Sports Pain Doesn’t Mean Gain

Injury prevention for triathletes

By Bruce R. Wilk, PT, OCS


Not only is it important to prepare for triathlons by swimming, biking and running, it’s necessary to learn how to avoid injuries that come from training, competing or everyday life. Injuries ruin your gains from training and keep you sidelined from competition. That’s why it’s doubly important to learn the causes of triathlon injuries so that you can prevent them. I’ve compiled the most up-to-date information on swimmers, runners and cyclists so that you can learn from the mistakes of others and thereby prevent them from happening to you.

A triathlon- related injury is considered to be any injury that occurs while training or racing in a triathlon. The largest misconception about triathletes is that their cross- training routines make them less prone to injury than other athletes. In reality, studies show that triathletes have an injury rate of 75 percent. Among Ironman competitors, that figure skyrockets to 91 percent.

Since the body is a complex mechanism that relies on combinations of muscle groups for power, balance and shock absorption, its not as uncommon for an untreated dysfunction in one part of the body to lead to problems elsewhere. For example, a knee injury can cause the low back to become excessively stressed, thus resulting in low-back pain.

Triathletes’ high frequency of injury stems from the complexity of the sport and the broad range of knowledge needed to train and compete safely. The triathlete must learn about appropriate equipment specifications, proper body mechanics and overall training programs that prepare the body for the physical stresses of triathlon. Because experience is most often your best teacher, you can prevent injuries by understanding the medical literature on injuries as they relate to swimming, cycling, and running.

Low rate of swimming injuries. Swimming has the lowest rate of injury and the fastest rate of recovery among the three disciplines. Shoulder pain is the most frequent symptom, causing at least temporary interruption of training and racing for 66 percent of all elite swimmers. In comparison, shoulder pain is experienced by 57 percent of all pro pitchers, 44 percent of college volleyball players and 29 percent of all javelin throwers, according to medical studies.

The large number of hours needed to excel in swimming, as well as the high frequency of shoulder movement needed for each training and competitive session, causes the higher rate of injury among elite swimmers. In most cases, swimmers suffer shoulder injuries resulting from overuse syndromes.

Treatment can include a combination of rest, icing, anti-inflammatory medications and physical therapy to eliminate motions that aggravate the shoulder muscles. Recovery should also include modification of stroke mechanics through proper coaching to decrease injuries, repetitive motions. With proper care and training, injured swimmers generally recuperate quickly and completely.

Beware of cycling trauma. Trauma is the most common cycling-related injury. The arms, face, head, and legs are the most often injured body parts. Approximately 600,000 cyclists visit emergency rooms each year because of training, competition and recreational accidents.

Collisions with automobiles account for nearly 99.5 percent of all cycling deaths and a similarly high percentage of serious injuries. Of course, the best solution to this widespread problem is training in areas with less traffic. Closed race courses also decrease the chances of potentially life-threatening injuries.

If traffic-free environments are not available, pay close attention to surrounding vehicles whenever you ride. Remain constantly alert, so that you can react quickly to potentially hazardous situations.

Sixty-two percent of all serious injuries among cyclists involve head trauma, a fact that underscores the importance of helmet use. Helmets reduce the likelihood of serious skull fractures by about 85 percent and decrease the incidence of facial injuries by more than 73 percent.

Cyclists can also fall prey to overuse syndromes that may cause pain in specific regions of the body. Around 60 percent of all competitive cyclists will experience serious neck or back pain during their careers. Knee pain is also common.

Other common overuse cycling injuries include ulnar neuropathy, a type of nerve damage to the ulna nerve of the wrist; and iliotibial syndrome, a tightness of the iliotibial band of the leg. Most of these problems can be prevented by adjusting the bike frame to your individual needs. Proper therapy can aid in reducing the symptoms.

Runners and overuse injuries. While cycling causes the most traumatic injuries, running has the highest incidence of overuse syndromes. About 90 percent of all runners experience injuries that will interfere with their training and competitive schedules.

Knee pain is the most common injury symptom among runners. Other frequent types of dysfunction include shin splints, Achilles tendinitis, plantar fascitis and iliotibial band syndrome.

Intrinsic or extrinsic factors cause running injuries. Intrinsic factors relate to actual anatomical features and motor functions- such as leg length and foot mechanics- that you have little control over. Extrinsic factors relate to external conditions experienced during training and competition, including running surfaces, shoes, schedules, distance and intensity.

Time is on your side if you’re a runner, because the rate of injuries tends to decline as you gain more experience. Researchers believe this tendency results from the fact that the musculoskeletal system becomes stronger after years of exercise and actually learns to function more efficiently. Runners also tend to run “smarter” with experience, learning from their earlier mistakes. Therefore, they become less prone to common overuse syndromes.

Who treats the triathlete? If you learn how to prevent injury, you may not need to know who treats injured triathletes. But, just in case…a recent survey of triathletes showed that 65 percent sought professional help for their injuries. Physicians were the most frequent type of professional sought after, while physical therapists were seen by triathletes with the second- highest frequency.

Putting knowledge to use. Your best bet at preventing injury is a training program that features balanced strength, flexibility and endurance through appropriate weight- lifting, stretching and cross- training. Your body copes with the varied stresses associated with triathlon competition when you exercise musculoskeletal groups that are related to swimming, cycling, and running.

According to medical literature, triathlon- related injuries are generally temporary. You can usually recuperate fully with proper medical and rehabilitative treatment. If you recognize the early symptoms of common overuse syndromes and react swiftly to traumatic injuries, you can avoid chronic dysfunctions and return to your sport with relatively brief interruptions in your training routines.

Copyright 2010 by Florida East Coast Runners and Bruce Wilk.  Reproduction or reprinting without written permission is illegal.

More Articles at