I would like to start off with how we approach "injury". Many, if not all, of us have experienced injury in some form or another. In my experience, each injury has taught me something different. What is it? How can injury be defined? It would be a challenge to take on all injuries in one blog entry so I am going to stick with the injuries related to endurance activities. We have all watched the hits in football, ankle rolls in basketball, ski crashes and are aware of the major traumatic acute injuries. As a Wisconsinite, it would only be appropriate to use football as an example. Charles Woodson broke his clavicle in the 2nd quarter of the Super Bowl. A traumatic injury like this tends to be specific and easy to diagnose, usually by some type of imaging. However, most of us who have run, swam, biked, rowed, etc regularly enough have had the opportunity to experience more nonspecific injury related to repetitive use or cumulative trauma. Many of these "injuries" seem to start without a known specific trigger. Yet, they can be very frustrating and can linger. Included are terms like runners knee, runners butt, "shin splints", etc.
While we often give a name or diagnosis to many of these injuries, the real challenge is finding the trigger or the cause. Most of us have been told that a few weeks, months off will "heal" the injury but return after that time only to find the irritation is still there. So, what does that mean? While I don't believe we have fully developed the ideal "diagnostic system" for injuries related to repetitive use, I think we are on our way. I tend to look for firing patterns, weak areas, asymmetry (comparing left and right sides). Gray Cook, a physical therapist, developed a tool called the Functional Movement Screen. The basis of the screen is to use a set of 7 exercises to screen for weakness in a movement pattern or asymmetry from left to right sides. He has identified the most functional pattern and, in turn, can screen for "dysfunctional" movement that might cause injury. In running, this would be very useful as we use the same muscle groups combined with impact and repetition. People I have treated know that I tend to harp on glut firing, shortening the stride to allow for the push from the gluts as opposed to pulling from the hamstrings. The body needs to fire the muscles properly while having stability to control movement (both of which i will write more about at a later time). Identifying what is firing correctly, what areas need to be stabilized (not stretched), and what needs more flexibility are all key in assessing repetitive use injury.
This time of year always seems to trigger achilles injuries, iliotibial band problems, pain at the hamstrings origin, among others. Often, the injury is not a major tear or anything that needs major intervention but may need a "tune up". An area that may have been previously weak could be exaggerated by increased running on the ice/snow. Excessive motion due to instability or dysfunctional movement patterns can also be exaggerated by running on the slick surfaces. Staying on top of the "tight" areas with restricted range of motion can while strengthening/stabilizing the areas that are too flexible/loose are two key components to preventing major flare up or irritation or injury.
On another note, I am looking forward to Spring! Although it is pretty easy to run higher base mileage outdoors, I can't wait to do less laundry! Wearing three pairs of pants and six layers on top makes for too much laundry! I am looking forward to writing more about training, injury prevention/treatment, and hope you find it interesting/useful.
