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An Idiot’s Guide to Finishing an Ironman (and Staying Married)

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As I write this I am now 4 weeks out from Ironman New Zealand. Which means that most of the big sessions are now in the bank, the mental preparation has been done, and the main part of what’s left is just getting excited to actually race soon! It will be almost 3 years since I last lined up for an Ironman, with a lot of water under the bridge in that time. This time around my goals are completely different: to finish an Ironman one year after my son was born. The training has reflected that with less focus on performance, more focus on efficiency and creativity – trying to get the quality sessions done around being a new mum and running a business (not easy but do-able). I’m aiming to get to the finish happy, healthy and with the ultimate prize at the finish line – seeing my baby boy Jude with my husband Patrick waiting for me.

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I must say it’s been a super fun lead up and I’ve been really lucky to have an awesome crew to train with. I’ve accidentally convinced one of the guys I ride with to sign up for his first Ironman (go Pete!), which has gotten me thinking about back when Pat and I did our first Ironmans. I also get asked a lot of questions from my patients about how I manage the training around family and work, how I stay motivated, and what Ironman training involves. I love to talk, so I’m more than happy to share some pearls of wisdom that I have learnt along my Ironman journey so far – which has included both tremendous highs and momentous f#ck-ups. I’ll never “know it all” and that’s what I love about the sport – it’s ever changing and always challenging!

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Ironman is Not Normal, and You are Not Superhuman…

…But in order to finish one, you need to get yourself to a point mentally and physically where the Iron distance seems “normal”, and your body is “scary fit” – that is, on any given day, you could bust out a 4km swim, 180km bike, and a marathon if you had to. So while on a more objective level Ironman isn’t “normal”, you should surround yourself with people who encourage you, have faith in you, and even better – have done it themselves. Avoid people who tell you how “crazy” or “impossible” it is, especially in the month before the race….and in the same spirit, maybe don’t tell every person you run into on the street that you are in Ironman training (unless you do want that negative reinforcement time and time over…plus let’s be honest, not everyone wants to hear about it).

I’ll never forget last time we did NZ Ironman, we were on the flight over and I found a documentary on this marathon runner on the in-flight entertainment list. I start watching it, and the theme of the whole thing was along the lines of being super dramatic about “how epic the marathon distance is, and how the training is the hardest thing you could ever face” and so on. Needless to say I had a chuckle and then turned it off – we were flying towards a race in which we were going to do a marathon AFTER swimming 4 km and riding for 180 km, on hills no less. We had spent the last several months mentally getting to a point where that was not only OK but appealing, so I didn’t need to hear about how hard the marathon is in great detail…

Final note on the Scary Fit phenomenon: it does not mean you are Superhuman. If you do stupid things, you will still break (see my previous post on Busso Ironman 2012 – “The Upside of Injury”). Super Fit is good; Super Stupid is not. Respect your body, be nice to it, and build into things gradually and with consistency.

Make a Priority List….And Stick to It

Mine goes like this:
1) My husband and baby boy
2) Running our Physio Clinic
3) & 4) Ironman training and Social Life.

The last two are tied because I sway between the two. The priority list becomes super important when you get to those tough decisions during the training block: you have a long run scheduled but you also have an invite for breakfast with girlfriends; or it’s your husband’s birthday on a Sunday when you have a 5 hour ride planned and a 3km swim with several hours of exhausted-getting-your-sh#t-together time in between the two. The priority list is important to help you decide when you should change the plan, so that you can get to race day and not only be fit but also still have a marriage, a child who knows your name, a business that’s still functioning and friends to tell you how awesome you are for finishing an Ironman. You may think I’m joking here but you would not believe how many Ironman athletes I know who can pull out amazing race times but are unhappy in every other aspect of their lives. A bit of perspective and some smart decisions go a very long way. Most Ironman athletes by their very nature (myself included) are very “Type A” control freaks; learning to be a bit more flexible with fitting training around your life and relationships (not the other way around) is key to getting it done and still being happily married at the finish line.

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Involve Your Family and Friends – it’s supposed to be FUN

Following on from the above point – I try to combine points 1, 3 and 4 by training with my husband and friends where possible, and if we get really creative, our baby boy Jude as well (usually for part of a long run in the Mountain Buggy). I have a Cycling Wife (thanks Carly) plus a bunch of guys who are always keen to come for part or all of my long rides (I’m talking 4-5 hours on the road). I do think that for newbie Ironman athletes, it’s important to do some of the big sessions on your own to ‘get into your own head’ – more as a confidence thing to prepare to do it on race day – but I don’t think it’s healthy to be doing all of your sessions on your own.

There’s a tradition in Ironman to go back to the finish line after you’ve done your race to cheer on the rest of the athletes and bring them home. You have up to 16 or 17 hours (depending on the race) to get the distance done. I always say that everyone should experience an Ironman finish line at least once in their life – even if it’s just watching the athletes finish. Watching the emotions of the age group athletes as they come down that finish chute after what’s likely been the hardest physical and mental thing they’ve ever done, hugging their husband or wife and crying with tears of happiness, pride, relief, joy…. In a world where we are bombarded with negative news stories and surrounded by obesity and chronic diseases, it’s heartwarming to be reminded of what the human body and mind is capable of doing when it is treated well. It’s a sight you will never forget, and it’s one of the many reasons why we will continue to travel away to triathlons as Jude grows up – so that he too can be surrounded by such an uplifting and inspiring group of people doing extraordinary things as a reminder of how positive life can be. Personally, I found watching my husband finish his first Ironman far more emotional than finishing my own first Ironman (and it still makes me teary thinking about it). There’s something special about being on that journey together. Race day is the celebration, but there’s a lot of hours of training that happen in the lead up, and involving your loved ones makes it so much more special.

Reality Check: Lower Your Standards

You can pick up any fitness magazine these days and they’ll have you believe that not only is Ironman achievable, it’s even easy – it must be, since every Tom, Dick and Harry is doing one now (Men’s Health Magazine and Triathlete I am talking to you). Not only that, but the Holy Grail of landing a Kona spot (ie qualifying for the world championships) should be on your “goals” list now too, apparently.

What these magazines fail to address is the reality of the Age Group Ironman World: lots of unhappy marriages; lots of athletes running away from something in their lives or having a mid life crises and training 30 hours a week, or worse – the newbies that sign up and never make it to the start line because the training alone leaves them broken and disillusioned.

Be clear on your goals, and see the situation for what it is: if you are considering doing your first Ironman, just aim to get to the finish line HAPPY and HEALTHY. Full stop. The athletes that qualify for Kona are insanely talented and spend upwards of 20 hours a week year in, year out training for that right. They will be at the finish line not long after the Professional Ironman Athletes are. Forget about everyone else racing; just set your own goals, focus on enjoying the journey, and allow yourself to be proud of your efforts. Less than 1% of the world’s population will ever finish an Ironman; you should be proud of that, no matter what the finish time is.

The Serious Stuff: Get a Good Coach (+ Dietician + Physio)

OK I’m a Physio so I can’t help myself: I am always mystified by people who are willing to drop 6k on a bike, 1k on race entry, god knows how much on travel, accommodation etc….and won’t invest any money at all in a coach, let alone a good one (yes, just like anything you get what you pay for with coaching). Trust me on this one: you will get way more confidence, speed, fitness and less injuries if you have a decent coach as compared to a decent bike. A new time trial bike might make you look super fast but the joke’s on you when the old ladies on their road bikes start passing you in the second half of the bike leg (I’m not joking…). I’ve had the same coach for the last 5 years: he knows my body; knows how to handle me; when to push and when to back off. Doing an Ironman without him guiding the process would feel like trying to swim without my right arm. Triathlon is an expensive sport but you can spend money wisely to get the most out of your journey.

On a similar note, it’s worth spending the money on seeing a good sports dietician and a physio before you start your big training block. This is particularly important if you have any injury history, or if you are looking to alter your body composition and get advice on race day nutrition and how to train that aspect of the race. If you go out there and start downing Gu’s for the first time on race day you will spend more time in the port-a-loos than on the bitumen; there’s a reason they call nutrition the “fourth discipline” of triathlon. Your body can store about 90 minutes worth of glycogen for exercise, so the nutrition plan becomes super important if you want to race for upwards of 12 hours and finish in one piece. A Physio can help with bike set up, core work and screening for injury risk so that you can strengthen up before an injury derails you.

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If you have goals of doing a triathlon or even an Ironman one day but don’t know where to start, don’t hesitate to reach out to one of us and have a chat – or even better, come along for one of our group runs or rides. We can help guide you with your training (see our Bio on Ironman coach (and my coach) Scott DeFilippis on our home page) as well as your injury prevention plan, bike set up, dietician referral, sports nutrition products and much more (we stock Gu nutrition products at First In Physio).

Thanks for reading and as always, Happy Training! You can follow the final weeks of my journey to NZ Ironman on Instagram @KRISTY_SHANNON – I’d love to heave you along for the ride. Thanks to everyone who has reached out already, it really means a lot to have your support along the way. Race day is the 5th March, 2016.

Kristy Shannon
Director and Principal Physiotherapist
First In Physio

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The Upside of Injury

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Status Update: “Broken”.

Most athletes and a fair share of non-athletes have been there. The nature of our profession is that for the most part, we see people when they are down and out; our job is to diagnose the damage and to build them back not just to par, but to stronger than they were before the injury. My usual position as a Physiotherapist is to guide my patients from the tough day of diagnosis, through the often lengthy rehab process and safely back into their return to sport. We often get quite close to our patients and as athletes ourselves, ride the journey with them. In 2013 I was unlucky enough to flip the coin and be the one sitting in the sports physician’s office trying to swallow the gravity of my own injury situation: a stress fracture gone wrong following my latest Ironman triathlon. I think in this situation it’s arguably easier knowing less rather than more – I knew before the lovely Dr Chris Ball told me that I was looking down the barrel of major foot surgery, and a very long time away from my beloved sport.

 

 

 

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What it looks like to finish an Ironman on a broken foot…it ain’t pretty!

 

Injury of any kind sucks, and I always advocate well-managed injury prevention program as “Plan A” but in reality, injuries happen – most athletes don’t have the most solid grasp on their self-preservation dial (and hey, I was beating my husband by 2 hours in that Ironman – there was no way I was pulling the pin so close to the end!). Jokes aside, there can be a silver lining. The team you have around you and your attitude are key to getting through the rough patch and flying out the other side as a more resilient and stronger athlete.  As tough as injuries can be, I have learnt over the years from the process with countless patients as well as from my own experience post- foot surgery that there can indeed be a few upsides to injury:

 

  • Learning opportunities:
    • First and foremost, immediate questions need to be asked: What is the best course of treatment for short and long term outcomes? What are my options? (often there are a few good ones, especially where surgery vs conservative treatments are involved). How long will I have off my sport? Will this affect work/school etc?
    • Once a course of treatment has been set that you as well as your health care team are happy with, the less urgent but just as important questions need to be asked: What went wrong? What will I do differently next time? Where is the weak link in the chain? How do we (as in, you and your Physio +/- surgeon and sports physician) build the body back to a point where it’s stronger than before? How can I prevent this from happening again? Do we need to change things upon return to sport (training load, technique, footwear etc)? Knowledge is power, and I cannot reiterate enough that you need to ask and ask until you get the answers that you need; your sanity during your rehab and your ability to avoid injury in the future depends on it. If you aren’t happy with your physio/doctor/surgeon, then find another one – you need to find the best quality care at all costs to get the best results.

 

  • Respect for your body’s boundaries:
    • So you found that mystical line in the sand, the actual safe limit of what your body can achieve; many never find it so you can take one thing away from the situation and that is that as an athlete, you are tough! But going forwards, if your injury was “overuse” in nature (ie stress fractures, tendinopathies etc) then you need to respect that boundary. Learn from it and take note of your body’s cues in future training and racing scenarios.
    • If your injury was more traumatic in nature (eg broken tibia from a soccer clash or dislocated shoulder from a cycling accident), then there’s not a lot more you can do other than accept that playing sports involves risks. Given a choice, you’d still take those risks to sitting on the couch getting fat and unhealthy, right?!

 

 

  • An Attitude of Gratitude:
    • There’s nothing better than that moment your surgeon (or doctor or physio) gives you the go-ahead to do some exercise. Even if it’s technically “rehab” – “I’ll take it!” you yell as you hug them (Ok exaggeration. Only slightly though.) Prior to a major injury you may be guilty of complaining when the alarm clock goes off at stupid o’clock, if it’s cold/hot/raining; if the session is too hard…or not hard enough….If your race didn’t go perfectly, and so on. Afterwards I can honestly say that every single step I take is done with an “attitude of gratitude” – my coach and husband will vouch for the fact that every run is a bonus, every race is a bonus, and I am thankful to be able to have a fit, strong and healthy body again. Hell, I’m even grateful to be able to do the housework these days – taking an independent person and attaching them to crutches for 3 months is enough to send anyone crazy! I have been guilty of treating my body somewhat like a rental car in the past, but I now appreciate it and treat it much more lovingly (Karma, my friends, Karma…).

 

 

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  • Mental Toughness:
    • And by this I don’t mean your ability to push through and “eat the pain” as my husband would say – if you got injured in the first place by pushing too far you definitely don’t need to learn this. But in my experience it’s often the athletes who are able to blindly push through that are also in need of some mental “balance”. I am by no means exempt from this generalisation. I took the time after my surgery to finally learn how to slow down and meditate (I highly recommend it, you’ll never look back), as well as to focus on other things in my life other than training 20 hours a week and working full time. It was not the most fun I’ve ever had – by choice I would much rather be working and training! – but it has taught me a sense of balance which I had never had in my life before, and I think that this has benefitted both aspects of my life well after the initial injury period. For most athletes I would therefore consider the slowing down process as “building mental toughness”, even if it’s not the traditional sense of the phrase.

 

 

  • Absorption of training:
    • A wise triathlete (Emma Snowsill) once said that if you don’t allow your body to rest, it will force you to via sickness or injury. I would put pregnancy in the same category here simply because the reduced training load while you’re growing a human has the same affect – time to let the body take stock. To absorb all the months/years of training it has done, and to build back a little stronger. As physios we educate patients on how a bone will actually be stronger where it broke after the healing has occurred, because extra bone is laid down in the healing process; this is a nice metaphor for the entire healing process of the body. Reassure yourself that you WILL come back from the injury, and that all the training you’ve done in the past will not be gone.

 

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Sesamoid bone graft and 1st Metatarsal dorsiflexion osteotomy on my Right foot, done in 2013 by Dr Ben Forster

 

 

So there you have it, my version of what I’ve learnt through injury in a nutshell. I’ve kept many details of the injury and whole rehab process pretty close to my chest up to this point; as a physio it is not the easiest boat to be in. Physiotherapy may be my “day job” and I certainly love it, but I am first and foremost an “athlete” and in the past have certainly had trouble switching that part of my personality off, even if the Physio part of my brain is telling me something is a bad idea. As I get older and more experienced with both Physiotherapy and Ironman racing, I am learning how to strike the balance but it is always a work in progress. I am very fortunate to have two very patient and understanding men in my life in my husband Patrick Shannon and my coach Scott DeFilippis. Without them I would not be on track to be lining up again for Ironman NZ in 4 months’ time – 1 year post-baby and just over 2 years post foot surgery.

 

Hopefully this post will hit home with a few “broken” athletes out there and help to get you through and back to your passion. If you would like to follow my journey back to the Ironman start line you can find me on Instagram (@KRISTY_SHANNON), I’d love to have you along for the ride!

 

Kristy Shannon

B.Appl.Sc(HMS); B.PHTY(Hons)

Director and Principal Physiotherapist First In Physio  

 

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Fun Run Season is Here – How to Stay Injury-Free!

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While other states are shivering into their hot chocolates, we are lucky enough in the far North of Queensland to be experiencing perfect running weather – beautiful crisp and sunny days with minimal humidity in the air. There is no better time of the year to be upping your running training and looking ahead to one of the many fun runs on offer around the area in the coming months.

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Not coincidentally, it is about this time of year that we start to see an influx of running injuries come through our clinic doors. As runners ourselves, we can understand the frustration and stress involved with having to sit out of training or worse, missing your planned race. There are many simple things that runners can do to minimise their injury risk and keep their bodies healthy and minds happy. We’re pretty sure you know all of these , but like most runners, need a simple reminder that you are not “special” – your body is not superman and it does, in fact, need just as much time to adapt to training stimulus as everyone else’s does!

 

  • Training Load

A large proportion of running overuse injuries are caused by simply doing too much, too soon. The classic situation is the runner who has had a few months off, maybe gained a few kilos and not been diligent enough with their strength work, and then decides to do an 8-week training program for an upcoming half marathon or 10km fun run. The first few weeks go by OK with sore muscles and slow shuffling, and then week 3-4 hits and you have shin or foot pain that won’t go away in a hurry…..Sound familiar? While the enthusiasm is great, it is important to “train for the training”. Consider your base level of fitness before jumping feet-first into any training program; if the first week of the training program looks “scary” to you, then you are not ready yet. Running is a wonderful sport for the body but it comes with a high injury risk if you are doing it sporadically. Once you are gradually building up the weekly mileage, give yourself a recovery week once a month, typically reducing the training load to about 60% of your previous week, further giving your body a chance to absorb the training. The healthiest and usually the fastest runners are those who are consistent with their training, year-round, allowing for natural and gradual increases and decreases in their load around race season and off-season.

 

  • Specific Strength Work

Every time you take a step when running, you are literally doing a single-leg squat with up to 4-6 times your body weight going through the chain from your foot up through your knee, hip, pelvis and spine. Think about that. The amount of recreational runners we see come into our clinic who cannot do one quality single-leg squat with one x their body weight – let alone quadruple that amount – is truly scary! Your muscles are very well equipped to take up the excess loads of running so that your joints and bones don’t have to get overloaded; in fact, well-trained muscles will act like springs and propel you forwards with ease and speed. We recommend that all runners do a minimum of 2-3 strength sessions a week, but it must be run-specific ie lots of core, glutes, single leg squat work and lower limb strengthening as well as the all-important balance and flexibility work. A quality session might take you 20-30 minutes, but it will be the best injury prevention investment you can make. An Exercise Physiologist or Physio with an interest in running can help you to design a program that addresses your weaknesses, and most can be done in your own lounge room without fancy equipment.

 

  • Running Technique

If your core and general strength is good, your balance and flexibility and adequate, and you are not excessively overweight, you will have a much easier time achieving optimal running technique. What is “ideal” technique is an often-debated topic amongst the literature, and when it comes down to it, everyone is different and will have a slightly unique “perfect form” that suits their body. Having said that, there are certain key factors that need to be considered to ensure that you are running safely, for both injury management and to increase your speed and efficiency. These include things like high knee lift to utilise the powerful glutes; mid or forefoot strike to optimise the calf muscles as a spring; a leg turnover of about 180 strides per minute (count how many times per minute your right foot hits the ground, then double it); a nice upright torso with a very slight forward torso lean etc etc. If you feel like you aren’t running at your best or you continually get overuse injuries such as shin pain and plantar fasciitis, having a qualified professional assess your running technique could prove to be a worthwhile investment. Coaches, Physios, Podiatrists, and Exercise Physiologists with an interest in running are all qualified to do such an assessment.

 

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Nutrition

Running is a wonderful sport for promoting weight loss and maintaining a healthy body weight. The best runners tend to be the lightest, but that doesn’t mean that you have to look like Paula Radcliffe to enjoy healthy running. If you are more than 5kg above your ideal body weight, be respectful of the extra load on your body as you increase your training load. Also ensure, no matter what your weight, that you fuel well before, during and after your hard run sessions. Optimal nutrition results in faster recovery, better performance and less injuries. Accredited Sports Dieticians are the best people to talk to about fuelling for both running performance and for weight management.

 

  • Shoes

This can be another controversial area that professionals love to debate over. Most qualified health professionals have their opinion on what shoe type is best for you; my advice would be to listen to your body. If you feel like it is hard to run fast, that your shoes are working against you, or that you get a lot of niggles in your current shoes, consider trying something different. I am a fan of the 4mm heel drop shoes and have had great success in them with all of my runners, but as with anything – change needs to be a very gradual thing. If you are used to running in super cushioned, 12mm heel drops and you suddenly swap to a “barefoot” style of running shoes (which I don’t recommend either, unless you weigh 40kg and look like the Kenyan Olympic marathoners), your body will be shocked by the change. You need to allow adequate time to adapt and ensure that you lower your training load and increase your strength work while you change over. I also advise people to have two pairs of runners on the go and to rotate them throughout the week. Most recreational runners doing 40-80km/week will need to change their shoes over every 3-4 months, depending on their weight and the surfaces they train on. This may seem expensive, but when you consider what equipment in some other sports (like cycling) costs, not to mention the cost of a potential injury, it is a relatively cheap investment for foot health!

 

  • Training Surfaces

Try to vary your terrain as much as possible – this is good for load but also a great way of incorporating some strength work and balance (eg. soft surfaces like trail running) into your running. Cement is the highest load for your body to cope with so try to do less than half of your training on it as a general rule.

 

  • Factors outside of Training

This is the one area that runners often neglect. Our training isn’t separate to the rest of our lives, it is included within it. That means if you are tired from lack of sleep, stressed from work or family, or under-fuelled from working through lunch – these things will all impact on your running form and also increase your injury risk. You need to consider how your body feels going into any run – and adjust accordingly. If you are wrecked from work or stress, don’t do that hard track session today; swap it for an easy 5km run and come back stronger for the track session in a few days’ time. I will also add here for the ladies that wearing high heels on fatigued legs is a great way to give yourself a stress fracture – you would be amazed how many times we have seen this in our female athletes! If you must have that big day at the races, at least wear lower heels and stretch calf muscles etc before and after the event.

 

 

The number one take-home point is that the body hates rapid change. The human body is an incredible specimen capable of adapting to remarkable training loads: think about what Ultramarathoners and Ultraman (back-to-back Ironman triathlon events) athletes are capable of achieving. They are no different to you or I – they don’t have magical superpowers that allow them to run 100km. They simply dedicated themselves to the process early in their lives and have consistently added training load to allow adaptation in a slow and planned manner. The bottom line is that our body will adapt beautifully to change, if we allow it time to do so. It’s not exciting, but if you ask any long-time marathon runner, it simply works. So if you’re like me and you idolise those crusty 70+ year-old distance runners that line up beside you at races, hoping that one day you too will be still running happily at their age, then take a leaf out of their book: consistency is the key to a long, happy running life.

 

Happy Training!

 

– Kristy Shannon    B.Appl.Sc(HMS); M.PHTY

Physiotherapist and Exercise Physiologist

 

 

REFERENCES

American College of Sports Medicine., American Dietetic Association., Dieticians of Canada. (2009) Nutrition and Athletic Performance: Joint Position Statement. Medicine & Science in Sports & Exercise. 0195-9131/09/4103-0709/0

Barr, K.P., & Harrast, M.A. (2005) Evidence-Based Treatment of Foot and Ankle Injuries in Runners. Phys Med Rehabil Clin N Am 16:779-799

Beck, B.R., Rudolph, K., Matheson, G.O., Bergman, G., Norling, T.L. (2014) Risk Factors for Tibial Stress Injuries: A Case-Control Study Clin J Sports Med 0:1-7.

Buist, I., Bredeweg, S.W., van Mechelen, W., et al (2008) Prevention of Running-Related Injuries Among Novices. Am J Sports Med. 36:33-39.

Van Gent, R.N., Siem, D., van Middelkoop, M. (2007) Incidence and Determinants of Lower Extremity Running Injuries in Long Distance Runners: a Systematic Review. Br J Sports Med 41:469-480.

 

Why it’s Important to Stay Active When Injured

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One of the most common misconceptions among the general public is that one must “rest” while injured.  I’ve lost count of how many times I’ve had one of my Pilates clients call to cancel “because they have back pain”.  They should be coming to Pilates because they have back pain!  Often the assumption is that the injured or painful structure needs to “rest”.  Rest from aggravating activities?  Most definitely.  Rest from all activities?  Definitely not.  The body requires blood flow, nutrients from the inflammation process, and gentle movement to stimulate healing.  If this can be done with minimal pain, you have a win-win situation: the body can get stronger while it heals itself.

Conversely, one of the most common misconceptions and fears amongst athletes is that their physio or doctor will tell them to stop their activity when an injury is looming, so they avoid making an appointment.  This often results in delayed diagnosis and treatment, worsening of their condition and significantly prolonged time off their sport in the long run.  The earlier the injury is treated, the more likely it is that the athlete will be able to continue with a modified version of their usual sport – which can mean faster healing, improved biomechanics through careful analysis and correction, and less time on the sidelines.

 

 

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Whichever end of the spectrum you sit at – from previously sedentary to elite athlete – there are a few key points to remember when facing an injury: 

1)      Activity Modification is the key.  Be creative!  Your Physio and Exercise Physiologist will be able to develop a program for you to follow, no matter what the injury, how long you’ve had it, or how you got it.  Even athletes with broken legs can be training hard in the gym and possibly the pool if done correctly.

 

 

2)      Golden Rule: Pain must stay below 2/10.  Some pain is good, and normal, in order for healing to occur.  80% of an injury’s healing occurs in 20% of the time (ie if a lumbar disc injury takes 10 months to get back to 100%, 80% of the gains will be achieved in 2 months, then next 8 months will be spent getting the final 20%).  Why wait the whole 10 months to get back to fitness?  The amount of muscle loss and degeneration achieved in that time may well set you up for a lifetime of back injuries in the future.  Staying fit through swimming, walking, Pilates, etc and keeping the pain <2/10 may well prepare you for a lifetime of less back pain.

 

3)      Athletes will often “train” harder when injured than when not.  Look at it like a time to rebuild the body and to work on any weaknesses that caused your injury in the first place.  Ask an elite athlete how much time they had to lay around and feel sorry for themselves after their last major injury.  Chances are, they will tell you how it was the hardest training they’ve done – hours spent in Physio and Exercise Physiology sessions, the gym and the pool.  Not to mention nailing their nutrition and recovery in between those sessions with extra sleep, massage, ice baths and so on.  We are all designed to be athletes, even if our modern “sitting” lifestyle has made that hard to believe.  So a middle aged man with a lumbar disc injury is no different – he should be doing more activity when injured in order to assist the healing and make him stronger than before the injury.  Look at it like this: the injury is a cry from your body that something is not right.  The rehabilitation process is your chance to fix that, so that you never have to experience it again.

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4)      The same principle applies for joint replacements.  Another very common misconception is that you should “rest” and ease off activity after a knee or hip replacement.  This couldn’t be further from the truth.  In the months leading up to a joint replacement, patients need to be working hard on their muscle strength in order to get the most out of the surgery and to assist in their recovery.  Your Physio or EP will be able to give you the least painful and most safe exercises for this.  After the surgery, the work continues – ever wondered why the Physio is there on day 1 to kick you out of bed and get you walking?  Because the joint will do best if you stay active.  Those “bed exercises”?  Same deal.  We need to wake up the supporting muscles as efficiently as possible for the body to heal well.  The pestering about your pain levels?  Because if your pain isn’t well-controlled, we won’t be able to exercise effectively.  There is always method to our madness……

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5)      Its never too early to see your Physio; prevention is the best cure.  My patients often come in with full-blown injuries, such as low back pain or chronic plantar fasciitis.  When I’m taking their history, they say that they first experienced the pain months ago and that it’s been progressively getting worse, and yet it’s taken them this long to see me.  They sometimes feel as though the problem has to be “serious” to warrant a visit – this couldn’t be further from the truth!  Had they come in when the pain first surfaced, the treatment would have been so much more efficient and the consequences much less significant.  Your physio can also help with prevention of injuries.  If you know you have a job where you sit a lot, then it might be worth chatting to your Physio about some strategies to prevent the onset of neck and back pain – being proactive is the key.  Physios and EP’s are well-trained to work with you to find an exercise program that is safe for your body, that fits in to your lifestyle, and that you enjoy doing.

 

The human body is an amazing specimen, capable of adapting to most things that we throw at it.  Your body puts up with a lot – why not give it something back by prioritising healthy ageing?  You only have one body, after all.

 

– Kristy Shannon

B.Appl.Sc(HMS); M.PHTY(Hons);

Director and Principal Physiotherapist – First In Physio

 2013-09-05 TRX planks II website version

 REFERENCES                                                                                

Adams, T; Band-Entrup, D; Kuhn, S.; Legere, L; Mace, K. (2013) Physical Therapy Management of Knee Osteoarthritis in the Middle-Aged Athlete.  Sports Med Arthrosc Rev 21:2-10.

Chilibeck, P.; Vatanparast, H.; Cornish, S.; Abeysekara, S.; Charlesworth, S. (2011) Evidence-based risk assessment and recommendations for physical activity: arthritis, osteoporosis, and low back pain.  Appl Physiol Nutr Metab 36: S49-S79

Williams, P. (2013). Effects of Running and Walking on Osteoarthritis and Hip Replacement Risk.  Med Sci Sports Ex

Melov, S.; Tarnopolsky, M.; Beckman, K.; Felkey, K.; Hubbard, A. (2007) Resistance Exercise Reverses Ageing in Human Skeletal Muscle.  PLoS ONE 2(5): e465