Prevention of overuse injury
The key point that I have learnt from my injuries is that the opposite to doing ‘too much, too hard, too soon’ is to do ‘the right amount, at the right intensity, at the right time’. This is crucial for avoiding injury. Then if you are injured the challenge is to get the right diagnosis from a competent doctor and to rest and protect the injury in the correct way.
The Golden Rule for prevention: ‘do things for the right duration, at the right intensity and at the right frequency’;
‘the right amount’ (duration)
– When starting a new activity, start slowly. Work out what your comfortable baseline of activity is then increase by about 10 percent per week up to a sensible maximum
The ten percent rule This is the idea that you should only increase the amount you do something by ten percent per week. For example, if you run you should only increase your distance by ten percent a week. The cardinal error is to increase the amount you do something, reduce the recovery time and increase the intensity at the same time. In the case of running this could translate as doubling your distance each week, increasing how fast you run and reducing your rest days.
Regrettably, however, though the ten percent rule is often quoted it is mired in controversy. Nevertheless, the basic principle that you should not increase an activity too quickly, is still sound and following the ten percent rule may be a good way of doing that.
‘at the right intensity’
– It is always better to avoid doing something if you feel that you are forcing it and experiencing a sense of strain. This is why you must make sure that you spend enough money so that you have the right equipment and tools to do what you are doing.
Correct posture and technique is crucial when doing activities whether it is how you speak or how you type, or altering posture through something like a shoe raise. Poor posture can increase the stress that your body experiences which is equivalent to increasing the intensity. A sudden increase in the speed of your activity also increases the intensity and can cause an injury, e.g. suddenly cycling or running faster.
‘at the right time’ (frequency)
– Even what seem to be small changes to your routine can have a big impact if they mean that you are losing some of your recovery time. The right amount of stress is not just determined by the amount of stress caused by a given activity but also other activities that stress that part of your body e.g. when I injured my left knee I had changed my routine by doing exercises that involved my left knee and generally using my left knee more (because of problems with my right knee), so I was adding to the frequency of the stresses to this joint.
Follow general guidelines for health promotion
Essentially, it is about maximising one’s overall state of health, and the three ways of doing this outside of specific medical intervention are adequate rest, diet and exercise.
Maintain a healthy balanced diet with an adequate number of calories
The fatigue that poor quality sleep can cause can predispose to injury
Stopping smoking can reduce the risk of injury in former smokers
This is a difficult one because exercise is recommended as an antidote to emotional stress, but emotional stress may also predispose to injury. So exercising when under emotional stress may be counter productive sometimes. Cortisol is produced by the adrenal glands when we are under stress and too much cortisol can damage collagen, which is needed for tissue repair.
Another way in which psychological stress can predispose to physical injury may be through hyperventilation. When we are under stress we sometimes hyperventilate which causes vasoconstriction and an increase in body temperature. There is evidence that when heat is increased in tissues this can cause a breakdown of tendons. Maybe this means that via hyperventilation, emotional stress can be a risk factor for injury, not just in tendons but in other bodily tissues.
3 magic words
There are three words that you can say to yourself to avoid situations where you may be injured. They are;
stop When you are aware that you are doing too much, just say to yourself ‘stop’ and walk away. An alternative is ‘let go‘.
wait When you are aware that you are rushing things and likely to have an accident or overdo something, just say to yourself ‘wait’ and let some time pass. When you are building up your activity levels wait and do it gradually.
no When someone tries to get you to do something that you know could cause injury, e.g. lifting a heavy item, then simply say ‘no’. You can be polite about it, but still be clear , simple and straightforward.