By Yasmine Hassan

The dos and don’ts to avoid tissue injuries.

Generally, exercise-related injuries are not caused by a trainer’s negligence, but in many cases could have been avoidable. With the increase of boot camp-style training’s popularity, there has been an increase in soft tissue overuse injuries.

Appropriate injury screening, prevention and management systems are essential, particularly when conducting groups with less one-on-one interaction.

Footwear

The biggest single factor you can influence in terms of lower limb injuries is footwear. Every pair of shoes has a certain amount of steps, after which they lose their shock absorption capacity. Once the shoe stops absorbing the shock, the leg does. Having a pair of shoes correctly fitted is essential.

Beware of Leather “walking” shoes. These shoes do not have the same degree of sole construction, in terms of density and shock absorption ability.

Did You Know?

Removing the shoe by stepping on the heel and forcing them off the lazy way stretches the shoe’s heel cup, causing a less snug fit. The rear-foot then moves around more in the shoe; decreasing stability. So, always untie laces before removing.

Training Error

One of the biggest contributors to soft tissue injuries is a sudden increase in training load, primarily running. Many clients think the pain must be normal as they haven’t exercised for a while or feel “soft” if they complain about it.

Tendons, muscles and bones adapt well with a structured and gradual increase in load. If the increase in load is faster than the adaptive ability of the tissues, then they will start to break down resulting in tendonitis, stress fractures, myofascial (muscular) pain and other injuries.

Tendonitis/Tendinosis

Tendonitis literally means inflammation of a tendon. The most common sites of tendonitis are the Achilles tendon, (back of foot), the patella tendon (knee), the extensor tendon of the elbow (tennis elbow) and the supraspinatus tendon (shoulder).

In general, tendons are very poor healers due to the low blood supply. Some studies suggest an average healing time of 12 months for tennis elbow and Achilles tendonitis.

Stress Reactions/Fractures

The most common stress reaction we see is shin splints (medial tibial stress syndrome). The most common causes are tight calves and excessive pronation of the feet (flattening of the arch of foot.)

On average, a stress fracture will take three months to fully recover.

Myofascial Pain

Myofascial pain refers to pain coming from muscles and/or fascia. It is common for clients to complain of progressively tight muscles or pain when commencing new exercise modalities such as running or higher impact classes. A myofascial trigger point is a “knot” or band within a muscle that tightens up, won’t let go with stretching and becomes a pain-generating source.

Did You Know? It is common for a trigger point to refer pain to somewhere else. For example, tightness in the shoulders/neck refers to a headache.

How can we reduce risk?

• Look for trainers who provide pre-exercise screening.

• Ask for a handout on what to expect from training, especially if you are coming from a low fitness base.

• It is not a “no pain no gain” situation, you should request to be informed about the difference between DOMS (Delayed Onset Muscle Soreness) and abnormal pain.

• Inform your trainer at the first sign of any new pain.

• Look for trainers with injury recognition qualifications.