INJURY PREVENTION AND
RECOVERY FOR
TRIATHLETES
Matt
How are women different?
• Skeletally:
– You are shorter and smaller
– You have a wider pelvis
– You have shorter limbs re...
How are women different?
• V02max (ml/min)= 40% lower
• Correct for mass (ml/kg/min)= 20% lower
• Correct for fat free mas...
How are women different?
• You are generally 2/3 as strong as men
• You are weaker in the upper body, strongest
in the leg...
My ♀ Observations
• Very determined
• Stubborn
• Attention to detail
• Emotionally involved
• Can be equally as stupid as ...
FEMALE ATHLETE TRIAD
Eumenorrhea Normal
Bone
Adequate
energy
availability
Amenorrhea Osteoporosis
Energy
deficit +/- eatin...
ENERGY AVAILABILITY
• Energy availability = Food in – fuel burnt in training
• Energy left over used for normal bodily fun...
SECONDARY AMENORRHEA
• Normal: 28 days
• Irregular: 35 days-90 days
• Amenorrhea (Absence): >90 days
• In athletic women, ...
SECONDARY AMENORRHEA
• General population: 1.8-5%
• 17% Team sports
• 52% Ballet
• 67% Runners
• 100% Gymnastics
• 2-4 x r...
LOW ENERGY AVAILABILITY
• EXCESSIVE EXERCISE
• REDUCTION OF ENERGY INTAKE
• COMBINATION OF BOTH
• EATING DISORDERS:
– ‘Cli...
NUTRITION
“Maybe I was too strict on diet and too strict
on training. I think I got a bit obsessed. If
you think that eati...
Over-training
• Reduced performance short and long-term
• Days to months to recover
• Physiological
• Biochemical (sympath...
Overtraining symptoms may include
• Depressed mood
• General apathy
• Decreased self esteem
• Emotional instability
• Rest...
Monitoring
• Stress Questionairres
• iThlete
• Sports tracks, cycling peaks etc
Coping
mechanisms Stress
Sport Social
Work Friends
Study Health
Family Travel
Money
Growth
Positive
effects
Negative
effec...
Recovery
AIS: $17 million recovery and swim centre
QAS: $10 million recovery centre in 2008
US Olympic Training Centre, Colorado
Sp...
RECOVERY METHODS
• Physical
– Stretching
– Active recovery
• Passive
– Massage
– Compression wear
• Hydrotherapy
– Cold im...
Nutrition
• Re-hydrate
• High GI snack 30 minutes post session:
– Gel
– Sports drink
– White bread sandwich
• Carbohydrate...
Active recovery
• Low intensity aerobic exercise
• Exercise bike on sideline, pool session next
day for team sports
• Help...
Stretching
Massage
• Reduces muscle force production
• Increased confusion, decreased vigor on
Psych questionnaires
• Relaxes you
• R...
$45
High density
90cm x 15cm
Foam Roller
Contrast/cold immersion evidence
• Mixed results across different sports
• Common finding: improved perception of
recovery...
Cold and contrast protocols
• Cold: 1 minute cold immersion, 2 minutes
standing. Repeat x 4-5
• Contrast: 2 minutes hot, 1...
Compression
• Very mixed findings on effect of compression
garments.
– Variety of brands tested.
– Different protocols
• B...
Compression: suggested mechanisms
• Increase venous circulation
• Reduce swelling in lower limbs (travel,
standing occupat...
http://mimiandeunice.com/
Recuperative
• Yoga
– Shifts ANS to parasympathetic
– Improves quality of next sleep
• Meditation
– Reduces stress hormone...
Sleep
• 1950’s: 8 hours
• 2000’s: 6.5 hours (30% = 5 hours)
• Teens 9 hours
• 3-5 x 90 minute cycles of REM and non-REM
sl...
Sleep tips
• Turn clocks away from sleeping position
• Turn off mobile phone
• Don’t work in bed: sleep or sex only
• Redu...
Shift workers
• Nap at work
• Avoid morning light
– Drive straight home to bed
– Wear sunglasses
• Make arrangements to sl...
RECOVERY SUMMARY
• Nutrition
• Ice bath/contrast
• Compression after session
• Massage when you feel necessary
• Stretchin...
Core Stability
• “Optimal alignment and control of the spine
and pelvic regions to ensure efficient transfer
of momentum a...
Sprechen sie?
• Control unnecessary movement
• Improved efficiency/economy of movement
• Reduce risk of injury
• Control o...
Core Stability & Injury
• Pain: inhibits neural input to muscle
– Moderate pain: slow twitch units
– Severe: slow and fast...
Core and Running
• Gluteals (particularly lateral muscles)
• Maintain horizontal pelvis, minimise rotation
of lower limb
•...
FLOOR PROGRAM
• No equipment
• Relatively quick
• Should be challenging
• If too easy, progress using resistance bands,
sw...
Stretching
• No studies looking at passive stretching and
recovery
• Debate regarding injury prevention
• Anecdotal eviden...
WHEN NOT TO STRETCH
• Back Pain or Sciatic symptoms
• Persistent muscle tightness not relieved by
significant stretching: ...
Let’s Stretch
Pecs
ITB
Hamstring
Gluteals
Hip Flexors
Calf
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
Elite Energy Women's Triathlon Camp 2013
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Elite Energy Women's Triathlon Camp 2013

  1. 1. INJURY PREVENTION AND RECOVERY FOR TRIATHLETES
  2. 2. Matt
  3. 3. How are women different? • Skeletally: – You are shorter and smaller – You have a wider pelvis – You have shorter limbs relative to torso • Body Composition – You have higher percentage of body fat (26% vs 14%) – This is distributed in hips and thighs – You have less muscle mass
  4. 4. How are women different? • V02max (ml/min)= 40% lower • Correct for mass (ml/kg/min)= 20% lower • Correct for fat free mass= 10% or less • Endurance performance is 5-15% less than males: 75% due to extra body fat, 25% to cardiac and haemoglobin differences
  5. 5. How are women different? • You are generally 2/3 as strong as men • You are weaker in the upper body, strongest in the legs • Corrected for body weight: no difference • You make the same relative strength gains as men, but without the same increase in muscle size
  6. 6. My ♀ Observations • Very determined • Stubborn • Attention to detail • Emotionally involved • Can be equally as stupid as males • Mentally tough • Seek treatment/advice
  7. 7. FEMALE ATHLETE TRIAD Eumenorrhea Normal Bone Adequate energy availability Amenorrhea Osteoporosis Energy deficit +/- eating disorder
  8. 8. ENERGY AVAILABILITY • Energy availability = Food in – fuel burnt in training • Energy left over used for normal bodily functions • Too low: body reduces amount of energy used for cellular maintenance, thermoregulation, growth and reproduction. Body goes into survival mode, health is impaired
  9. 9. SECONDARY AMENORRHEA • Normal: 28 days • Irregular: 35 days-90 days • Amenorrhea (Absence): >90 days • In athletic women, menstrual disorders result from pituitary gland not producing sufficient LH at the right frequency. • Can happen with negative energy balance from increased exercise alone, restored with increased dietary intake • Functional hypothalamic amenorrhea
  10. 10. SECONDARY AMENORRHEA • General population: 1.8-5% • 17% Team sports • 52% Ballet • 67% Runners • 100% Gymnastics • 2-4 x risk of stress fracture!
  11. 11. LOW ENERGY AVAILABILITY • EXCESSIVE EXERCISE • REDUCTION OF ENERGY INTAKE • COMBINATION OF BOTH • EATING DISORDERS: – ‘Clinical mental disorder characterized by abnormal eating behaviours, an irrational fear of gaining weight and false beliefs about eating, weight and shape”
  12. 12. NUTRITION “Maybe I was too strict on diet and too strict on training. I think I got a bit obsessed. If you think that eating a piece of cake is going to stop you from winning an Olympic medal, you don’t have a life and you can forget about a medal. I haven’t eaten biscuits or junk food since I can remember and here I am, flat as a tack. So pass the Tim Tams” Emma Carney
  13. 13. Over-training • Reduced performance short and long-term • Days to months to recover • Physiological • Biochemical (sympathetic nervous system) • Psychological • Immune System • Musculo-skeletal
  14. 14. Overtraining symptoms may include • Depressed mood • General apathy • Decreased self esteem • Emotional instability • Restlessness • Irritability • Disturbed sleep • Weight loss • Fatigue • Impaired performance • Loss of appetite • Increased resting heart rate • Increased vulnerability to injury • Hormonal changes • Lack of supercompensation • Susceptibility to infection and depressed immune response
  15. 15. Monitoring • Stress Questionairres • iThlete • Sports tracks, cycling peaks etc
  16. 16. Coping mechanisms Stress Sport Social Work Friends Study Health Family Travel Money Growth Positive effects Negative effects Stress Finite capacity
  17. 17. Recovery
  18. 18. AIS: $17 million recovery and swim centre QAS: $10 million recovery centre in 2008 US Olympic Training Centre, Colorado Springs
  19. 19. RECOVERY METHODS • Physical – Stretching – Active recovery • Passive – Massage – Compression wear • Hydrotherapy – Cold immersion – Contrast immersion • Recuperative – Adequate sleep – Daytime naps – Meditation, – Self-hypnosis, – Yoga – Relaxation • Dietary
  20. 20. Nutrition • Re-hydrate • High GI snack 30 minutes post session: – Gel – Sports drink – White bread sandwich • Carbohydrate and protein “meal” within 2 hours post session – Liquid meal drink – Protein bar – Meat and veg.
  21. 21. Active recovery • Low intensity aerobic exercise • Exercise bike on sideline, pool session next day for team sports • Helps lactate clearance (likely to clear anyway by next session) • Expends energy • Impractical/unattractive for most endurance athletes • Incorporate warm-down, walk at end of session, swim?
  22. 22. Stretching
  23. 23. Massage • Reduces muscle force production • Increased confusion, decreased vigor on Psych questionnaires • Relaxes you • Reduced muscle soreness • Decreased DOMS symptoms • Improved immune response • Early detection of problem areas
  24. 24. $45 High density 90cm x 15cm Foam Roller
  25. 25. Contrast/cold immersion evidence • Mixed results across different sports • Common finding: improved perception of recovery in legs
  26. 26. Cold and contrast protocols • Cold: 1 minute cold immersion, 2 minutes standing. Repeat x 4-5 • Contrast: 2 minutes hot, 1 minute cold x 4-5. Finish on cold • Don’t use: – cold or virus, – bruised, – heart disease, – recent injury
  27. 27. Compression • Very mixed findings on effect of compression garments. – Variety of brands tested. – Different protocols • Better muscle pain scores • Variable improvement in physical performance
  28. 28. Compression: suggested mechanisms • Increase venous circulation • Reduce swelling in lower limbs (travel, standing occupations) • Remove muscle damage by-products • Reduce blood lactate accumulation • Reduce muscle oscillation/vibration • Suggested protocol: air travel, post exercise
  29. 29. http://mimiandeunice.com/
  30. 30. Recuperative • Yoga – Shifts ANS to parasympathetic – Improves quality of next sleep • Meditation – Reduces stress hormone levels – Decreased blood pressure, stress levels – Structural changes in brain stress centre
  31. 31. Sleep • 1950’s: 8 hours • 2000’s: 6.5 hours (30% = 5 hours) • Teens 9 hours • 3-5 x 90 minute cycles of REM and non-REM sleep • Stage 3 sleep: release of growth hormones from pituitary gland, immune system response. Time for fighting disease and tissue repair.
  32. 32. Sleep tips • Turn clocks away from sleeping position • Turn off mobile phone • Don’t work in bed: sleep or sex only • Reduce caffeine late in day • Develop consistent schedule, slow down 30 mins before bed, darken lights • Cool room • Naps : 20 minutes at 2pm • Milk and sit in dark if can’t sleep • Wake and go out into light
  33. 33. Shift workers • Nap at work • Avoid morning light – Drive straight home to bed – Wear sunglasses • Make arrangements to sleep – Family – Room – appointments • Schedule a recovery day
  34. 34. RECOVERY SUMMARY • Nutrition • Ice bath/contrast • Compression after session • Massage when you feel necessary • Stretching when you feel tight • Stimulate parasympathetic nervous system with relaxation strategies • Be aware of signs of poor recovery and make changes early
  35. 35. Core Stability • “Optimal alignment and control of the spine and pelvic regions to ensure efficient transfer of momentum and summation of forces across this segment, resulting in greater precision and safety of dynamic activity”
  36. 36. Sprechen sie? • Control unnecessary movement • Improved efficiency/economy of movement • Reduce risk of injury • Control of spinal posture, movement between trunk and limbs
  37. 37. Core Stability & Injury • Pain: inhibits neural input to muscle – Moderate pain: slow twitch units – Severe: slow and fast • IE: stabiliser muscles more susceptible to wasting and weakness from pain
  38. 38. Core and Running • Gluteals (particularly lateral muscles) • Maintain horizontal pelvis, minimise rotation of lower limb • Abdominals: to avoid excess lumbar movement • Endurance needed for long run and races
  39. 39. FLOOR PROGRAM • No equipment • Relatively quick • Should be challenging • If too easy, progress using resistance bands, swiss balls etc
  40. 40. Stretching • No studies looking at passive stretching and recovery • Debate regarding injury prevention • Anecdotal evidence: reduces sensation of muscle tightness and soreness • Sustained stretches 30secs+
  41. 41. WHEN NOT TO STRETCH • Back Pain or Sciatic symptoms • Persistent muscle tightness not relieved by significant stretching: joint problem? • Avoid static stretching immediately before sport
  42. 42. Let’s Stretch
  43. 43. Pecs
  44. 44. ITB
  45. 45. Hamstring
  46. 46. Gluteals
  47. 47. Hip Flexors
  48. 48. Calf
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