Getting back to training after an injury
By Anne Linton MD
When your hopes of strong results are challenged by an injury from a crash, a mis-use or unresolved muscle imbalances, you may fear losing the fitness you’ve gained through your training, or worry about performance at your “A” priority races or delaying the start of your cyclocross season. What is the best way to get back to training at your full capacity after minor injury?
First, this is probably one of the most important times for you to be in close contact with your coach. Your coach needs to know how you are feeling, mentally and physically, and what your doctor says about training.
How do I know when I can get back to normal training?
1. You have been cleared by your health care practitioner.
2. You have full range of motion of the injured body part with little or no discomfort.
3. The injured body part is back to 90% strength compared to the opposite side.
4. You have minimal pain or swelling on the affected area during or after training.
5. You are mentally confident to return to training and racing.
When should I seek medical help before returning to training?
- Any suspicion of a head injury must be addressed by a health care practitioner.
- Obvious deformities in a joint/bone or muscle need to be addresses by a health care practitioner.
- Nagging pain that lasts longer than two weeks with rest should be evaluated by your health care practitioner. There may be underlying physiological or biomechanical issues.
- If your energy seems below normal, you may want to have you blood work evaluated to see if you are anemic, or have low Vitamin D levels. If you might have a viral illness, allergies or other conditions which could contribute to you feeling poorly and they are not clearing up after a week, talk to your health care practitioner.
What is the typical healing timeline for a minor (non-fracture or ligament/tendon tear) injury?
- Swelling and pain decrease or disappear in 24-72 hours
- Bruising can last up to 10-14 days
- Range of motion of a joint usually improves over 7-14 days
How long does it take to lose fitness?
For the average athlete, I find the hardest part of coaching is not getting them to train but rather getting them not to train when it is making things worse. We all worry about losing fitness and form, and so try to push through minor irritations thinking they will go away. Pushing through increases the chance of nasty set backs and losing even more time.
But what are the facts about losing fitness? It takes a good 10 days to two weeks to become measurably deconditioned. This time varies depending on your fitness prior to the injury.
The fitter you are before you get injured or sick and have to take time off, the longer you can be off and not loose your fitness. Studies have looked at both beginning and more experienced exercisers. What they found was that those who were fit and training regularly for a year and then stopped exercising completely lost about half of their aerobic conditioning in three months.
Beginning exercisers who had just started a training program for two months and begun making noticeable improvements in their aerobic conditioning who stopped exercising completely for two months completely lost the aerobic conditioning they had gained.
What will help me return to full training faster?
1. Understand that training too much too soon can inhibit full recovery from the injury.
2. Utilize the principles of functional retraining – you should be able to perform the specific motions and actions required for your sport effectively before returning to full activity.
3. The injured body part should be 90-95% as strong as the opposite side before returning to hard training and/or racing. This is where you need to do all the recommended exercises your physical therapist has given you and as often as they recommend. Otherwise, you risk having an imbalance that can lead to further problems.
4. Progressively return to training starting at 50% effort and activity and increasing both effort and activity by 10-15 % per week, as tolerated. Ask your coach what that really means for you.
So what do the coaches at Wenzel Coaching recommend for returning to training?
|1 easy day recovery zone for not more than half the time of your longest workout
If you feel weak on
the first easy day, take another easy day.
|4 symptom-free days of endurance level training before returning to hard training, 6 symptom-free days before racing.
|6 days to return to full training:Day 1-2 Aerobic training-do 1/4 the length of your longest recent session and do it at a recovery pace.
Strength- do 1/2 your normal sets and 1/2 your normal weights.
Day 3-4 Aerobic training-do 1/2 your long session at an endurance pace
Strength- do normal weights but half number of sets
Days 5 and 6, Aerobic training- do 3/4 your normal long session at an endurance pace
Strength- do normal lifting routine
|No racing or hard riding for at least 6 daysDiscuss with your coach
|First 2 days 1/4-1/3 normal long ride time at a very easy pace, then 2 days roughly 1/2 of normal long ride time, endurance pace, then 2 days of roughly 3/4 normal ride time endurance pace, then return to existing plan, perhaps with small modifications.
|No racing for 2-4 weeks depending on importance of race. Discuss with your coach.
|Depending on length of time may need short block of base, then increased intensity as tolerated. May want to redo testing to see if threshold has changed.
|Anywhere from 4 weeks up to return to racing but discuss with your coach.
|Most likely will need to do at least 3-4 weeks of easy endurance base building with increasing intensity just as you would after a month rest period. Redo threshold testing.
|Do base and transition to hard training/racing as you would after a one month rest period.
Don’t try to make up the missing days. If you missed something important like a strength or power test, talk to your coach about how to reschedule.
If you feel any recurrence of symptoms in your training, go back to a recovery pace and call your coach. The goal is to progress in your training with increasing intensity as you tolerate but any increased symptoms you should go back to your previous intensity level (i.e. if pain during endurance riding go to recovery, if pain during moderate intervals go back to endurance etc). Note that nearly all of this advice applies to minor illnesses as well. As you work through this process be sure to be in close contact with your coach as they can help you navigate this and get safely back to your level of training and racing.
While you are in this process remember you can cross train or do some yoga to maintain your fitness (if it doesn’t aggravate things). Use any extra time you may have to catch up on other things in your life, spending time with family, friends or working on that house project you have been putting off.
References: American College of Sports Medicine Position Paper “Return to Play” 2005