the injury feels “good enough” and try to jump back into what caused the injury in the first place. While this may seem convenient initially, it can cost you a lot more time and money in the long run. The main change that has happened in this scenario is a reduction in symptoms to baseline. That doesn’t indicate complete healing. The tissue that was affected has not been restored to its prior function. This is where most people get it wrong. Symptom reduction to baseline means it’s time to start rebuilding, not claim a victory. A well-designed rehabilitation plan should take you from the onset of symptoms all the way to full return to performance. If you’re a runner, this means you can run at the frequency, volume, and similar pace to pre-injury. If you’re a soccer player, this means you can perform all ball skills, make the passes you used to make, change directions, and sprint as you did before injury. If you do CrossFit, this means that you can perform your previous skill level of gymnastics and lifts as you did pre-injury. Not all rehab is made the same. Be sure that you are being guided by someone who can get you to the finish line.
Demands > Capacity
In every injury scenario, we can conclude that the physical demands placed on the body were greater than the physical capacity to withstand that stress. This is true for one-off freak accidents, soft tissue injuries, bone stress injuries, and so on. This is another very common area that people tend to get wrong. Think of all of the people you played high school sports with. Line everyone up and race to see who’s fastest. How many hamstrings do you think would be pulled? Most of them. Most people after the age of 20 stop sprinting. This means that when the hamstrings are exposed to the extreme stresses of sprinting, they don’t have the eccentric strength, firing pattern, etc., and get injured.
One easy way to avoid things like this is to be strategic about progressing exercise frequency/volume/intensity and introducing new forms of exercise. The body can and will adapt to the stresses being placed upon it if given time. A runner who runs normally runs 6 miles per week, starts a new training plan where that weekly total increases to 13 miles per week. That’s over a 200% increase in weekly volume. When low back pain or Achilles tendinopathy arises, it’s likely not the specific tissue that was the cause; it was loads > capacity. Running injuries most commonly occur from training errors where loads are progressed way too fast, and the body becomes painful to signal improper loading and recovery.
Overtraining
This can be described as training stress that outpaces the ability to recover and adapt. Overtraining can occur in any athlete. Sports and training often require high levels of physical exertion to get better. High-level exertion needs to be met by high-level recovery. A week of daily private soccer training, team practice, and club practice, followed by a weekend tournament of 5 games that restarts every Monday, is a great way to feel the effects of overtraining. Slugging through a strength training block with a 6-day split, of which 4 are high days, with no clearly defined de-load and periodization planned, is another great way to feel the effects of overtraining.
It is crucial to understand how to organize training efforts to recover best and reach your goals. Without recovery, adaptation is halted, injury is welcomed, and you get nowhere. You may be wondering, how do I know when I’ve recovered enough? This is unique to each person and is often dictated by training age and lifestyle habits. One way that has been scaled via fitness trackers in recent years is using HRV as a recovery metric. HRV stands for heart rate variability, and as it sounds, it is a measure of time variability between heartbeats. This measurement can be a great indicator of how well your body is recovering from physical and mental stresses. When assessing HRV, it’s important to consider trends to identify variations from your normal values.
A few other key considerations to optimize recovery include sleep, nutrition, and rest days. Sleep is the most important and underrated recovery tool on the planet. When sleep consistency, efficiency, and time are not optimized, injury risk increases significantly. A quick rule of thumb for sleep: go to sleep and wake up at the same time every day, optimize your environment to avoid interruptions through the night, avoid caffeine after 12 pm, and aim to sleep 7-9 hours each night. Regarding nutrition, this is your body’s fuel to provide the means to perform. Adequate protein and carbohydrates are essential in creating an environment to build lean muscle mass and replenish glycogen stores. When these can come from whole foods, even better. Lastly, rest days. In the sports and performance world, the “no days off” culture is fake 99% of the time. Anyone successful knows that rest is absolutely critical. Referring back to the soccer example above, a day or two of complete rest would go a long way in allowing that athlete to adequately recover, restore nervous system function, reduce sleep debt, and ultimately allow them to train at a much higher level. Aim to break up consecutive days of high physical demand. This doesn't mean that you have to do nothing, but account for deloads throughout the week, month, and year for best outcomes.
What's worse than getting injured is staying injured. Training is a lifestyle, not a current trend. The goal of training or playing sports isn’t to win today; it’s to win tomorrow and the next day. That’s why we do it. Don’t let a small setback develop into a huge roadblock. If this speaks to you or someone you know, we would love to help you create a game plan. Call us today at 404-548-8263 or complete a contact form, and we will reach out to you!
Best,
Dr. Mike Jones, PT, DPT
Board Certified Orthopedic Clinical Specialist
Certified Strength and Conditioning Specialist
Owner/Founder - Stamina Performance Physical Therapy
Dr. Mike Jones
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