Triathletes push their body to the limit, and sometimes those limits can bring the body to its breaking point. Injuries are common, and quite possible. It comes with the territory.
1. Swimmer’s Knee
How is it Caused?
Swimmers knee is most common in the breaststroke, but is often found with those who have improper swimming form. This improper form comes mainly from the kick portion of the swim by an external rotation that places a high amount of stress on the medial collateral ligament (MCL) as well as the medial patella. This injury will not happen immediately, but the repetitive nature of swimming will cause excessive wear and tear on the knee with improper swim form. This is likely because the majority of beginner triathletes have little swim experience.
How Can it Be Fixed or Prevented?
If you have swimmer’s knee, one of the best ways to rehab the pain is to reduce your intensity and exercise that affects the MCL. You should also introduce a strengthening program to strengthen the muscles around the knee including quadriceps and hamstrings. In order to prevent an injury such as swimmer’s knee, it is necessary to focus on proper form and drills while in the water, and a proper strength-training program.
2. Plantar Fascitis
How is it Caused?
The plantar Fascia is a connective tissue that runs along the bottom of the foot from the heel bone to the ball of the foot, supporting the arch of your foot.4 This fascia can become inflamed through many factors that include: improper foot strike, overtraining, recent increase in training volume, and an imbalance of muscle strength. The pain of plantar fasciitis is typically felt through pain in the heel that can increase throughout training and even during the day when not training.
How Can You Treat or Prevent It?
One of the best ways to treat plantar fasciitis is to stretch the Achilles tendon and fascia. The American Orthopedic Foot and Ankle Society outline some of these stretches.4 Another option is to take anti-inflammatory medication, invest in a pair of orthotic inserts, and get a cortisone shot or to see a therapist to provide a fascia release technique that will help alleviate pain. You can prevent the pain of plantar fasciitis by creating a proper training schedule, slowly working your way up in training volume and intensity as well as having your running gait analyzed to produce proper running technique.
3. Broken Collarbone
How is it Caused?
A broken collarbone is the bone that is most likely to be broken while riding a bike if you are involved in a crash. This is because the collarbone is directly connected to the shoulder and is a thin, curved bone. Due to the position and the nature of cycling, when a crash happens, if the rider falls directly on their shoulder, or on their hand, the energy is transferred to the shoulder, and the angle will likely cause the clavicle (collarbone) to break.1
How Can it Be Treated and Prevented?
A broken collarbone is treated either by immobilization or by surgery. Depending on where and how bad the break is will determine whether you would need to have surgery or if immobilization would be the best option. You can prevent this from happening by knowing how to properly control and maneuver your bike. Many riders will go out onto a ride without knowing how to handle their bicycle properly and end up causing a crash with others and often times by themselves. If you need to develop bike-handling skills, drills can be found online and local bicycle shops will likely have ongoing classes for new riders.
4. Fallen Arches
What is it Caused By?
The arch of the foot plays an important role in the stride and absorption of impact on the body while running.3 It helps to distribute the weight properly across the feet and up the leg. Fallen arches occur in the same area of the foot at plantar fasciitis, however instead of an inflamed fascia, the posterior tibial tendon can become weakened through overuse, improper training, or foot strike and in turn, can tear. When this tendon tears, the arch of the foot falls, causes an internal rotation of the foot that leads to pain in the foot, ankles, knees and more.3
How Can it Be Treated and Prevented?
Rest and recovery can treat fallen arches. Purchasing properly fitted shoes and/or insoles can also alleviate pain, but may also cause more pain depending on how the body adapts and the severity of the strain or tear. In certain cases, surgery may be an option. The best prevention is to maintain proper running and training shoes for your foot. Keeping your arches and feet strong through training can also help prevent arches from falling. If available, when doing a cool-down, light jog around soft, clean ground in socks or barefoot may help strengthen the more than 100 muscles and tendons in your feet.
5. Rotator Cuff Tendinitis
How is It Caused?
The muscles and tendons that hold your shoulder into place and connect it to the clavicle and the shoulder blade form the rotator cuff. Swimming relies heavily on the rotation of the shoulder to move efficiently through the water. After time, the tendons in the shoulder can become inflamed, causing pain when lifting your arms, lying down at night, attempting to button your shirt and more.2 If this tendinitis goes untreated, it has the ability to cause a tear within the rotator cuff, which requires surgery to repair.
How Is It Treated and Prevented?
Depending on the seriousness of the injury, the inflammation can be treated with rest and anti-inflammatory medication. You should always consult a physician for proper treatment, as the rotator cuff is critical in all shoulder movements. Treatment can also include physical therapy, massage, dry needling, and exercises that can help increase the range of motion, but can take up to six weeks to recover.2 During this recovery, proper progression should be taken in order to avoid long-term effects on the shoulder and surrounding areas.
6. Hamstring Strain
How Is It Caused?
While running, after the knee is extended, the hamstring (back of the leg) and the gluteus maximus work to bring the foot back to the ground to prepare for the next stride. Hamstrings are naturally weaker, and fatigue faster than the quadriceps that work to extend the knee. When this imbalance becomes to great, whether by strength or fatigue, and the intensity is pushed, the hamstring can be quick to be pull. Depending on the grade of the strain, the pain can range from mild and uncomfortable to unable to walk or pick up the affected leg.
How Can It Be Treated or Prevented?
The immediate treatment for a strained hamstring is rest, recovery and to begin a rehabilitation program after finding out the severity of the strain. Stretching and strengthening along with low-impact activities will likely be prescribed. A key to the rehabilitation process is to take it slowly; a hamstring injury is one that if rushed back from is likely to happen again. Proper strength programs that target hamstring development in an attempt to reach a close ratio of hamstring-to-quadriceps muscles can prevent hamstring injuries.
7. IT Band Syndrome
How Is It Caused?
Iliotibial Band Syndrome (ITBS) can be caused by overtraining and will affect the lateral (outside) part of the knee. ITBS can occur in beginner and elite triathletes, runners and cyclists. ITBS can be extremely painful and can take you out of training if not treated. Increasing training intensity too quickly, improper running or cycling form along with muscle tightness and imbalance cause it.
How Can It Be Treated or Prevented?
If you are feeling pain through the outside of your knee, it’s best to have a physician test for ITBS. It can be treated from rest and stretching. One of the causes may be a tight IT band, but the tightness may also be stemming from other muscles near it. Creating a stretching program that targets the inner thigh, hamstring, calves, hip flexors and gluteus can help relieve tension. Making sure that you have proper fitting shoes and that your current shoes are not worn out is also necessary. You can prevent ITBS by tracing your mileage and training – using proper progression models to make sure you don’t have a sudden increase in training before your body is ready for it. The good thing about triathlon is that you have the ability to train for three different sports, use variable methods of cross training and maintaining stretching and strengthening programs.
8. Shin Splints
How Is It Caused?
Shin splits occur often during high intensity training and in the first stages of training for a runner or triathlete just starting out. Shin splints typically develop when inflammation occurs within the muscles and tendons around the tibia (shin bone) from repetitive exercises while running. If shin splints go untreated, they can develop into stress fractures which is a small crack in the bone caused by excessive tension and overuse. It can also be caused by a weakness in muscles around the shin, improper training, improper form and repetitive workouts.
How Can It Be Treated and Prevented?
The best recovery from shin splints is rest – typically about two weeks. Keeping legs elevated, taking anti-inflammatory medication and using compression during training can also help alleviate the pain. Shin splints will not typically need surgery, but if they develop into stress fractures, immobilization will likely be required. You can prevent the pain by wearing properly fit shoes, gradually increasing training volume and intensity while using exercises that will strengthen the muscles and tendons around the lower leg.
References:
1)Lennox, Craig. “The Collarbone: Pro versus You.” Ride Media. 11 Oct. 2013. Web. 10 Aug. 2015. <http://www.ridemedia.com.au/ride-features/the-collarbone-pro-versus-you/>.
2)Miller, John. “Physio Works – Physiotherapy Brisbane.” Shoulder Tendonitis. Web. 10 Aug. 2015. <http://physioworks.com.au/injuries-conditions-1/rotator-cuff-tendonitis>.
3)Nordqvist, Christian. “What are flat feet (pes planus, fallen arches)? What causes flat feet?.” Medical News Today. MediLexicon, Intl., 11 Sep. 2014. Web. 9 Aug. 2015. <http://www.medicalnewstoday.com/articles/168608.php>
4)” Plantar Fasciitis.” Plantar Fasciitis. Web. 10 Aug. 2015. <http://www.aofas.org/footcaremd/conditions/ailments-of-the-heel/Pages/Plantar-Fasciitis.aspx/>.
5)”Top 5 Swimming Injuries.” – Swimming Injuries. Web. 10 Aug. 2015. <http://www.physioroom.com/sports/swimming/2swimmersknee.php>.
