3Who has had to stop or alter training because of an injury or pain?
4Who has continued to train despite an injury ---- knowing you were doing damage or digging a deeper hole to recover from?
5Suppose you are having that magical day Suppose you are having that magical day. You have trained months to get ready. You have sacrificed diet, family time, and rest to train. You had to buy a plane ticket and hotel. Your race fees and tribike transport was paid. You start having a pain you know is bad. You are on PR pace.Do you stop?
6Suppose you are racing and having that magical PR day Suppose you are racing and having that magical PR day. You suddenly feel chest pain. You know if you continue, the consequences could be really bad.Would you continue?
7General Principals of Treatment Understand the mechanism of injuryAthlete Rationalization: A break from activity causes disorganization of the strength and flexibility of muscles2-3 weeks off leads to significant losses of fitness especially the endurance componentsReturn takes twice as long as the down time
8When can I run/ride/train again ? The Question Becomes:When can I run/ride/train again ?NotWhen will I be healed?
9Integration: Athlete-SportsMed-Chiro-PT-Coaching RaceNormal prep for racingBuild phaseIncreased WorkoutBegin workoutModifiedInjury phase
10Healthy Progression Very Individual You can kill a career by going to fastMake a Goal for the End of Each Phase“You are lucky-You get to do this for fun“Conrad Stoltz
11Initial Treatment Phase I (3-6 weeks) Goal : to eliminate the pain or stimulus for pain***Stopping the activityGet the correct diagnosis !!!NSAIDS ( oral or topical), injections ?IceActive or inactive restGentle stretching or Range of motionDeep tissue massageChiropractic TreatmentSet Your Phase 1 Goals: More time with family, Learn about nutrition, Swim technique or speed, read books, learn Spanish
12Initial Treatment Phase I Rest ----Ice------hydration
13Initial Treatment Phase I Avoid Temptation to Not Rest
14Initial Treatment Phase I Active RestCross training, walking, swimming that does not cause pain**If cross training causes pain, you need complete rest!Chiropractor: Active Release and modalitiesPhysical Therapy (with dry needling)Core StrengtheningYoga, pilates are great for flexibility and strengtheningHot yoga is incredible for flexibility, core, balance, heat acclimatizationStretching***All that does not cause pain*****
15Integration: Athlete-SportsMed-Chiro-PT-Coaching RaceNormal prep for racingBuild phaseIncreased WorkoutBegin workoutModifiedInjury phase*Pain or injury is better
16Initial Treatment Phase II (? weeks): Assume pain is absent We are beginning our sports specific motion (train coordination of joint and muscle)****be aware of the pain******Set Your Phase 2 Goals: Time with family, continue nutrition , Yoga, Core strength, swim , better run or bike technique
17Proper Weight Too much Too little Just Right ? 4 x body weight each step across your hip , knees and feetToo littleNot enough nutritional ability to trainBone density declineJust Right ?
18Phase 2 How do I avoid the abnormal stress that led to injury ? Form and TechniqueMechanics of repetitive loadOrthotics/ShoesBike fitGeneral and Specific Strengthening
19Form and Technique Gait Analysis Drill Work Shoe Wear Crucial is determining repetitive stressCadence (Metronome)Specific exercises to address these issuesDrill WorkStriding ONFitness Goals LimitedShoe WearGeneral and Specific Training
20Aquatic Based Return to Running Deep Well running*Zero gravity*Good cardio with high cadence*Work hip flexion and careful of extension, straight back, arm swing*Use as a return from injury or supplement**Pete Pfitzinger 9 week planUnder water treadmillUp to 30%Alter G treadmill-50-90% weight bearRunning
21Form and Technique Bike Fit This must fit your flexibility and your race plans**Not everyone should be “nose down”Cleat Position
22Integration: Athlete-SportsMed-Chiro-PT-Coaching RaceNormal prep for racingBuild phaseIncreased WorkoutBegin workoutModified**understand mechanism**gait and bike fit**proper strength /balanceInjury phase
23Phase 3 : Increased Volume Use of a CoachDevelop a Long term and short term planTrainingRacingRecoveryJournalDevelop An Aerobic Base to build volume and intensityBALANCE
24Run Progression in Phase 3 Track/grasswalkinggraveljoggingHilly or unevenrunningCuttingFitness Challenge to set zones
25Phase 3: Increased Run Volume Use of Run/ Walk Program***Rules of progression*Each stage should last 1 week. You can obviously progress the total time by increasing the interval . In stages 1-8 do not increase the interval by more than one.*If you have pain-skip a run ( 3 days ) and return to the previous stage. If you still have pain at that lower stage please notify your doctor
26Run WalkStage 4-7 are jogging steady or zone 2 ( no intensity); the walk is good form good arm swing . This should be done no more than 4 times per week.Stage 4: 4 min run / 1min walk x ___Stage 5: 6 min run/ 1 min walk x ____Stage 6: 7 min run/ 1 min walk x _____Stage 7: 8 min run/ 1 min walk x _______Stage 8: 9 min run/ 1 min walk x______
27Run WALKStages 8-10 : the run pace intensity can increase by adding strides focusing on perfect form and, terrain can vary. This should be % of normal pace prior to injury. The walk is same as above. You may want to do a shorter steady run without breaks on other training days.Stage 8 7 min run/ 45 sec walk x______ with ____ x strides @____________Stage 9 8 min run/ 45 sec walk x _______ with ____ x strides @____________Stage 10 9 min run / 45 sec. walk x _____ with ____ x strides @____________
28Run -WalkStages 11-14: This progression is meant to realize longer race pace with scheduled rest. This would be normal run walk training for, marathon, half marathon, Ironman or half iron manStage min run/ 45 second walk x ____Stage min run/ 45 sec walk x_____Stage min run / 45 sec walk x ______Stages 14 and 15: the athlete should decide where they want their nutrition and interval to match that plan. Build the time to match the event .Example1 : I plan on running 730/ mile marathon pace and I want to walk for nutrition every 2 miles. That would give 15 min run/ 1 min walk.Example 2: I plan on running 9 min/ mile for Ironman and walk 30 seconds through the aid stations. This would we 9 min run/ 30 second walk.Stage min run / 1 min walk x ______
29Bike Progression Fitness Challenge To Set Zones Trainer RecumbantTrainerOn the road or trailsFitness ChallengeTo Set Zones
30Integration: Athlete-SportsMed-Chiro-PT-Coaching RaceNormal prep for racingBuild phaseIncreased Workout*increase run volume*increase bike volume*Strength/core/yoga*Test to set zones/aerobic baseBegin workoutModifiedInjury phase