General Discussion Triathlon Talk » Overuse injuries--Can someone give me hope? Rss Feed  
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2008-08-05 12:20 PM

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Subject: Overuse injuries--Can someone give me hope?

Its been a year now since my body started falling apart.  It all started with ITBS and then I started having lower back pain (si joint), piriformis syndrome, and a lot of pain in my hips (mostly the right side).  I've been to 3 PTs, 2 Doctors, and 2 Chiros and had 2 cortizone injections.  I've made a lot of progress but everytime I try to start training again things flare up after only a few weeks.  My 2008 season is shot.  I've been resting completely for the last few weeks and I'm feeling really good, but my hips and lower back still bother me a little.  I've always been active, so this last year has really worn on me mentally. 

So, I'm looking for a little hope.  Have you sucessfully overcome an overuse injury (or several?).  How did you do it?  How long did it take?  Any advice would be appreciated!! 



2008-08-05 12:30 PM
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Subject: RE: Overuse injuries--Can someone give me hope?

I am constantly dealing with injuries, so I feel your pain. I actually visit my Rolfer (similar to ART) before seeing my PT, doc, podiatrist, etc. He's the best, and his work brings relief faster, in most cases, than rest, PT, etc. It really depends on etiology of the injury, though. You need to find medical professionals you like and that care about you, and keep a good relationship with them.

Tight hip flexors can lead to a lot of the issues you're describing. I would seriously consult a Rolfer (or ART)...it appears that's an avenue you haven't tried. Good luck and hang in there .

2008-08-05 3:48 PM
in reply to: #1582710

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Subject: RE: Overuse injuries--Can someone give me hope?

Thanks Lauren, I've noticed in the past that you've had lots of experience with injuries and always have great advice. 

I tried ART and it worked great with my piriformis problems.  But I'm hesitant to go back to the PT that did it because everything else she had me do totally flared me up (REALLY bad!).  In fact, all three times I did PT, I came out WAY worse then when I started.  I've had good luck with PT in the past, but for some reason PT has not worked AT ALL for these injuries.  I need to look into Rolfing.  Unfortunately, my PT benefits dried up in March! lol! 

The last chiro I worked with was actually really good.  He didn't really do any adjustments, but encouraged me to rest (that's finally how I got over my hip bursitis).  He also did u/s and e-stim.  But once we started trying to do some PT type stuff and slowly working out again things started to flare. I got up to WALKING 15 minutes, swimming 500yds, and riding my bike 20minutes before I had to stop--again.  I'm just tired of the starts and re-starts.

My plan right now is to slowly start doing some upper body strength training and core work (slowly meaning adding one excercise at a time to help eliminate any excecises that aggrivate things).  I'm not going to do any lower body work or s/b/r until I'm 100% better (or REALLY closee).  Does that sound like a good plan?  If things don't progress in the next 4-6 weeks, I'm going to go back to the orthopedic dr and maybe run some more tests to see if we are dealing with something more serious than overuse injuries.

I've been told that my hip flexors are loose, but my back/glutes are tight creating an imbalance.  I know my core is REALLY weak, and I'm hoping that working on my core strength, stability, and balance will help. 

So have you ever got to the point where you are 100% better, or do you just live with the pain?  What are your workouts like coming off of an injury? 

Thanks for letting me pick your brain!   

 Any other advice out there? 

2008-08-05 4:03 PM
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Subject: RE: Overuse injuries--Can someone give me hope?
I recently wrote this in a post titled "Knee Pain". Thought it might be relevant here, too:

Here's my take on pain:

Repetitive motion pain is from moving your body too much, too fast and/or the wrong way. Think of pain as a gift to figure out what you are doing wrong.

Too much, Too fast? Are you following the 10% rule to only increase your mileage OR your intensity by only 10% per week (NOT BOTH!) ? Are you giving yourself recovery weeks every third week?

Have you looked at your running technique? Heel striking puts alot of strain on your joints. Try Pose method of running, or Chi. (six of one, half dozen of the other, but I prefer Pose). Both of those methods encourage a midfoot landing with your weight under your hips.

When I first started running, I had a lot of pain in my hip. Getting past the 4 mile mark was very painful. I had to build slowly - two steps forward, one step back. I had to look at my running form. It took about 18 months to finally figure it all out, but now I can run alot more than 4 miles, and without pain.

It takes along time for joints to get strong, much longer than muscles and lungs. Your muscles and lungs may feel like they can go forever, but your joints aren't yet ready, so give them time.

The original knee pain post was related to running, so I didn't mention about getting your bike properly fitted to make sure your moving your body correctly there as well.

One more thing: how is your nutrition and sleep? With six boys to take care of, are you taking care of yourself? Overdoing it with training, AND not getting enough sleep AND not eating good food, you might just be putting your body over the edge. Too many straws to break the camels back.

I like your idea to start one thing back at a time, to see how your body manages. Good luck!
2008-08-05 7:55 PM
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Subject: RE: Overuse injuries--Can someone give me hope?
keyone's advice is sound.  I'll second it, and just add that 10% increase in volume or intensity week is too much for some people, especially those who are coming back from overuse injuries.  Given that you are getting pain every time you come back, I would, if I were you, scale volume and intensity WAY back the next time you try to come back (as in, pretend like you have been a couch potato for 10 years and you are just (re)learning how to run or bike), and increase more slowly than 10% per week.  In fact, I'd increase not at all for the first month and just see how it goes, then introduce increases ever so conservatively.  This will be ever so frustrating, but surely not as frustrating as not being able to train at all due to yet another injury.
2008-08-06 12:00 AM
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Subject: RE: Overuse injuries--Can someone give me hope?

keyone, thanks for you post.  I made SO many stupid mistakes last season and I've paid for it dearly.  I was just so excited to finally have my body back once and for all after having my last baby that I totally went overboard.  I have looked at my running technique.  I've had a few PT look at my gait and took at POSE running class last fall.  But my injuries have kept me from running much at all, so I haven't really had the chance to change my form.  I also had 2 bike fits, but again I haven't been able to ride much.  My last chiro was really good about treating me as a whole.  He had me up my calories and protien.  Last season I was trying to loose the baby weight (and not sleeping much of course with a newborn!) so I know my poor nutrition and lack of sleep didn't help there.  I've done a lot better with that in the last few months.  I like what you said about pain being a gift to figure out what's wrong.  I'm an optimistic person, but hitting the year mark with this injury has really brought me down. 

mdickson, thanks for the advice as well.  You are right, I need to start back VERY VERY VERY SLOWLY and make sure I have rest days/weeks too.  I know my biggest problem is that I do too much too soon.  Patience is NOT my virture! lol!

I had a REALLY good day today--the best I've felt since Christmas!  Obviously the complete resting is doing some good.  I'll get there! 

 



2008-08-06 3:59 AM
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Subject: RE: Overuse injuries--Can someone give me hope?
i've had all of the above, minus the cortisone, but add in a laminectomy...all in the years before I started training for tri.

I started swimming, then biking to recover initially from teh surgery itself, and then in order to get stronger from the nerve damage in my right leg from the disc issue I had.

I ran for another 2 years or so, but finally stopped, and now I focus mostly on biking.

I also do stregnth training in a variety of ways including dumbell routines, crossfit and p90x.

As long as I'm active i hold up pretty well...but running beats me down
2008-08-06 4:03 AM
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Subject: RE: Overuse injuries--Can someone give me hope?
Since you tend to overdo it on your own, why not look into getting a coached training plan so that you know exactly what to do? That way you won't be tempted to sneak extra stuff in on your own...well you will still be tempted!

When I started training seriously I dealt with overuse injuries as well, though not as severe as you describe. Spent lots of $ on ART getting fixed up. Found that having a coach and a plan helps to keep it in check.

I have learned that this is all a long slow process....getting fitter and faster just takes time, especially where running is concerned. I tend to try and look at the big picture now and envision where I would like to be in 5 years not 5 months.
2008-08-06 7:28 AM
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Subject: RE: Overuse injuries--Can someone give me hope?
I too deal with a lot of injuries, although thankfully mine are a bit less severe than what you seem to be dealing with. However, I would simply suggest that you get in a habit of stretching at least a couple times a day. It seems that tight muscles in one area can lead to injuries in others.....

-Matt
2008-08-06 9:54 AM
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Subject: RE: Overuse injuries--Can someone give me hope?
I had to deal with stress fractures this year and the only way I was able to recover was to take time off. I hate to say it, but sometimes this is the best solution. My doc originally said take 6-8 weeks off running and riding. I was still able to swim so used the that 6-8 weeks to work on my swim.

After 8 weeks I got the green light to ride easy. Nope, didn't work. First ride and had lots of pain. No running and riding for another 4 weeks. But, my swimming was improving. After 12 weeks of no running and riding I tried again. Starting with short slow rides for 2 weeks and then running REALLY slow and short and I was fine.

Now, 3 months back into IM training and I feel great. Hired a coach to get me ready and he has worked with me to overcome the injury and started me back slolwy. I'm probably not at the fitness level yet that I was last year but I'm sure I'll be stronger and very well prepared for IM.

So, my recommendation, take time totally off. Let your your body heal. Take 2 or 3 months off if you need to. Your body will feel better in the long run. Mine does. Sometimes you have to take a step backwards to go forward.
2008-08-06 11:46 AM
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Subject: RE: Overuse injuries--Can someone give me hope?
Lot's of good advice so far, but I will add two main points:  structural integrity and recovery.

Structural Integrity- could include run technique/form, shoes/orthodics, bike set up, proper weight training/stretching/yoga to create optimal structural balance in the body. (a good chiro goes a long way with weights etc..)

Recovery- I hear "over training" alot- and at times for most age groupers it really might be under recovery.  Nutrition is TOP-TOP-TOP on this list.  Athletes burn up alot of antioxidants and other nutrients during training and an optimal nutritional program is needed to keep up.  Sleep-- again we are not talking "average person" who doesn't train-- and I am betting most of the typical type A triathletes don't even get that much.  Keep in mind that each person is different, so individual sleep requirements may vary.  But do you get 7-8 hrs?  Stress levels will also effect recovery in that it burns up nutritional sources and a host of other hormonal responses that are "bad".  Relaxation techniques can aid in lowering stress and recovery.

One thing I have also noticed with soft tissue problems is that there is likely a chronic dehydration to go with it.  Endurance athletes can get in the "hole" very easily, and once in the "hole" it is very difficult to get out.  A sports doc that I went to years ago (for soft tissue over/use issue) had me drink watered down sport drink every morning- and a few times a day even if I was not training.  I recovered very quickly with that and the other therapies.  fyi.

Chronic injury is a sign that what you are doing is not working so well....GOOD LUCK in finding the right mix for your recovery. 
 
 


Edited by energy7OMgirl 2008-08-06 11:47 AM


2008-08-06 1:56 PM
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Subject: RE: Overuse injuries--Can someone give me hope?
It can be done. Just need patience and a lot of discipline to strectch, massage and avoid any type of activity that increases pain or inflamation. If fought an extremly chronic ITBS in my left leg (6 months) but I am 100% healed and will be participating in an Xterra this weekend. My pain started 1 month before last years Chicago Marathon but of course I was to stubborn not to race it so I did and the outcome was chronic ITBS. I attended ART therapy for 5 months and did not ran at all. A couple of month ago I was sure I would never be able to race again. So be positive and you will get better soon.
2008-08-07 12:41 AM
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Subject: RE: Overuse injuries--Can someone give me hope?
Thanks everyone!  You have all given me GREAT advice.  I think I'll feel better in a few days when our local tri season ends.  I've kinda pushed myself hoping to do some sort of triathlon (even as a team) but now I'll have a whole YEAR to recover and come back stronger next season.  Plenty of time to rest, eat well, strengthen and SLOWLY SLOWLY start training again. 
2008-08-07 1:00 AM
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Subject: RE: Overuse injuries--Can someone give me hope?

Jenn - your post is really timely. I am dealing with my own bout of injuries and it has been getting me down as well.  It hasn't even been that long for me (about 5 weeks) so I can only imagine how you feel after a YEAR! (and I pray that that is not me in a year!).

I am dealing with ITBS as well - that really hasn't improved in the 4 weeks I have been having it 'treated'.....and more recently it is suspected that I *may* have a torn cartilage in my knee....As well as tennis elbow in my left arm. 

I really couldn't figure out what caused my injuries because my volume or speed certainly didn't increase that rapidly (my running volume had actually decreased since the spring).....BUT the above posters made some good points about recovery....i don't think I was very cognicent about ensuring adequate schedule recovery.  That could very well be a big piece of the puzzle for me.

this is my first tri season and I at least got to do two tris this year so not all was wasted....my hope at this point is that I am well enough to train for next season and remain injury free for the whole season.

Good luck to you - I hope you heal soon!

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