"Repetitive Strain" Injuries in Contact Sports

A little while back I posted a little shortie entitled "Injured? Take a Break!" The message behind this post was simply for endurance athletes to step out of their "comfort zone" and make wise...ahem, *common sense...choices when suffering from an injury.

Please consider this current post its sequel.

Often we, as clinicians, frown upon the volume of training some coaches espouse upon their athletes, criticizing the high mileage their athletes spend on the road and in the pool.

Our argument? "They are fatigued, they need to rest and recover." The coaches' argument? "I've sent many athletes to world championships and this is how we've always done it."

Both may perhaps be valid points. Perhaps. So where is the disconnect?

Is high volume training really that bad?

Without question, high volume training may increase the severity of musculoskeletal injuries sustained (Brooks et al, 2008), especially in contact sports where the variables that influence the risk factors of injury are greater than that of non-contact sports. And absolutely, ultra and extreme endurance training regimens may result in acquired training intolerances of which high volume training may lead to unwanted skeletal muscle pathologies in those with such intolerances (Grobler et al., 2004). But in an appropriately individualized and periodized program for a given athlete, I really cannot place 100% blame on high volume training as the cause of injury for non-contact sports.

So let's shift our focus just a little bit here. Where could we place some of the blame?

I recently listened to a podcast interview between Mike Robertson and Tim Vagen where they discussed this very topic. You are more than welcome to listen to this podcast here. I think Tim and I share similar sentiments in that perhaps some of this blame should be placed on the complementary training, or more specifically the lack thereof, that such athletes perform. Specifically when it pertains to addressing muscle imbalances.

You see, in 2010 we are working with athletes who live in a different generation. A generation that includes facebook, drive-thrus and escalators. And a generation where perhaps not everyone in western society are fit to wear vibrams, let alone run a marathon in them.
But let's get back to muscle imbalances. Very often I use the analogy of a car with a slight alignment issue (I'm sure many of you do as well). Driving from home to work on any given day will not likely result in a malfunction or breakdown. But driving across the country?

I hope you get my point.

The problem I see quite often is in the lack of complementary training non-contact athletes perform. Swimmers and runners alike, these athletes (and often their coaches) seem to be pre-occupied with getting their mileage in.

"My knee hurts but I need to run 12 miles tomorrow", or

"My elbow hurts halfway through training and I know I need to come see you but coach won't let me miss practice"

Do you see what I'm getting at?

I am all for adhering to one's training regimen and by no means do I have the right to question the amount of volume a specific coach programs into their...well...program. In fact, this IS their program and who am I to question it. But, the point I am trying to convey is that we must complement this training with the addition of exercise means that address those imbalances that may present themselves as a result of the lifestyle that we live. Especially in novice, intermediate, recreational, and student athletes. We simply cannot apply programs meant for professionals in such populations. This just opens up the possibility for "repetitive strain" injuries.

So if you consider yourself a non-contact athlete, be it a runner, a swimmer or the like, and are either self coached or coached by a professional, then I encourage you to take the time to start employing complementary strategies to your program. Even if it does mean cutting your training short.