Being injured and in pain is the worst. It holds you back from performing activities you enjoy and even everyday tasks can be tougher to do to the standards that you’re used to. There are often also mental hurdles to overcome when trying to come back to sports or the training that you love.
When you sustain an injury that needs physical therapy, this means that one or more of the body’s systems was not robust enough to handle a particular stressor it was up against at the time.
This could be because of an exercise choice, too much of a particular activity over time, not be ready for the particular activity or simply fatigue that leads to less than ideal movement quality. There can be many reasons. Either way, the body was not resilient enough to fend off the stressor and it broke down. The best way that we know to build up resilience against injury is through fitness.
One of the biggest challenges that we can face when trying to navigate an injury and resume regular movement or training is knowing exactly what’s appropriate to do. When can we begin to veer off the rehabilitation road and flow onto the training highway?
The answer lies in a connecting the various professions that have the most to offer at ALL stages of your journey. Specifically, your physiotherapist and your strength and conditioning coach or trainer.
For a long time there’s been a gap between physiotherapy and strength and conditioning when there is so much to gain when these worlds collide and there is a combined focus and collaborative effort towards not only getting you back to the activity that you most enjoy but also making sure that you are even more unbreakable in the future.
When you’ve been injured, you’ll need a physiotherapy lens at the site to examine the damage extent, get you out of pain and on the road back to function. Towards the end of treatment, your strength coach or trainer then merges into the game to deliver fitness strategies that should result in you needing fewer trips to the physiotherapist and the long term result of building resiliency against future damage.
The fact of the matter is, your physiotherapist can get you out of pain and back to normal, but they’re often not equipped with the tools to get you far stronger than you were and need. It may very well have been (and often is) a lack of strength and readiness for the activity that led to the injury in the first place.
Your strength coach can get you better than you were, stronger, faster, fitter and less damage prone, but they cannot directly apply the same healing and rehabilitation strategies.
Both of these skill sets have the same goal; to apply a certain stimulus and provoke a certain adaptation that results in you getting a little better. They just exist at different ends of the continuum.
Often, if you’ve been hurt what you need is some combination of the two skill sets working with you at the same time for best effect.
For all the jazz around foam-rolling these days it may be surprising to know that the underlying mechanisms are still not well understood and there is a paucity of high-quality and well-designed studies available.
Some of the proposed mechanisms of effect may include:
1. Reflex neural inhibition
2. Increased stretch tolerance
3. Mediating pain-modulatory systems
What we do know is that foam-rolling appears to be effective for producing short-term gains in flexibility without reducing performance. And while the benefits to muscle function have not yet been established, there does seem to be a demonstrable reduction in post-exercise muscle soreness as a result of post-exercise rolling.
So, from the research that we do have, it’s safe to say that foam-rolling is perhaps not the miracle saviour for poor exercises choices or not moving enough that we once thought it was.
1. A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Wiewelhove, et al. 2019
2. The Science and Physiology of Flexibility and Stretching : Implications and Applications in Sport Performance and Health. Behm, 2018.
We’re often asked about the benefits of going through a full range of motion with your strength exercises. Here is why we recommend that you do and what it means for your training.
1. You get a more complete stimulus and development across the full length of the muscle. We know that muscle fibres don’t always run the entire muscle length from origin to insertion. We also know through the specificity principle that strength gains are specific to the joint angles that are trained so it is important to cover as much of the movement arc as you can. A full range of motion allows greater activation of as many fibres as possible and better strength and hypertrophy gains.
2. Technique standardisation. When you go through the same, top to bottom range for each and every rep, you can be sure when you are progressing and not simply changing form to accommodate the load.
3. Length and strength in long positions. Research has been piling high with the benefits of loading in long muscle lengths (such as in the bottom position of a squat or stiff-legged deadlift, pull up, or bench press where you feel the greatest stretch). This enables strength gains specifically in those ‘stretch’ positions where typically we are not able to produce as much force. Loading into lengthening (eccentric loading) also allows greater overload as well as flexibility improvements.
4. Less injury risk. There is a greater dispersal of stress across more joint systems and larger excursions of motion mean that less load is needed to provide an overload. This greatly reduces the likelihood of a training-related injury.
There certainly are circumstances were you might consider reducing range, such as:
1. To provide a greater overload in a particular joint position thereby effecting a specific muscle or group of muscles. Less range means more weight can be used so caution is advised here. This is to be used sparingly and mostly for the advanced lifter only.
2. Specific sport application – half squats have been shown to have carry-over to running and sprinting activities.
For the most part, the bulk of your training should emphasise taking the joint through as much pain-free range as is controllable and the muscle through full stretch to full contraction. It might mean you’re using a little less load however the benefits hugely outway the risks:
Although a relatively recent addition in Australia, Compression Garments (CG) have rapidly become quite the fashion statement, initially designed to promote recovery from hard training and competition and subsequently to help improve performance.
Compression Garments are a type of tight-fitting form of clothing made from elastic material providing a gentle compression of the limbs. Some of the reported positive outcomes include:
There is also the possible placebo effect and psychological aid of wearing CG and perceived recovery and performance improvements to be factored in, as anecdotally athletes often speak positively of their helpful effects. The magnitude of physiological recovery improvements observed in the literature are similar to what has been seen with cold-water therapies or light exercise.
While the research currently has shown some recovery benefits from wearing CG it should also be noted that a great deal of the research is of poor quality and clouded with inconsistencies.
It should be added that there is also the risk of bias due to
While there have been some benefits shown and no observed adverse effects on performance or recovery with their use, there is still also no reliable criteria for best practice.
It is therefore suggested that if CG are used they should be used as an adjunct to more proven and reliable recovery enhancing modalities such as enough quality food, good sleep hygiene, as well as fatigue and stress management strategies. Currently, the research is not strong enough to provide conclusive recommendations.
Following our introduction to recovery, we’re going to continue the series looking at some of the research around many popular recovery methods and offer some practical
First up on the list is sleep – one of the most important influences on recovery, one of the simplest to address and yet is often the most overlooked of all performance variables.
Sleep is a needed resource for psychological and physiological wellbeing, during which time many of the bodies more potent repair and recovery processes are kicked into overdrive. It is generally accepted that the primary purpose of sleep is restoration – To recover from previous wake-period operations and/or prepare for functioning in the subsequent wakefulness period.
An individual’s recent sleep history (consisting of both duration and quality) can have a dramatic influence on daytime functioning. Research has firmly established that sleeping less than 6 hours per night for four or more consecutive nights can:
1. Impair cognitive performance and mood
2. Heighten risk of illness and injury
3. Disturb metabolic health, appetite regulation and immune function
There are many reasons why sleep habits may be negatively affected, some of which include:
Stress, nervousness, thinking, worrying, planning.
Unsuitable diet/nutrient deficiency
Poor sleep habits and environment (eg noise, lighting, temperature, late television watching, late caffeine use, late activity).
In addition to the above, Erlacher et al. 2011 asked 632 german athletes from various sports about their sleep habits leading up to important events or competitions, with the results showing that:
Factors identified as reasons for poor sleep included:
The value of quality sleep is clear and it is easy to see how it can be impacted by many of the above variables which we all face from time to time. What isn’t so easy though, is how best to mitigate these factors to ensure that you get a good night sleep and subsequently prevent the associated performance decline from sleep loss.
Suggestions for improving sleep:
1. Develop a ‘POWER-OFF POLICY’ before bed
Switch off tv, computers, tablets, and smartphones 1-2 hours before sleep time. These will disturb the production of hormones that prepare you for sleep.
2. Develop a ‘Wind down’ routine before bed
Slow down and de-stress as much as possible before bed and try to establish consistent sleep and wake times. A shower before bedtime has been shown to improve sleep onset latency. Research has also shown that almost half of all insomnia cases are linked to stress or emotional upset. Avenues to reduce stress are highly individual and situation dependent, so finding ways to reduce stress are paramount to improving sleep, and long-term health and wellness. Some proven strategies include:
Habits and Environment
3. A quiet sleep space is a key
If noise can’t be avoided try using headphones with instrumental music at a low volume, or keep a fan on for an acutely distracting ‘white noise.’
4. Temperature, darkness, and clothing
Approximately 18 degrees Celsius is a cool room temperature that has been shown to help comfortable sleep occurrence. Thick bedding and clothing must also be avoided if it causes overheating. A dark environment with limited lighting can also help the body recognise that it’s night time and time to begin the process of preparing for sleep.
5. Coffee and heavy meals
Avoid caffeine, big meals and heavy amounts of liquid before bed.
6. Take Naps Where You Can & Need To
Naps can be beneficial to catch up on lost sleep, however, avoid them later into the afternoon if it might impact your regular sleep time. Blanchfield et al. 2018 recently showed that a short afternoon nap improves endurance performance in runners that obtain less than 7 hrs of nighttime sleep. Napping might be an important strategy to optimise endurance exercise in other athletic and occupational scenarios when sleep is compromised (eg long-haul, intensified training etc).
”Every training element has a point of diminishing returns. Our job (the coach’s job) is to find it shift emphasis and cycle back at the optimal point in time.” ~ Derek Hansen
For many people who play winter sports like football, soccer, AFL, netball and hockey, pre-season training is just around the corner or may have even started already. Completing a whole pre-season program is not only vital for fitness levels and skill practice, it can be a massive component of preventing injuries throughout the season!
A 2016 study found that elite AFL players who completed <50% of their pre season training were 2x more likely to sustain an in- season injury than those who completed >85%. This isn’t just relevant for AFL though; it’s relevant for all sports at any level.
This is a telling stat, and one that needs to be at the front of all athletes’ minds whilst participating in pre-season training. Even if you’re injured, there is something you can do. Pre-season isn’t just about “getting fit again”, it can be used for rehabbing those niggly injuries still hanging around from last season. The is also lots of research showing that increasing strength can help prevent many common sports injuries including hamstring and adductor (groin) muscle tears, rotator cuff and other shoulder injuries, shin splints and other sprains and strains.
Research from the Australian Institute of Sport (AIS) also shows that avoiding rapid spikes in training load helps you avoid injury not only in pre-season, but during the season as well. Going straight in to in-season training and competition loads causes a huge spike in strain through your body and this dramatically increases your risk of injury during the season.
So make the most of your pre-season training. Get yourself to those sessions, and work on everything you can! Remember, the work you do now will pay off come start of season if you make the effort!
Not sure what to do for your pre-season training? Let one of our Strength & Conditioning coaches or Exercise Physiologists get you on the right program to boost your performance and reduce your risk of injury
Reference: Murray et.al 2016 Individual and combined effects of acute and chronic running loads on injury risk in elite Australian footballers
At Central Performance we see a lot of runners coming in either for physio treatment or running training with our running coach/physio superstar Ben Liddy. We know that runners love to run and can be like a bear with a sore head when they can’t run due to injury. One great, and often overlooked, way to both improve running performance as well as reduce the risk of injury is to add some strength training to your running training.
Traditionally it was believed that strength training won’t improve running performance as lifting weights will make people bulky and slow. However there is now good evidence that strength training improves running performance by increasing running efficiency. An increase in running efficiency means you to use less energy while running.
Strength training helps improve running efficiency by increasing the rate of force development (RFD) of a muscle. RFD is how quickly a muscle can produce force. The higher the RFD the quicker a runner is able to spring off the ground, reducing the ground contact time and therefore reducing the amount of energy they use.
Also contrary to popular belief, the best form of strength training for runners is not light weights with high reps to build endurance. Research shows that the most effective form of resistance training for runners is heavy weights with low reps and plyometric (power) training. Using heavy weights for low reps helps to increase neural drive to the muscle which helps to improve RFD. Plyometrics also help to improve RFD and power development. Plyometrics involve jumping exercises and help teach the body to use muscles and tendons like springs, reducing ground contact time and thereby improving running efficiency.
The best types of resistance exercises for running are compound exercises such as deadlifts, squats and lunges. These exercises use almost all the lower body muscles in a coordinated fashion.
Research shows that weight training twice per week causes significant improvements in running efficiency and performance. It has also shown that for competitive runners reducing weight training to once per week during the competitive season maintains the improvements made with twice per week.
Strength training also helps to reduce the risk of injury to runners and all other athletes. A recent review in the British Journal of Sports Medicine showed that resistance training can lead to a 66% decrease in sports injuries and a 50% decrease in overuse injuries. The below picture does a good job illustrating why strength training is important injury prevention for runners.
As you can see the soleus muscle, one of the muscles in the calf, needs to handle between 6.5-8.0 times bodyweight on ground contact during running. Having to tolerate such huge forces obviously requires a lot of strength otherwise the rsk of injury is greatly increased. A good guide for having adequate strength in the calf muscles is to be able to confidently do 30 single leg heel raises on each leg.
Tendinopathies are a very common type of running injury. They occur when the amount of load going through a tendon overloads the tendon’s ability to recover from it. Commonly occurring tendinopathies for runners are hamstring and achilles tendinopathies as both the hamstrings and calf muscles are extremely important in running. One of the best ways to improve a tendon’s capacity to handle load is by resistance training. Heavy resistance training provides a beneficial stimulus to tendons to help them build strength, remodel and allow them to adapt to high volumes of load put through them during running.
You can book online or call us on 9280 2322 for more info.
This post was written by Hugh Campbell, our senior Exercise Physiologist. He has extensive experience and has attended numerous post-graduate courses on running biomechanics and the role of strength training in runners.