http-equiv='refresh'/> Global Therapies: Injuries Part 2: Extrinsic Factors

Wednesday, 13 July 2011

Injuries Part 2: Extrinsic Factors

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In part 1 of this blog I gave you an overview of what might be the causal factors in injuries, and we briefly covered the two categories: intrinsic and extrinsic - essentially anything from within you or external to you.  I'm now going to look in more detail at extrinsic factors. In this category we have three subsets which will be covered in turn: environment, equipment, and training and competition.

So what can cause an injury? Well, it can be just pure bad luck of course - tripping on a stone or catching your toes on a tuft of grass - these would be extrinsic factors from the environment. Other environmental factors could be the weather (too hot or cold, wet or dry), and nothing can prepare you for that, even with the best equipment available, we cannot control what the weather does. But we can - obviously - choose when we go out in the hills or out to train.

Another environmental factor is (and the stones under-foot or grass tuft amount to the same thing) - the terrain. Whatever surface you train on you need to be aware of the factors that could lead to injury, be that shin splints from road running, twisted ankles from the fells, or muscle strains from the speed session on the track.

But what about that twisted ankle. Could it be the fault of terrain alone? No. Poor fitting, inappropriate or faulty equipment could also play a part. It seems common sense, because shoe manufacturers make 100s of different types of trainers for a myriad of different purposes, that choosing the most appropriate footwear is vital. Common sense it may be, and wearing fell shoes on the fells seems obvious. I have however seen runners on road and moorland in highly inappropriate shoes. Just don't do it. The shoe makers spend thousands of pounds on research and development so we can have it just that little bit easier. No guarantee you won't injure yourself, but you're taking one precaution by choosing the best equipment for the job.

If you're playing in a team sport or one which involves equipment such as a tennis ball then there's a risk of direct trauma were the ball to hit you. As accidents like this are totally random there's not a huge amount you can do, except for wearing appropriate protective gear if your sport uses any.

Training and Competition make up the third extrinsic factor. This is where I experienced problems. I made sudden changes and the increase in demands was too much for what my body could cope with. You could say that I had a poor programme (that is if I had a programme at all - I didn't, just a little over enthusiasm) and that I was inexperienced.  So I've learnt my lesson the hard way. You don't have to. The final part here is whether or not you're at the start or end of your sports season, if it has one. At the start you might be overly ambitious, not up to 100% fitness; towards the end you'll be fatigued from playing many games in a short period of time, potentially continuing through injury when you should be resting - but you can't let the club down. Remember, you only have one body so look after it. And listen to it.

This leads me on to a couple of rules which I'm now applying to my fell running:

Rule #1 Don't make sudden changes to your training. This is where the FITT principle of training is useful - Frequency, Intensity, Type and Time - make changes to any of these in small steps - use the 10% increase rule as a maximum to any of these aspects and you should be making steady and safe gains. I'll blog about the FITT principle in more detail soon.

Rule #2 Have a programme. Write down what you are aiming for and make the target date realistic. If you don't have an aim in mind (be that a race or competition) then keep a record anyway so you know what you've done, and by how much you can increase the following week. Make sure also that you note any slight niggles or aches - this could be a warning of an impending injury or a wake up call to keep things progressing a little slower. Your body tells you it's in pain for a reason - to protect itself. So Listen!  A training diary is the place to note rest as well. Having quality rest days, and quality recover days are vital to making forward progress in fitness because your muscles and soft tissues have time to repair themselves and learn how to cope with the stress of your hard training days.

Rule #3 Talk to other people who are doing the sport you're wanting to do. Ask them about training and good choices for equipment or routes that would be suitable. If there's a local club then join them, but be realistic in what you can achieve. My first run with the local club was a tad ambitious and in hindsight definitely too much to do. I was prepared to walk and turn back if necessary, but the pull to keep going meant that I ran further, faster and on tougher ground that my body was ready for.Whilst being tremendously supportive of me being a novice, the club didn't know me, what my background was, what I was capable of. Only I could know that, and it was only me who should have known that the run that particular night was not for me. 

So we have three extrinsic factors which could influence whether or not we suffer an injury:  environment, equipment and training/competition. Injuries are such a complex thing and it's difficult to pin down one factor that leads to them. What you can do is be prepared so that you stand a much better chance of avoiding them. Part of being prepared for any activity is having considered all the factors which influence how you perform. I've only looked at extrinsic factors here; I'll write about intrinsic factors soon.  We'll see that they're all connected, impossible to separate and equally important.

I've now been out for two further rehab runs, on 9th the aim was 5km and yesterday was 20 minutes (distance not important). Both runs were completed using the run/walk strategy and both were pain free. I actually felt good. I must say, I like the run/walk thing, the 5km run was pretty much at the same pace as I was running pre-injury, which isn't bad considering I've only run once in the last month, and that I walked for about a third of the time. Given that I felt so good after each run it was hard to stop, but, reminding myself of why I'm doing this - for rehab and to stay injury free - I reigned in any fancy ideas of longer/further runs and am sticking to my training programme.

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