Injury Prevention and Load – Are You Conditioned?

With a lot of hardship and uncertainty surrounding us, it’s been so great for me to see so many people out exercising on a daily basis.  Sitting inside for unusually long lengths of time has prompted the daily run or walk (once seen as a ‘chore’ by some) transformed to a blissful escape into the fresh air and an opportunity to get the heart pumping. Whether it’s the search for a quick endorphin high, or even some active mindfulness to tie us over in an unsettling time, I’ve loved observing this change.

But what we are now seeing in sport and exercise medicine is an increase in injuries related to a spike in load. This relates to load progression or specifically the acute: chronic load ratio.  If chronic load is your base fitness (fitness built up slowly over time which is consistently performed) and acute load is your recent week(s) of activity (akin to the ‘fitness burst’ of lock down) then we want this to be a low number, a low ratio in order to prevent injury whilst getting fitter.  

Informally, if you take the metaphor of alcohol tolerance; you can’t go from drinking one glass of wine each night to eight glasses a night without paying for it in some (big) way.  Avoiding ‘binge’ exercise is the same concept. Building load needs to be slow with consistent progression to help condition the body for what you are ultimately wanting it to do.

In sport, an elite marathon runner with years of mileage under their belt may be able to run 140-160km per week with no significant issues, but on the flip side a relative sedentary athlete might break down if they go from no running for two months to running 20 km per week. This relatively low volume of training represents a proportionally high acute load to the more sedentary person. Injury means pain, reduced productivity and time off from whatever that may be.    

Becoming sedentary rapidly causes a de-training effect and the chance of injury is at its peak when returning to work, the mountains or the sports field if our overall load has dropped off, even transiently. If you’ve had 6 weeks off the building site and didn’t pick up a weight or do some specific maintenance loading during the lockdown the chance of injury is high as you return back to work. If you’ve spent a month playing play station and you are hoping to get in the hills with a pack for hunting or hiking post-lockdown, then now is the time to get some gradual loading and kms in your legs; before adding mountains and heavy packs - until the chronic load and conditioning is rebuilt.

Your tendons are your built-in load capacitors and, together with your muscles, support your joints so any programme should have a specific method where you show your body some load, have scheduled breaks to allow it to recover/adapt, and then increase it slowly in some way; duration, frequency, intensity and/or terrain.

Luckily a carefully designed programme can dramatically reduce the injury risk. It is the consistency of training (i.e. not getting injured and needing weeks/months off) that helps people achieve their goals. Like most things in life minimizing breakdowns is the key to productivity and success.

We have a wide array of local experts who can help with appropriate loading such as your local gym strength and conditioners, physiotherapists, coaches or guides in your specific field.A Sport and Exercise Physician can also help if you have a barrier to being active - health or injury-wise. Getting the right advice (and equipment) from the experts reduces the rate of injury and increases your longevity with exercise and your overall enjoyment being active – which ultimately is what it is all about.

Applying this to myself, 2020 sporting wise is dedicated to the year I finally learn how to skin and hopefully backcountry ski. This is particularly motivating given my love for trying new things and specifically anything involving going up a mountain. Being a new skill, I’m at risk for injury so it needs to be introduced with a plan.  My base fitness ‘chronic load’ has been worked on over many years and is high which puts me on a good platform – but to reduce my injury risk I’m working on my core, my posterior chain strength (specifically firing those butt and hamstring muscles), single leg stability to help my knee biomechanics. I’m also talking to an expert to get the correct equipment and doing more hill reps to condition my lungs for the cold, sunrise ascents....and yes I’m fizzing!

As my track and field coach father used to say ‘the wider the base, the higher the peak’, so gradually build that base load, seek expertise for any barriers such as injury, and use your local experts in your sport or activity to get some professional advice.  

A fantastic local video has done the rounds recently ending with “Queenstown, we will adventure again!”  I feel this deeply.  For most of us, it is a large part of why we live in this beautiful part of the world, and what better time to get physically prepared so we have less time on the sideline with injury.  Now is the time to focus on preparation and specific loading for whatever your personal adventure is. There are some stunning Queenstown sunrises to be seen from remote places up high!

See you soon

Dr Sarah Beable

To make an appointment with Sarah

Ph: +64 3 662 9400

Axis Sports Medicine - Queenstown is run by Dr Sarah Beable, a locally based Sport and Exercise Medicine Physician, she is one of the New Zealand Olympic team doctors and also works with the New Zealand Snow Sports team.  Sarah is a keen athlete herself and she has excellent knowledge of the demands of certain outdoor pursuits and physical occupations specialising in the diagnosis, and management tailored to your goal.