Thursday, January 23, 2020

Pain Part Three: HURT

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So far in this three part blog saga I've looked at 'Fatigue' and 'Exertion' as two of three main types of "pain" (if you haven't read the previous instalments, you should be able to find them below this posting). Now it's time for the final part, "hurt".

This is potentially the most contentious of the pains to look at, and once again I stress that I am not a medical professional, just another amateur triathlete trying to learn from my own mistakes and pass on what advice I can.

For me personally, the most important thing to learn when it comes to hurt is to distinguish between hurt that you can train through and hurt that needs rest to fix (accepting that there’s a massive grey area in the middle, which we’ll get on to in a moment).

As mentioned in my post on fatigue, with the increase in training volumes since getting a coach (Mark Shepherd, @gobi_one), it’s now entirely normal for me to train with some sort of ache or pain, usually in my legs. I guess the lesson I have learned is to differentiate volume-induced pains from those that indicate (or are likely to lead to) injury.

It’s perhaps ironic that as I write this blog, I am five days away from my first proper race of 2011 (the Wokingham Half-Marathon, a good pre-season test of fitness), and I have a mix of pains and aches in my legs. The tightness in my glutes and upper hamstrings tells me that I’ve been running pretty hard the last couple of weeks (ties in with coming out of base and starting my speed work), but I also know that as long as I warm up properly and don’t go nuts, I can continue training with no real worries (this is a judgement you can only really make with experience).

What is potentially causing me a worry is a sharper pain I am occasionally getting in my right knee, especially on climbs. I first noticed this on Sunday doing a long off-road run (lesson learned; long off-road runs probably not best move week before a race!). My strategy so far this week has been to follow the RICE protocol and then take it reasonably easy and let the knee fully warm up before asking anything of it – I even did a track session on Monday night and that confirmed that there doesn’t look like there’s anything particularly wrong. If I was getting pain, then that (for me, at least) would be a different story and rest would definitely be on the cards.

Another type of hurt I have experienced is an ACJ (shoulder area) injury that made swimming quite an ordeal. For that, there was no option but to accept that some form of rehab was going to be necessary before I could get back in the pool properly. And that’s when I turned to a professional to get a set of exercises designed to strengthen up the affected area without either prolonging or adding to the injury. I still have a left/right imbalance now, so the rehab exercises continue to be a part of my gym routine, even though I’m back in the pool.

Another example which some of you might remember from my ramblings last year was when I had a nice accident practicing flying mounts onto my bike – the day before Marlborough Triathlon. Not my finest hour and it left me with a swollen and very sore foot. However, the ankle itself was fine and although the foot hurt like hell when putting a shoe on, it was fine thereafter. So I raced. Perhaps not the best decision, but the foot held out fine during the bike and run legs (funnily enough, it hurt more in the pool than anywhere else) and I managed a top-ten finish, so I think by more luck than judgement my decision to race was the right one (I didn’t get any further pains etc in the next week either, so racing definitely didn’t make it any worse).

So what am I saying here? I guess it’s the same thing I’ve said for the fatigue and exertion posts – engage brain! I think as humans we are programmed to know when something needs our attention versus when we can ignore pain. Yes, ego or ambition can override this, but that’s where it is important to be honest with yourself.

If you get a strain or worse, isn’t it far more sensible to ease off for a period of time and then re-introduce your body to the exercise in stages, to be sure that whatever wasn’t quite right has had a chance to heal?

A friend of mine who can usually easily outrun me is currently struggling to keep up with me on short fast spurts. Why? Because he didn’t listen to his body and trained through an injury that got worse until he had to stop completely. Had he accepted the injury at made changes to his training schedule to accommodate, he’d probably be whopping my ass again already. Instead of which, he’s probably got another couple of months recovery ahead. At this time of the year, that’s bad news.

One final note, if you’re injured and it isn’t immediately obvious exactly what’s wrong, get professional help! I work with Kim Ingleby and Nancy Braithwaite, both based in Bristol and both excellent at helping identify the cause of injuries and setting out a plan for recovery.

Apologies again for the ramble, congratulations if you made it to the end! Till next time…

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Matt Fisher runs - so it's all his fault! He pretends to be a triathlete, but really he is a husband, father and company VP. But he has raced for the GB Age Group squad a few times and is a two-times qualifier for the IM70.3 world champs