The Most Effective Way To Treat Triathlon Overuse Injuries
Part 1 - How not to treat your injuries

In the sports of swimming, cycling, and running, collectively known as triathlon, overuse injuries are as common as tacos in Spanish Harlem. They're as frequent as fake boobs at the Boca Town Center mall. And, finally, they're as common as cute Florida females glancing at me and thinkin, "who's that guy!"

Before I get into the meat of this article series, The Most Effective Way To Treat Triathlon Overuse Injuries, I need to explain to you why other injury treatment protocols suck.

The Format of Most Advice Articles

I am going to introduce my article with a brief explanation and example of why the articles and books you read regarding overuse injuries in sports are TERRIBLE. This will then lead into why that 'expert' doctor also sucks. I'll use an example of a random coach posting advice onto his Blog:

Usually, when you read some pontificating blog author's advice on overuse injuries, he puts a little disclaimer on the beginning of the article, such as, "I am a fucking idiot, I have no training credentials, I am not a medical doctor, and I can't even finish a sprint race. However, I am going to make some recomendation for your injuries. I read Triathlete Magazine while taking a dump this morning, and I think I can cure your problems. Before trying any of my recommendations to treat your injuries, please consult an expert."

The typical preface then goes on to list several terrible rehab exercises that will leave athletes undertrained, weakened, and frustrated. Or, if the athlete does manage to get to an "expert", that jackass will profusely soliloquize* why the blogger chose incorrect exercises and why he, the expert, will select more appropriate exercises. These new, more appropriate exercises will leave athletes undertrained, weakened, and frustrated.

So you see, if you consult man on the street, fellow athlete, triathlete online/magazine article, expert doctor, you're screwed.

Dead Reckoning: How the advice givers end up hurting you

Everybody wants to give you advice on how to cure your injury, the problem is that none of that advice is based on anything. It's the old problem of Dead Reckoning.

I'll explain the dead reckoning thing. Dead Reckoning is trying to explain a peoples voyage by working back from their final destination. I will explain why the exercises your Dr. prescribes for your injury (final destination) are based on a rather questionable starting location and how that advice got messed up along the way.

Imagine some university wants to study how athletes suffering from achilles tendonosis (yes, it's tendonosis, not tendonitis) can be rehabbed and returned to the playing field effectively. After recruiting 7 athletes for the study, they run a study that shows athletes return to the field 5% faster if they gently stretch the soleus 3 times a day as opposed to doing nothing.

Although errors in university strength and conditioning studies are more common than overuse injuries in triathletes, those errors really aren't the point of the study. However, bonus points if you can point out the errors in the study. There's many. Leave them in the comments section.

Let's suppose that this data is reliable. Athletes return 5% faster if they gently stretch the soleus 3 times a day. That means there's a very small correlation between stretching that calf muscle and increasing healing time of the degenerated collagen fibers in the tendon. Here's where the Dead Reckoning comes in. Some athletes in the stretching group must have experience the quicker healing, but some wouldn't have. Basically, the study shows that stretching might slightly help some people.

Triathlon Magazine sees, "the study shows that stretching might slightly help some people." They print an article stating "Groundbreaking research shows stretching the calf CURES achilles tendonitis!" Notice that triathlon turned a correlation into a causation, and they didn't even get the injury right, and the didn't even get the muscle (soleus) right.

Your physical therapist, who majored in PT because, "dood, that's where the hot injured marathon chicks go" picks up a copy of Triathlon Magazine to do some "research" and "post graduate studies". He sees the achilles stretching headline.

You show up at that therapists office, and he has you stretching the shit out of that calf. Three times a day, from different angles, with people pushing on the calf for you. He says you can run lightly, but nothing major.

Three weeks later, your achilles hurts more (because you were ripping it apart) and your run training volume is down. You're weaker and less fit. This is just one example of how poor injury advice hurts you.

The Takehome Advice
Magazines, doctors, therapists, fellow athletes will all try to help you with advice about how you can treat your overuse injury. It's all wrong.

*Editors Note: Frey has noticed that people only use "profusely" when talking about bleeding or sweating. He's making an effort here to use "profusely" in more situations.


Libby Maxim said... @ September 1, 2009 at 5:54 PM

hello frey, Part 2, i mean my injury ain't getting any better, tee hee

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