Training Through Injuries

author : AMSSM

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Frequently it is possible to continue to train despite an injury, but it can be difficult to know what injuries you can safely train through and how to train without doing more harm.

By Benjamin Moorehead MD

Member AMSSM

What common injuries or problems can be safely trained through, and to what extent?

Frequently it is possible to continue to train despite an injury, but it can be difficult to know what injuries you can safely train through and how to train without doing more harm.

Running accounts for most triathlon training injuries, and swimming is responsible for the least amount of injuries; therefore, this article will focus on common running injuries. Running injuries are generally overuse type injuries. Runner’s knee, patellar tendonitis, iliotibial band (ITB) syndrome, shin splints, stress fractures, plantar fasciitis, and Achilles tendonitis are a few of the most common overuse injuries that affect runners.

For each of these injuries it is important to correct any underlying cause to prevent the injury from recurring. Frequent causes might include improperly fitting shoes, worn out shoes, a rapid increase in training, or excessive total training (including cycling and swimming). If you suspect any of the preceding is playing a role in the injury, it needs to be corrected.
 

Runner's Knee

Runner’s knee presents with pain over the front of the knee or behind the kneecap. This is the most common type of knee injury. Keys to deciding whether or not to continue training include the level and duration of pain. Pain that goes away with warm-up is generally safe to continue to train through. Pain that persists after the workout requires additional rest and recovery time. Also, pain that is severe or causes you to alter your running form needs additional rest. It is important to seek further care if you have significant swelling, instability, or pain which does not improve with rest.

Shin Splints

Shin splints refers to pain over the front of the lower leg. This is caused by an irritation of the muscle attachment over the shinbone. Pain with shin splints is typically diffuse covering a broad area of the lower leg. It is ok to continue to train while experiencing shin splints. Running mileage should be decreased, and training should be on soft surfaces or a treadmill to reduce impact. Emphasis should be placed on stretching before and after activity. Cycling distance should also be decreased. It is safe to continue swimming during this time.

It is important to not mistake a stress fracture for shin splints. One key difference is that a stress fracture is more point tender. If there is just one focal point of pain and the pain persists through activity, this may indicate a stress fracture. If a stress fracture is caught early, you may be able to continue to train with some modification. If you are concerned about a possible stress fracture, you should hold off on training until you are evaluated by a physician.

Key Points

Unfortunately, there is not enough space in this article to discuss each of these in detail, but there are a few key points to help out with other injuries. Most injuries are due to overuse. This means that you are causing repetitive stress to the injured part (bone, tendon, muscle, etc.), and not providing enough recovery time. Often what needs to be done is to increase the recovery period and decrease the injuring activity. That does not necessarily mean stopping the activity, but simply decreasing. If pain goes away after a warm-up period, it is generally safe to continue. If the pain begins to persist longer or continues after activity, it is time to cut back on the aggravating activity (running, swimming, or cycling). Finally, if the pain is severe, or if there is swelling of the injured area, it is important to rest until you are evaluated by a physician.

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date: October 7, 2008