The Road to Recovery
An injury that derails your training plans can come as a bit of a shock to the system. Here's the SheCycles Clinic Survival Guide to recovery for both mind and body. And this time it's certainly from first hand experience!
BODY…
When you are injured you'll probably get back to training more quickly if you actively help your body recover than if you wait for the problem to resolve on it's own. There's always something that can be done while you're waiting for the healing process to do its stuff, but the first thing to do is acknowledge that you're injured and know when to stop.
Kim's swollen ankle and foot - Ouch!!
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Acute Injuries
Acute injuries are those that are caused by a single incident (often accident!) and usually result in immediate or rapid pain and swelling. Stop what you're doing! Pain, especially when associated with swelling or bruising, is your body telling you to stop to prevent further injury. After that, the well-known RICE approach will help in the early days (particularly the first 24 hours):
Rest
Stop using the injured part, or at very least minimise the stress on it.
Ice
Cooling the injured part helps reduce the inflammatory response by reducing the blood flow to the area. Take a bag of ice and wrap it in a towel (don't apply ice directly to the skin as this can cause damage) and hold it against the skin for 10 minutes. Repeat several times with 10-minute breaks between applications.
Compression
Applying gentle pressure can also help limit swelling. Elasticated bandage does the job well. If you do use this, don't let the sense of extra support around the injured area fool you into returning to use it!
Elevation
Keeping the injured part elevated will aid the return of circulating blood and help minimise swelling.
After 2-3 days, when the swelling has subsided, you may find it helpful to use a heating pad, warm water, or rub in deep heat. Warmth reduces stiffness and promotes healing by increasing blood to the injured part - but don't use it in the first couple of days as it will actually worsen swelling.
Early Mobilisation
Steps to relieve pain and swelling are only half the treatment. With most minor injuries, early mobilisation is key to regaining function while healing. To do this you should move the joint gently through a pain free range of movement, which will gradually increase as the stiffness decreases. Simple exercises such as drawing letters of the alphabet with your toes are useful for ankle injuries.
After this you can move on to stretching and strengthening. Again, you should avoid doing anything that causes pain. Stretching should be planned and gradually increase the range of movement over a period of time. Strengthening exercises should initially involve a very light resistance using something like a Theraband, before moving on to activities done using body weight.
Proper Rehab
The most important message is that proper rehabilitation for acute injuries can prevent poorly healed acute injuries become niggling chronic injuries.
Chronic Injuries
Chronic injuries are also known as overuse injuries. They are caused by repeated motions over time, and can be due to doing too much too soon or too hard.
The same initial management with RICE and early mobilisation helps kick things off. If you're lucky, and have recognised the problem early enough, then stopping for a couple of days or cutting back on the activity that's caused it may solve the problem. Being self-aware is key here - many of these injuries can be avoided by listening to your body and knowing when a rest is needed. Switching to an alternative exercise, for example swimming for a few days off the bike, may stop the niggle becoming an injury.
When the pain and swelling settles, return to training at an easier level than where you left off. It is also worth trying to work out what cause the injury. The most common cause for injuries in cyclists is either crashing the bike (definitely an acute injury!) or a poorly fitted bike. You may need to also look at your pedals and cleats, this is your body's main interface with you bike so ill fitting cleats can cause havoc with your natural biomechanics. If you have knee pain, then look at your saddle height. For back pain, look at changing the reach to your handlebars. Once you've looked at this then the last thing to check is your technique. Suboptimal technique can put unnecessary stress on your body too.
…MIND AND SOUL
An injury can be an emotional as well as physical setback and the healing process can certainly be affected by what goes on in your head. Depending on the severity of the injury (or even the context of the circumstances) it can feel devastating. The good news is that recognising the psychological and emotional dimensions of your injury can help you on the road to recovery.
Positive thinking and a sensible approach to healing will help you get back on track to full fitness. Here are a few ways you can meet the challenge:
Planning & Preparation
Successful recovery begins with understanding your injury. It's important to know as much as possible about the nature and extent of the injury, how long recovery is expected to take, and what you need to do to recover.
If you end up seeing a doctor, physiotherapist, or other sports therapist then make sure you try to get the answers to as many of these questions as possible. They may not be able to give you exact details (everyone's body is different) but should be able to give you a rough guide about what can be expected.
Once you know this information you can start planning your return to full fitness. Having a rehabilitation plan is as important as a training plan!
Attitude Adjustment
This is probably the most important part and probably the most difficult. It is well known that an injury can result in a grief type reaction with feelings of denial and anger before acceptance. The higher level of competition or the more serious the injury the more intense the emotions are likely to be. Many world-class athletes say that the most difficult thing to deal with is an injury.
You will probably feel like you want to get back to the level you left off from straight away. You need to accept that your body isn't going to be able to initially, but with sensible planning and gradual training it will be able to in the near future. It's important to remember the time scale you're working to when you get back to training. Keeping this in mind means you're less likely to feel frustrated about slow progress, or do too much too soon and end up back at square one.
Think positive. There's plenty you can be doing in the meantime…
Healing Techniques
Progressive Relaxation
A fancy term given to allowing yourself some chill out time! Using relaxation is a great way of getting you in the best state possible for the task ahead, whether it's racing or rehab. In the early days, try to make the most of the opportunity to give your body and mind a rest from the gruelling task of regular training. Then try some active rehabilitation.
Active Rehabilitation
We've already mentioned the benefits of early mobilisation including stretching and strengthening. The next progression is active rehabilitation.
Toning
Use this as a chance to do some training for other parts of your body. If you've injured your lower body then you can exercise your upper body and vice versa. Toning exercises - by which I mean low resistance, multiple reps, usually using no more than your own body weight - are an excellent way to improve muscle tone and strength, which will help when you get back to full training.
Swimming
Most injuries benefit from some form of hydrotherapy. The water supports your body while your exercising so minimal stress is put through the injured part. It's a great way to do some exercise as well as promoting muscle strengthening and reducing joint stiffness.
You may also benefit from Sports Therapy at this stage. The most well known is physiotherapy, but there are many health professionals out there to help you with your injury. Look out for the Guide to Sports Therapy coming next to SheCycles Clinic.
Top Tips
Know when to stop! Then RICE…
Early mobilisation, including gentle stretching and strengthening exercises can be done early on once the swelling has settled.
Make sure you look after acute injuries to avoid them becoming niggling chronic injuries!
Check bike set-up if you keep getting the same injury.
Some attitude adjustment and rehab planning will do wonders for your return to fighting fitness.
Include some toning exercises and swimming in your rehab training.
DISCLAIMER: Advice and information is provided via SheCycles.com Clinic on a free of charge basis as a supportive service to women in sport. It should not replace the use of your General Practitioner for medical problems. Copyright 2007 Dr K Hurst
Tina-M
