Overuse Injuries Common to Triathletes

These conditions are aptly called “overuse injuries,” and they are common among amateur athletes who ramp up their training within a short period of time, without allowing for the proper rest and recovery breaks.

Such are the trials of triathletes, who balance swimming, running and cycling in their vigorous training regiments.

South Florida is home to a growing legion of triathletes, who can train virtually year-round in all three disciplines. Events such as the Escape to Miami Triathlon, co-sponsored by Baptist Health South Florida, set for this Sunday (Sept. 20), are also propelling the popularity of triathlete training.

The event, which starts off at Margaret Pace Park on Biscayne Bay, features two Triathlon divisions that can draw a range of enthusiasts, from the beginner to the seasoned athlete. They are the “olympic distance” (swim 0.9 mile), (bike 24.8 mile), and (run 6.2 mile); and the “sprint distance” (swim 0.25 mile), (bike 13 mile); and (run 3.1 mile).

A Common Misconception About Triathletes
As more casual athletes sign up for triathlons, a misconception lingers about these events and the training required. Working different muscles — goes the misconception — reduces the chance of injury because the strain is spread throughout the body. But this notion is mostly a myth.

Triathletes tend to switch from a single sport — most often distance running or cycling — and add to their training the other two disciplines. But additional workouts without proper pacing and precautions lead to overuse injuries.

“Triathletes can suffer injuries from the compound effect of adding too much training without proper care and guidance,” said Gautam Yagnik, M.D., a specialist with the Miami Orthopedics and Sports Medicine Institute at Baptist Health South Florida, who sees patients at West Kendall Baptist Hospital.

Overuse injuries are common among triathletes preparing for competition. Studies have shown that the most prevalent sites of overuse problems are the knees, lower legs and lower back. Running and cycling are more likely to cause injuries. But even adding swimming, and overdoing it, can cause rotator cuff Tendonitis or shoulder pain.

“Cross-conditioning is important and a key training element for triathletes, but proper preparation, stretching, hydration, periods of rest and other precautions should be taken to avoid overuse injuries,” Dr. Yagnik said.

Here are the most common overuse injuries for triathletes (followed below with tips for avoiding them):

Achilles Tendonitis
The achilles connects the large calf muscles to the heel and this tendon can become another victim of overuse injuries suffered by triathletes. Achilles tendinitis most commonly occurs in runners who suddenly increase the intensity or duration of their runs. Most of these cases can be treated at home under a doctor’s care. But don’t ignore the symptoms of pain below your calf and above your heel. It can transform into a more serious, chronic issue.

Iliotibial (IT) Band Syndrome
This is an overuse injury of tissues of the outer thigh and knee. The IT band stabiliazes the leg, so when it flares up it can debilitate runners or bikers severely. The symptoms include a sharp pain or tightness on the outside of the knee just below the joint. The IT band starts in the muscles of the gluteus and hip, then moves down the outside of your thigh. You can aggravate the IT band by ramping up your mileage too quickly, on foot or on the bike.

Patellar Tendonitis
This is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump. This injury is commonly known as jumper’s knee, is most common in athletes whose sports involve frequent jumping — such as basketball and volleyball. However, triathletes are also prone to patellar tendonitis. Pain usually emanates from the center of the knee, almost right under the kneecap. Pain can be sharper when seated for long periods of time—like biking—or when walking up and down steps.

Rotator Cuff Tendonitis/Shoulder Pain
This condition affects the tendons and muscles that help move the shoulder joint and it’s not just an injury common with avid tennis players and golfers. Regular swimmers can develop this condition since the freestyle stroke develops the front of the shoulder and the chest, creating an imbalance between the two sets of muscles. Athletes who indulge in sports that require extending the arm over the head commonly develop rotator cuff tendinitis. This is why the condition is also be referred to as swimmer’s shoulder, pitcher’s shoulder, or tennis shoulder.

Stress Fractures
Most commonly occurring in the hip, foot, or tibia (the main bone in your calf) in triathletes, stress factures are overuse injuries. They happen when muscles become fatigued and are unable to absorb added shock. They are often the result of increasing the amount or intensity of an activity too rapidly, or in the case of triathletes, excessive training without proper breaks for rest and recovery.

Here are general tips for triathletes to help avoid overuse injuries:

• Proper stretching matters more for triathletes. Training for a triathlon requires muscles to endure repetitive motions. Stretching helps your muscles become more elastic. This will make you more flexible over time.
• Choose a triathlon that’s 12 weeks away or more because you need time to train properly, assuming you are already in good shape and regularly active.
• Do not over-do-it with your training. Your body needs time to adapt to new training routines and proper rest is crucial. If you are already fit, do slightly more challenging workouts instead of just adding workouts.
• Schedule your swimming first since it is the one discipline that is most difficult to coordinate. Running is most convenient, so schedule it last. Avoid the same activity twice in a row to keep a balance.
• Hydration is important particularly in South Florida’s humid climate, as is nutrition between workouts, while the body becomes accustomed to a shift in routines and intensity.

Do mostly moderate-intensity workouts during the first phase of training for a few weeks. Gradually add high-intensity workouts. Just prior to a race, include race-pace intervals or sprints.