Answer to a question

Answer to Question
by Andrew Nelson for www.tricoachandy.com
andy@getfitnyc.com

I was recently presented with a situation from one of the athletes on a women’s triathlon team:
She is a cyclist and a runner who has pain in the knee. The MRI showed significant edema, inflammation, and bursitis. The bursitis was the result of a fall. Inflammation is often the result of trauma; edema is a fluid buildup in the tissues of the body usually the hands, legs and ankles and can be from injury or pregnancy).

As a longtime athlete, she has worked hard to overcome some injuries (Runner’s Knee, most recently) and is concerned about losing the fitness she has gained.
She asked which procedure would get her back racing sooner?
The doctor gave her 3 choices - 1) cortisone shots; 2) 4-6 weeks of immobilization and crutches; 3) PRP, physical therapy, and complete rest (not even swimming).

Here is my take from years of coaching, running, racing, and being an athlete:

1- If you can manage it financially, get the PRP and the PT. Complete rest may lead to a greater understanding of why you race to begin with.

2- If you gained fitness once, you will not go back to “zero” if you take the time to heal. It may seem like you are "losing ALL of your fitness," but the reality is that is just not the case. If you make things worse by not recovering fully then you will be out longer.

3- Treat fitness and exercise as an investment in your body; a long term investment.  There will be ups and downs; as well as plateaus.  Fitness and health are not just for this season or this training cycle. Athletes, especially highly competitive ones, do get injured (in her case it was another bike accident avoiding a car).  

4- You can strength train without mobilizing the knee joint. Straight leg raise w/ankle weights, hip abduction w/cables, straight leg dead lift- all of these will strengthen the hips/legs without bending the knee.

5- Swimming can be done while still immobilizing the knee, ONLY IF THE DOCTOR CLEARS YOU. Swim with a pull buoy and a band around your ankles (and maybe even your knees). It feels strange at first but makes your upper body swim form and rotation come from the hips; where you’re stronger anyway.

6- Take it slow! If you were running 6-10 miles/session before the injury, start with a 1/2 mile easy jog. That’s right, 1/2 mile. Your body will need to reestablish neural pathways for optimal muscle ordering; an efficient gait. This will help the body to break the old injury cycle. If you try to come back too quickly and resume where you left off, you risk re-injuring yourself.

Even great doctors who are athletes often fail to see what great trainers and coaches are able to do to keep athletes moving. I once had a dentist who had been a teacher of Dentistry tell me: “Some dentists were A students and some dentists were C students. At the end of school they were all still dentists.” Coaches and trainers are not all the same; just like any professional.

I understand the head game of an injury (I once took 13 weeks off immediately after being trained for a marathon to recover from an accident). The “career” of an athlete can be cut short, and lead to a lifetime of pain, by not taking the proper down time or doing too, much too soon after an injury. Take time to recover fully from an injury. Sometimes a longer time recovering can mean a stronger next season and a longer athletic career.

Stay Healthy and use a great coach to help you achieve better results for next season.

The Effects ARE Real

Strength training improves your Marathon running. Strength training improves your bike sprint performance. Strength training makes your swim stroke stronger. I know that is hard for most runners to imagine and even harder for cyclists to see how more muscle can lead to FASTER times. I like to run! I am a running coach! I am a triathlon coach! But giving up 1 or 2 runs a week in exchange for focused Strength training can improve your run and or bike regardless of distance. Throw in some speed work and you just might drop that marathon time/century time/mile swim time.

The science is clear and unwavering that strength training improves your running economy and helps to better vascularize your muscles, improving blood flow during exercise. So why don't more people who call themselves athletes strength train? It makes you more lean. It makes you stronger. It reduces injury. And if done properly, improves your balance and function in everyday activities. It even makes you look better.

So I ask again: Why don't more runners strength train? I mean pick up something that weighs more than they do. Simple answer: Runners like only running. To that end they should build muscle so they have the stable, strong base to continue to run without injury. My father is a lifelong runner and, at 67, he JUST got what I have been telling him for 10 years. Cyclist fear having more weight to carry up hills but the strength:weight ratio improves more than the weight stays on. Swimmers do not float as well, though but somehow finish faster.

Now I will make the argument that lifting heavy improves endurance performance. Yes, at the professional level running more, faster helps you to run a marathon faster. However, most people who run do not spend 2-3hrs/day working out and 21 hours only recovering like the pros do. Most people spend the day sitting down at a desk letting their hip muscles get short and junky. Strength training and the preparatory work necessary to lift are great at making a runner, cyclist, swimmer or triathlete stronger and more flexible, allowing a powerful run stride/pedal stroke/swim stroke that is more efficient.

I would also make the argument that preparing your body to strength training helps to make you better at the other sports. If you are a triathlete you need to be very flexible, very strong, and have tremendous endurance. Strength training combined with swimming, biking and running can make you a very balanced strong and focused person. More muscle allows you to finish stronger, recover faster and prepare better.

Don't just watch a video on YouTube of how to do the following lifts, get some professional coaching or at least take a small strength training class.
My recommended lifts for endurance athletes are as follows:
Dead Lift (build to fewer than 6 reps. GO HEAVY)
Dumbbell snatch
Kettlebell swings (initiate from the hips)
Thrusters (Front Squat to Jerk press)
Pull Ups
Push Ups
Squats (build to fewer than 6 reps with great knees placement)
Med Ball Chop or slam/ Med Ball Cross Body lift
Box Jump

Now go have some fun being strong. The hills will look and feel easier.