Elite Energy Women's Triathlon Camp 2013
77
INJURY PREVENTION AND RECOVERY FOR TRIATHLETES
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Transcript of Elite Energy Women's Triathlon Camp 2013
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 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
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
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
My ♀ Observations
• Very determined
• Stubborn
• Attention to detail
• Emotionally involved
• Can be equally as stupid as males
• Mentally tough
• Seek treatment/advice
FEMALE ATHLETE TRIAD
Eumenorrhea Normal
Bone
Adequate
energy
availability
Amenorrhea Osteoporosis
Energy
deficit +/- eating
disorder
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
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
SECONDARY AMENORRHEA
• General population: 1.8-5%
• 17% Team sports
• 52% Ballet
• 67% Runners
• 100% Gymnastics
• 2-4 x risk of stress fracture!
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”
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
Over-training
• Reduced performance short and long-term
• Days to months to recover
• Physiological
• Biochemical (sympathetic nervous system)
• Psychological
• Immune System
• Musculo-skeletal
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
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
effects
Stress
Finite
capacity
Recovery
AIS: $17 million recovery and swim centre
QAS: $10 million recovery centre in 2008
US Olympic Training Centre, Colorado
Springs
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
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.
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?
Stretching
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
$45
High density
90cm x 15cm
Foam Roller
Contrast/cold immersion evidence
• Mixed results across different sports
• Common finding: improved perception of
recovery in legs
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
Compression
• Very mixed findings on effect of compression garments. – Variety of brands tested.
– Different protocols
• Better muscle pain scores
• Variable improvement in physical performance
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
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
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.
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
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
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
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”
Sprechen sie?
• Control unnecessary movement
• Improved efficiency/economy of movement
• Reduce risk of injury
• Control of spinal posture, movement between
trunk and limbs
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
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
FLOOR PROGRAM
• No equipment
• Relatively quick
• Should be challenging
• If too easy, progress using resistance bands,
swiss balls etc
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+
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
Let’s Stretch
Pecs
ITB
Hamstring
Gluteals
Hip Flexors
Calf
