Injury Prevention Strategies for Endurance Athletes

For this first article in a series on injury prevention strategies I interviewed two rehabilitation and conditioning professionals – Laura Snow, physical therapist and co-owner at American River Rehabilitation; and Darcy Norman, a licensed physical therapist, certified athletic trainer, and certified strength and conditioning specialist with Athletes’ Performance.

Before we dive in to this subject, just a quick reminder, in order to communicate we express in absolutes. The key is to take these absolute concepts and make them relative to our individual experience. That said, here we go…

Injury prevention in athletics is the most effective ways to insure consistent progress and performance gains. Through my experiences as an athlete, coach and trainer, knowledge gained with continuing education and recent interviews I offer three cornerstones of injury prevention –  a shift in training mentality from more is better to a balanced integrated approach is better; fundamental sound biomechanics; and understanding and patiently respecting the training process.

Both Snow and Norman agree, injury prevention starts with a science-based, systematic progressive training plan. A solid training plan focuses on sport specific training, but also includes foundational activities that insure the athlete possesses the strength, mobility and stability to train safely and effectively.

Generally speaking, endurance athletes would benefit with a mind shift in regards to training, away from a more mentality toward balanced integration. This philosophy carves time out of the sport-specific training to allow time for functional movement oriented movement prep, core stability, single leg strength, and hip stability and mobility exercises, as well as stretching and/or yoga. As we have discussed in previous articles movement prep activates the muscles and nervous system in preparation for the specific activity. An effective core stability program trains a strong pillar posture and the ability to maintain that posture through movement – essential for efficient generation and translation of power to the extremities. Single leg strength exercises improve imbalances and asymmetries, which if not corrected are culprits of injury. Hip mobility and stability insure sound biomechanical movement. Glute activation and hip stability effectively control movement, and efficiently alleviate the small stabilizer muscles, which lack endurance, from doing the work. Stretching and yoga improve asymmetries and range of motion facilitating the body’s harmonious efficient movement.

Injury prevention and performance gains also rest on the endurance athlete’s willingness to take that leap of faith from a training plan that consists primarily of slowly, sloppily, slogging more and more miles to adding systematic balanced integration of quality sport specific workouts. Training for endurance events is more than covering long distances. Endurance athletes who follow a more is better plan with little structure, intensity and rest – suffer greater overuse injuries, sickness, as well as performance plateaus. To help insure injury prevention, it is valuable for athletes to follow a progressive, yet gradually developed sport-specific plan based on his/her current fitness and training, and future goals.  In addition to pure endurance days, this plan includes speed and intervals, to fine tune economy of movement and train the lactate buffering, aerobic, anaerobic and nervous systems. Rest and recovery days and weeks take equal priority and demand as much diligent respect as workouts. The emphasis on the quality versus quantity approach appears to be a trend amongst the elite endurance athletes who have experienced fewer body break-downs and improved performance gains.

I asked Snow, what is the number one pattern she sees that leads to injury in endurance athletes, she replied, “Easy answer, too much of a good thing…high volume, lack of recovery time, sudden increase in volume and intensity.” Norman echoed the sentiment, “We always overdo. We ask ourselves, how much more can I do rather than what is the least I can do to receive the maximum benefit.”

Another valuable training plan ingredient for injury prevention is out-of-season and in-season supplemental training. For example, it is advantageous for a runner to supplement cycling on one of the week’s scheduled endurance days, which will contribute to the overall endurance base, while affording the benefits of mental and physical variety, and joint and muscular strength. Supplemental training is also effective for active recovery – I like to incorporate an evening low intensity, technique-focused swim following a morning intensity run session.

In order to possess sound fundamental biomechanical movement, the second cornerstone of injury prevention, we must first possess a foundation of strength, stability and mobility. This relies on efficiently functioning hardware and software systems – musculature, bone, tendon, ligament strength and the nervous system, respectively.

Norman says, “There is a trend that endurance athletes, especially runners, expect to be hurt at some point or several points in their careers. But if you have a sound program and mechanics, injury is 100% preventable. Running is not an impact sport – things and people are not purposefully hitting you, you can prepare for the impact. Everyone talks about biomechanics and economy of movement, but first and foremost you must develop a foundation of strength, stability and mobility. Once the foundation is established, movement prep with emphasis on glute activation and drills, reinforced and trained via intervals will develop efficient, sound mechanics.”

Professionals advise to stick with science-based biomechanical information and then make that information individually relative. They also remind us a little knowledge is dangerous – it leads to thinking in absolutes and taking concepts to the extreme, with expectation of immediate transformation and results. This all or nothing approach in runners has, according to physical therapists, led to increased injuries.  Therapists have seen an injury trend with runners taking the “new” running styles and minimalist movement to the immediate extreme attempting to reinvent their gait overnight. There are certainly validity to these techniques and they can be safely and effectively trained, but it is beneficial to employ a network of professionals, possessing a broad base of knowledge to assist in sound, safe biomechanical re-training.

 The final cornerstone of injury prevention is to understand, appreciate and enjoy the training process. An athlete who takes responsibility and understands the “why” of the plan profits with clear purposeful training. Training is an investment that demands patience and respect of the process, driven by a love of it. Athletic achievement is not an overnight proposition, it is daily dedication. If we change our perspective of our endurance training to a daily opportunity for mental and physical empowerment, we remove the sense of urgency that tempts us in to the cram-session, cut-corners, cart-before-the-donkey approach leading us down the path to injury.

I may have strayed off subject or stumbled upon the realization that injury prevention strategies offer a metaphor for life – balance, variety, back to basics, and remaining present to appreciate the journey.

Subsequent articles will focus on the benefits of pilates, yoga, nutrition and massage as injury prevention strategies for endurance athletes.

Cross-Country Ski Dry-Land Training – Make it Count

Because the snow season is finite – cross country skiers have developed dry-land progressions that mimic the on-snow technique. These progressions help clear the summer cob-webs and re-institute specific skiing muscle memory and body position awareness.

Body position is the foundation of efficient cross-country skiing – it provides a balanced, stable, powerful base. Key points to this position include – supple bent ankles and knees facilitating a forward position; and level hips, think of pelvis as a cup of water – we do not want to spill the water, or visualize the tailbone pointing directly down to the ground.

Maintaining this body position places us in a powerful dynamic position, while also allowing us to use the mass of our bodies to produce free energy in forward propulsion.  Let me explain. Body position becomes ineffective when skiers believe they are finding the forward position by hinging at the hips – this places the hips and glutes, the mass of the body weight behind them and they are then fighting gravity. In the correct body position – skiers essentially fall with the mass of their bodies from one forward move to the next forward move with my hips/glutes pressing forward on to supple bending ankles – free energy.

Dry-land training demands that the skier continues to mentally visualize and connect the movements to on-snow technique. This training is extremely effective, but as with all of our training it demands sincere intention and purpose – do it like you mean it. Cross-country skiing is heavily technique driven and dry-land is a fantastic opportunity to set the foundation of solid movement patterns and habits. Like all endurance pursuits, cross-country skiing is a game of efficiency. Dry-land affords the opportunity to refine movements and make every movement count toward forward propulsion.

A classic (also known as stride or diagonal) technique progression would resemble the following steps, and would take place on a steep hill.

Step 1 – Find that athletic stance, a powerful, balanced efficient body position – feet shoulder width, flex ankles and knees and press hips forward, hips level and torso fairly upright (again avoid hinging at hips placing mass of weight behind).

Step 2 – Maintaining body position – swing arms fore and aft from the shoulder sockets, focus on creating a long pendulum-like relaxed movement.

Step 3 – Leg swing – initiated by hips creating similar pendulum movement, relaxed range of motion, and again check back in with body position.

Step 4- Arm and leg swing together – opposite arm, opposite leg swing forward and back, just like walking and running. Maintaining athletic stance and initiating at the body’s core.  I think of my hands and feet as blocks of cement – shoulders and hips create the movement with hands and feet following.

Step 5 – Fall forward drill – grab a partner and practice falling forward from ankles, keeping heels flat. Preserve the body position – hips forward flexing only at ankles, feel the free forward energy you generate. Experiment with the difference when you hinge at hips forward – very little to no energy produced.

Step 6 – Shuffle – ensure good body position and then using the mass of your body shift weight forward on to supple relaxed ankles and knees, the feet are forced to keep up with the rest of your body. Place your hands on your hips to assist in continually pressing them forward. Your forward falling body position is creating all the energy.

Step 7 – Extended diagonal motion – use the pendulum movement of the opposite leg and arm described above, flex forward slightly at knee and ankle and move arms and leg past the body with proper timing, pressing hips forward – basically striding on to the next standing leg and opposite arm forward. After each movement forward – hold the position, check for balance and body position. Then repeat.

Step 8 – Kick impulse which replicates setting the wax pocket (grip that allows forward propulsion on classic skis). It is a quick compression in to the ground – for a split second we feel our entire transfer of weight. For this motion I think of standing on a scale and creating impact down to see the scale numbers soar. This movement has also been described as similar to squishing a bug.

In classics skiing we generate energy – by free energy of forward falling body position, the kick impulse and the pendulum leg drive and arm swing.

Step 9 – Timing leg and arm drive with the impulse down – as the opposite leg and arm pendulum drive forward the other standing leg, impulses down. Dry-land is an ideal opportunity to nail the all-important timing of this maneuver. After each move forward check balance and body position.

Step 10 – Link the movements, described above, and punctuate with fluidity, rhythm and symmetry.

Once this technique is mastered – it is applied to perform cross-country specific intervals known as ski walking, and plyometrics referred to as bounding.

Ski walking is performed by linking the progression with timing and applying power and energy to the movement, while maintaining body position. Ski walking is also a great tool for endurance runners seeking an efficient way to scale steep canyon trails. Ski walking can be performed with or without poles.

Bounding, also performed with or without poles, is the linked movement above, characterized by quick powerful movements to improve explosive strength. These are short bouts of 10-30 seconds.

There is also a dry-land progression used to institute and mimic skate ski motions, and is equally effective to build efficient cross-country relevant muscle memory.

Once the snow flies – there are citizens races nearly every weekend in the Truckee-Tahoe Basin. In my opinion – racing is the most effective way to improve your learning curve, and meet new skiing partners.  Check out farwestnordic.org for further details on clinics and races.

 

See you on the trails – when the snow flies

 

Got Balance?

Balance is a key element of efficient, enjoyable cross-country skiing. While some contend – they simply do not possess balance, don’t be a victim of this belief. Balance is trainable and early winter, as we twiddle our thumbs eagerly awaiting the snow, presents an ideal opportunity to fine-tune balance with dry-land drills.

As with all efficient movement, cross-country skiing requires three contributing components – joint range of motion, muscular mobility and strength, and a properly firing operating system known as the nervous system. 

Movement can be likened to a symphony. The nervous system acts as the conductor, coordinating and harmonizing the range of motion (fluid movements allowing storage and release of energy) and muscular strength (stability providing the foundation). In cross-country skiing this symphonic relationship results in propulsion and glide with less energy expenditure. 

Cross-country skiing demands more than muscular might – it depends significantly on our nervous system’s effective recruitment of muscles and the teamwork of the muscles to create sport-relevant movements. We improve by increasing the coordination between the nervous system, our software and the musculature, our hardware.

Balance drills fire the nervous system, hone proprioception (system of pressure sensors in the joints, muscles and tendons from which the body gathers information to maintain balance) while training the smaller stabilizer muscles. These drills are multi-joint movements that require stabilizing strength. Stablizers are small muscles that support joints as well as large prime mover muscles.

While some of these balance drills focus on general balance, others mimic cross-country specific movements – to implement sport-relevant muscle memory. I like to use balance drills, general and sport-relevant, as a warm-up for my strength and plyometric workouts.

All of the balance drills take place single-legged and I format them in a series of circuits progressing from the floor to half-foam roller to dyna-disc.  This pattern mirrors all of my conditioning exercises and drills, which evolve from simple to more complex. In this case we add complexity by increasing instability from floor to half-foam roller to dyna-disc. As with all of our movements – the focus is first on finding posture by engaging the trunk, and then initiating with purpose smooth, stable, strong movements from our center.

One example of a balance circuit is to start by standing single-legged on the floor and work a deep knee flexion and extension. This movement simulates the sharp knee angle and supple ankle we incorporate to compress and drive the ski forward. As with all of our movements, my initial focus during these drills is to engage my trunk and find my posture – this is my anchor and balance point. Once I engage my posture I initiate the movement from the hip joint, focusing on working that important femur, hip independence, think of a Barbie or Ken doll. While I am flexing and extending, I am focusing on maintaining hip, knee, toe alignment – important in all of our movements and sports, equally relevant to cross-country skiing to establish and maintain that flat gliding ski.  

I further challenge the neuromuscular response system by swinging the arms, from the shoulders, in an alternating striding motion, while still working the deep knee flexion at different cadences and depths, to train upper and lower body disassociation, as well as balance. While continuing to work  knee flexion, I progress the arms to a striding double pole motion and then extend my arms overhead to challenge my center of gravity. I finish the series – still standing on the one leg, composing and finding my center and balance, then closing my eyes.

This seemingly simple balance-focused movement also effectively strengthens the glutes, quads and hips, as well as the previously mentioned small stabilizer muscles. You will feel every part of your standing leg and trunk working to find stability and balance – from the arch of your foot to your shoulders.

I repeat this entire series on the other leg standing on the floor, then repeat single-legged on the half-foam roller and then dyno-disc.

These balance drill series provide an opportunity to experiment and play with body awareness – and what it is that allows you individually to find your balance. I find my best balance when I engage my trunk – and then confidently create with purpose strong smooth movements around that anchor point.

With consistent practice, you will experience amazing improvement in balance, as well as condition the muscle stability and mobility. While in the initial session you may balance on one leg for a few seconds – you will soon triumphantly single-legged stand through the entire series. Where those small stabilizer muscles may initially scream, after a few sessions they will supportively sing.

See you down the trail for cross-country ski relevant single-leg strength conditioning, plyometrics – and taking it to the next step with dry-land technique and strutting it on the snow.

 

Seize the Season – Shift to Ski Conditioning

Calling all endurance athletes to mix it up this winter – rather than riding around in the rain in a soggy chamois and running in soaked socks  – check out cross country skiing. Now that you have an amazing fitness foundation from summer endurance training – shift your focus and fine tune training with an eye toward winter pursuits.

The change of seasons and its accompanying weather, forces us to mix up the workout routine. Don’t fight, go with it. We are fortunate to live in a climate with distinct seasons versus, southern California where every day is 70 degrees with a marine layer – boring. With the motivation of snow-capped peaks nudging us along – consider shifting to ski conditioning.

In the northern California and Nevada – we have the luxury of being out of the snow, but within striking distance to sliding. As cross-country skiers, we are spoiled by the proximity to the Truckee-Tahoe region’s world-renowned variety of XC centers, including – Royal Gorge and Auburn Ski Club, easily accessible at the Summit; Tahoe Cross-Country; Tahoe Donner; Northstar Resort; and Spooner Cross-Country.

The key to the ski conditioning training is staying motivated on those gray days, and maintain and build upon that superior summer fitness. The goal is to stay consistent, capitalize on the inspiring outdoor training opportunities the foothills afford, and gain more ski-specific strength indoors – to be at our best when the snow flies.

While I generally gravitate to outdoor-oriented workouts, gyms are a nice option in the fall and winter. But keep the gym workouts challenging and functional movement-oriented to train movements rather than single joint, body parts. As we focus on preparing for ski season, strive to mimic ski-movement patterns by incorporating agility, coordination, and balance in to the exercises to develop strength and power. Get creative. 

I like to start all of my workouts with movement preparation. These dynamic movements – increase core temperature; lengthen, strengthen and stabilize muscles; engage and stimulate muscles effectively “preparing” them for the athletic pursuit; improve balance and proprioception; fine tune the nervous system and feedback mechanisms; improve flexibility; and institute sport specific movement patterns.

As with all of our movements – when performing movement preparation – we want to find that strong solid posture, by finding our individual neutral spine and then drawing up on pelvic floor, while upper abs draw to the abdominal mid-point. Crown the movement by firing those glutes.

Effective movement preparation will activate our powerful glutes – in movement, we want to train them to be the prime movers. When doing squat maneuvers we cue to reach and sit in to our glutes, chest high, with tummy up and in. There is a significant difference to a squat that emphasizes the quads versus the glutes. When reaching and sitting in to and thus activating the glutes – your knees will be almost directly over your ankles – your tibia nearly vertical to the ground, and you will feel back on your heels. When squatting with the quads – you will have a sharp knee angle and knees will likely be directly over the toes or slightly in front of the toes, and you will feel the greatest impact in quads.

Movement preparation exercises include – backward, forward and lateral lunges; pike walk; single leg standing knee hug; single leg standing hip hug; standing quad stretch; and the standing foosball player, to name a few. And the potent mini-band series, which focus specifically on glute activation and isolating hip mobility and stability. There are a variety mini-band exercises including over the knees squats, rotations and walks; and over the ankles. This series definitely cleans out the hip-joint cob webs. 

Again the emphasis and value is in doing each movement well. After making the initial movement to hone mobility and coordination – take a moment to go through the check list – find balance; stability; solid, strong pillar posture (neutral spine, tummy up and in); and fire the all important glutes. Movement prep is not a race, more is not better – generate movement with diligent precision from your pillar and set the tone and foundation for your upcoming workout.

By including 10-15 minutes of movement preparation before your ski-specific conditioning workout you will reduce warm-up time and the “meat and potatoes” of our workout will be quality dense and effective. As we move toward winter with colder mornings and less light – movement preparation is a fantastic way to kick off the day.

See you next time when ski conditioning focuses on developing a dynamic core stability program, with subsequent columns to cover balance drills and single leg stability and strength, and concludes with the practice of potent plyometrics.