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Injury 101: Returning from Injury Back to Sport/Running

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A Patient’s Step-by-Step Guide to Understanding Rehab and Returning back to Sport/Running

by Keval Panchal – Senior Chartered Physiotherapist

 

Part Two: Training Loads (& Loads… & Loads… & Loads)

 

Monitoring loads placed upon athletes in both training and competitions has become a hot topic in sporting circles. Sports scientists, coaches, and physiotherapists now closely monitor these loads to gain the most optimal training methods whilst also preventing any unnecessary injuries. Therefore, the athletes can perform at high levels, and in theory maintain these levels.

 

Although much research is based around athletes, it is recommended that even the average person should take heed of information on overload and training programmes to help safeguard themselves against injuries, but at the same time allow them to work within the most optimal capacities they possibly can. The key question for debate, is how much training is too much or too little?

 

Load itself is defined as the repetitive mechanical stresses and strains placed on tissues as a result of running or any other physical activity. These can be varied based on principles such as:

  • Frequency
  • Intensity
  • Time/ Duration/ Volume
  • Type – running patterns / types of varied training.

 

Approximately 80% of running injuries are caused by training error, overuse, or in other terms excessive loading. Bourdon et al., 2017, reported that the overall load may not be as important as the rate of change in load. A rapid increase is more closely associated with injuries. When running, the ground reaction force (GRF) is thought to be 2.5-3 x body weight per foot strike, which can add up to a mammoth amount of force. Assuming we have an 80 kg runner, who averages 500 foot strikes per mile. 80×2.5=200kg. 200×500=100,000kg of load per mile! With time and optimal loading, our bodies can adapt to this load, neglecting this, however, can lead to all kinds of injuries and compensations.

 

For the uninjured athlete/ runner, you want to be loading in an ‘optimal training zone’. This can be identified by your body undergoing positive improvements in strength, cardiovascular, and recovery. There are many ways in which loads can be assessed. Most commonly GPS trackers monitor speed and distance, but many studies have also validated the use of RPE (rate of perceived exertion) as a good way of monitoring load. This is simply used to monitor effort levels out of 10 during a run/activity, which has been proven to be very reliable according to studies by Mujika et al., 2017; and Gabbett et al. 2016. A simple measure of effort can be made by the following: RPE units x minutes = arbitrary load per miles ran. This can be used to calculate your workload ratio. In their paper Gabbett et al., 2016, explains that to avoid the likelihood of injury, there should not be an increase of more than 10%. Beyond this increase, the risk of injury can increase by as much as 30% and further dependent on the level of increased workload. They go on further to explain that there is a desirable ‘sweet spot’ of increasing workload between 0.8-1.3 as an average of the last 4 weeks.

 

Based on the information above, an ideal training programme would involve 4-6 weeks of training at a suitable level, 1-2 weeks of tapering down to 80%, then a gradual increase up-to 130% in training for another 4-6 weeks. This process could be repeated and continued steadily for long-term benefits. This would greatly reduce any incidence of overload and therefore injury.

 

Many athletes/ recreational runners from time to time will often get injured due to overtraining and traumatic injuries, and it is quite common for anyone to become frustrated with losing fitness and strength during the time out injured. The struggle comes with trying to get this fitness back and then maintaining this to progress forwards again after an injury. The next article will provide you with a solution to this burning issue based upon current research.

 

References:

Bourdon PC, Cardinale M, Murray A, Gastin P, Kellmann M, Varley MC, Gabbett TJ, Coutts AJ, Burgess DJ, Gregson W, Cable NT. Monitoring Athlete Training Loads: Consensus Statement. Int Journal Sports Physiology and Perform. 2017; 12, S2-161-170.

Busso T, Thomas L. Using mathematical modelling in training planning Int J Sports Physiol Perform. 2006: 1(4):400-405.

Gabbett TJ, Hulin BT, Blanch P, Whiteley R. High training workloads alone do not cause sports injuries: how you get there is the real issue. Br J Sports Med. 2016; 50(8): 444-445.

Mujika I. Quantification of training and completion loads in endurance sports. Methods and applications. Int J Sports Physiol Perf. 2017; 12: S2-9-17.

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