Our A to Z guide to triathlon injury and illness collated from Triathlon Plus magazine.

Triathlon Injuries - Muscle Strains

Triathlon training can cause injuries all over the body

Undertaking triathlon training plans can mean heavy workloads in three sports, which can in turn put the body under strain, leaving triathletes especially prone to certain sports injuries and illnesses. Below, we’ve compiled our guide to triathlon injures to help give you an overview and potential treatments to get you back in the pool or on the road. The information below is not a replacement for proper medical treatment and if in doubt, always err on the side of caution and book an appointment with your doctor or physiotherapist.

Click on the headings below to find out more about each triathlon injury.

A
Achilles Tendonitis
Athletes Foot
B
Black Toenails
Blisters
C
Calf Soreness
Chafing
Cold Prevention
Collapsing Arches
Cramp
D
Dehydration
G
GI Distress
H
Heat Stroke
I
IT Band Syndrome
J
Jet Lag
I
Insomnia
K
Knee Pain
M
Mental Crash
Muscle Strain
N
Neck Pain
O
Overtraining Syndrome
P
Piriformis Syndrome
Plantar Fasciitis
Post Ironman Blues
Postural Hypotension
R
Restless Leg Syndrome
Road Rash
Runner’s Knee
S
Saddle Sores
Sciatic nerve pain
Seasonal Affective Disorder (SAD)
Shin Splints
Snapping Hip
Sprains
Stitches
Stomach Distension
Stress Fractures
Swimmer’s Ear
Swimmer’s Shoulder
T
Tarsal Tunnel Syndrome
Torn Rotator Cuff

Achilles Tendonitis

More than 1 in 10 running injuries are caused by this problem.

The Achilles tendon is the largest tendon in the body, and connects your heel bone to your two calf muscles. The tendon is crucial for walking and running, as it provides you with the power to spring forward at the start of your stride.

Due to its location in the body, the tendon has relatively poor blood supply, so this makes it vulnerable to injury and slow to heal. Tendonitis occurs for a number of reasons and is described as acute when it comes on suddenly, or chronic when it develops over a long period of time. It is difficult to treat and the most easily identifiable symptoms include swelling, redness and pain when walking up and down hills or stairs.

FOUR COMMON CAUSES OF ACHILLES TENDONITIS

  • Suddenly increasing your training could make acute tendonitis in your Achilles flare up. This increase could be running faster, further
    or up hills without a gradual build up to the increased workload.
  • You might find overpronation in your running stride is a long-term cause. This is when your foot rolls in too much and puts increased pressure on the tendon. Specialist running shoes can help to correct this problem.
  • For ladies, wearing high-heeled shoes too often can weaken the tendon. This shortens the tendon and the calf muscle, and subsequent training in flat shoes stretch them beyond their normal limits.
  • Weak calf muscles increase pressure on the Achilles tendon, so you need to do exercises to strengthen them. Tight calf muscles decrease the ankle joint’s motion, which also weakens the tendon.

Athlete’s Foot

Three-quarters of us will suffer from this common infection, which thrives in damp changing rooms and sweaty training shoes making it a double threat for triathletes. Here’s how to treat and prevent athlete’s foot.

Black Toenails

This nasty ailment can destroy training programmes and races. Pressure builds up under the nail from the battering running gives your feet, making the affected toe extremely painful. Here’s how to treat and prevent black toenails.

Blisters

Avoid the swelling every triathlete dreads.

We’ve all experienced the nagging soreness of blisters, and it’s not fun. For middle- and long-distance athletes, blisters are
a constant menace. “A blister is caused by an abrasion on the top of the skin,” says consultant podiatric surgeon Mike O’Neill. “This is caused by shearing stress – repetitive backwards and forwards friction. The blister develops to protect the skin.” Although painful, O’Neill suggests only popping them if strictly necessary. “Heat up a pin over a match to sterilise it,” he says. “Then make two very small incisions either side of the blister to allow the fluid to drain. Then dress the wound and strap it up.”

FOUR STEPS TO PREVENTING BLISTERS

  • Make sure your running and bike shoes are a comfortable fit. It seems obvious, but most blisters are caused by ill-fitting shoes. If you’re going to be racing, break in your shoes a couple of weeks in advance.
  • Make sure that you have the best socks for the job. Go for acrylic or acrylic/cotton mix socks, or special ‘blister free’ sports socks that are designed especially for endurance athletes.
  • Many people believe a pre-race dusting of talcum powder is the answer, but research suggests otherwise. Talc actually increases friction and therefore your chances of getting blisters.
    Don’t be tempted!
  • According to our expert, the best way to prevent blisters is to rub surgical spirit into your feet after showering for a week before racing. “It really does work,” O’Neill says. “It prevents blisters in 70 to 80% of cases.”

Calf Soreness

Sore calves are a common problem amongst triathletes, so ensure you limit their effect.

Calf pain regularly affects most sportsmen and women, and triathletes are no exception. Tightness is usually found during or after the running leg, mainly brought on by the rapid switch from bike to run because of the different muscles that are used in each discipline. It occurs when the calf muscle is stretched beyond its natural limits through excessive force or repeated use. “Preventative measures can be taken by incorporating calf-specific exercises into your gym routine, such as calf raises [go to fitstep.com for examples],” Emma Deakin of the English Institute of Sport says. But if you do suffer soreness, don’t try to race through it. Rest for a couple of days if the pain is mild, but if the pain is acute then make sure you take action quickly.

FOUR WAYS TO TREAT CALF SORENESS

  • Ice packs Elevate and apply ice for 20 minutes every couple of hours to reduce bleeding and tissue damage within the muscle. Never apply ice directly to bare skin though .
  • Compression bandages These are inexpensive and using them will reduce the swelling. They provide ‘resting pressure’ to the effected area, which aids your rehabilitation.
  • Resistance bands If there has been a specific tear in the calf muscle, using these will ensure that the scar tissue is aligned properly – reducing pain and enhancing healing.
  • Shock absorbing insoles Worn inside your running shoes, these reduce the stress as you complete your rehabilitation. They can also prevent recurrence.

Chafing

Chafing can be especially bad while running, but also affects triathletes while swimming and cycling. Here’s how to avoid chafing.

Cold Prevention

Sidestep coughs and sneezes with our cold- prevention tips.

It seems perverse that endurance athletes, particularly triathletes, are more susceptible to catching common colds than those who do little or no exercise. It sounds illogical – especially as moderate exercise actually boosts the immune system – but it’s true. Certainly, there’s nothing that ruins a block of training like a nasty cold. Exercising while you’ve got a cold will make you feel worse, not better, draining your body of valuable energy it needs to fight the infection. If you must exercise, load up on carb-heavy sports drinks to fuel yourself. It’s impossible to escape colds completely, but there are steps to cut down the risk of infection.

FOUR STEPS TO STOPPING THE SNIFFLES

  • Wash your hands regularly with soap and water. Cold viruses live for hours on work surfaces and door handles. Washing your hands regularly – or using alcohol-based hand gel – cuts your chances of infection.
  • Stay out of crowds and away from children. The chances of catching a cold from human contact are slim, but the chances are far higher in crowded areas, and children are notorious carriers, so steer clear if possible.
  • Get your fair share of vitamin C. It has been proven to strengthen the immune system, making it the ideal thing when your body has taken a battering from the germs. Supplements are ideal for this.
  • Eat well. When you’ve got a cold, it’s not always what you want to do, but eating properly helps fuel your body’s fight against the cold. If you’re going to be back training as soon as possible, tuck into fruit and veg.

Collapsing Arches

Flat feet can flat-line your speed and endurance. Fallen arches can occur for a number of reasons and restoring strength can prove a very difficult task. This is usually a long-term injury and it can be best to adapt with orthotics. Here’s how to treat fallen arches.

Cramp

Cramp can strike at the most crucial of moments during a race and seems to target tired muscles. Smooth out sudden knots so you can train well every time with our how to stop leg cramps guide.

Dehydration

Staying properly hydrated enables your to maintain performance levels. The longer and hotter your triathlon, the more important it is to have a strategy to deal with dehydration. Here’s how to avoid getting dehydrated.

GI Distress, Runner’s Trots

Avoiding the runs when you’re out on a run isn’t something most athletes want to think about, but the runner’s trots are extremely comming when racing long and can spoil a race you’ve been prepping all year for. Here’s how to prevent runner’s trots.

Heat Stroke

When temperatures rise, make sure you keep heatstroke at bay or you could be looking at the medical tent rather than the finish line. It’s a threat in any hot, sunny race, so stay on top of it to perform at your best. Here’s how to avoid heatstroke.

Jet Lag

Underestimating the effects of travel can ruin your big race.

We triathletes are a jet-setting bunch. One of the major selling points of our sport is the opportunity to race in some exotic, far-flung places. But travelling across multiple time zones to reach the start line is a hazardous business, and if you ignore the potential pitfalls of jet lag and don’t take steps to avoid it then your performance on race day can be compromised, and you won’t be able to do yourself justice. After all, what’s the point of flying thousands of miles if you aren’t able to show your best form? Some of the symptoms include fatigue, nausea, interrupted sleep patterns and even constipation – none of which you want pre race. Here’s how you can avoid it.

FOUR WAYS TO LIMIT THE EFFECTS OF JET LAG

  • The week before you travel, adjust your body clock by ‘living’ in the time zone of your race destination – try to make sure you
    get up and go to bed at local time to where you are going.
  • On the flight out there, try to avoid dehydration by making sure you drink plenty of water and avoiding alcohol and caffeine, which can disrupt pre-race sleeping patterns.
  • If possible, on really long trips, try and break your journey overnight by staying in another city en route. This will help to limit your body’s exposure to jet lag, so you’ll be under less stress.
  • On arrival, avoid trying to sleep off the jet lag in one go. It has been proved that exposure to sunlight combats its effects, so instead of hitting the sack, get out and about when you can.

Insomnia

 Restless nights can be hugely damaging for triathletes.

We’ve all tossed and turned into the small hours of the morning, unable to drift off to sleep. All sorts of factors contribute to a sleepless night – stress, diet, temperature, noise and hormones to name just a few. Sleeping well on a consistent basis is also about routine in exactly the same way as your training is. In fact, you should consider a good night’s sleep as a crucial part of your training – just as important to your performance levels as your brick training and those long hours spent in the pool. If you are unable to sleep properly your mental and physical wellbeing will be compromised and that PB you’re chasing will be further away than ever. Try these zzz-inducing tips.

FOUR KEYS TO A GOOD NIGHT’S SLEEP

  • Decide on a regular bedtime and stick to it, even at weekends. If you find that you can’t drift off within a few minutes, get up and do something. Worrying about sleep only makes it worse.
  • Keep an eye on your diet and eating patterns. Have your main meal as early as possible (at lunch if you can) and don’t eat anything after 8pm. Also avoid caffeine and alcohol.
  • Keep your stress levels under control. Try making lists, organising yourself and prioritising things you have to do. Ensure you have plenty of time relaxing with friends and family.
  • Create a bedtime routine. Have a warm bath and some time reading a book or listening to gentle music. Avoid TV and computers, as electronic goods prevent you from relaxing.

Knee Pain

Learn how to manage this all-too-everyday cycling injury

Just like running, cycling can produce overuse injuries – especially in the knees. The most common is patellofemoral pain, and it accounts for around a quarter of all cycling injuries. Causes are typically: poor muscle flexibility; incorrect bike set-up; and excessive side-to-side swinging of the leg during the downstroke. Sudden training changes can also result in the pain, as can too much hill training or a volume increase. Symptoms include locking knees, cracking noises and swelling, and the pain can last for just a few minutes post-workout or several hours. In acute cases the pain simply doesn’t subside without total rest over a number of weeks.

FOUR WAYS TO COMBAT PATELLOFEMORAL KNEE PAIN

  • The most fundamental way to avoid knee pain is to check the set-up of your bike. This should be done by a professional bike mechanic, who will check your pedals, seat height and body position on the bike.
  • Strengthen your knee muscles so they’re more injury-proof in future. This can be done with some very simple but effective leg exercises such as squats, leg extensions and hamstring curls.
  • Regulate your training to avoid any shock to your knees. Avoid big changes to the frequency and intensity of your workouts. Build up the workload gradually and give yourself ample recovery time.
  •  Check your pedaling technique, as poor execution on the downstroke is a major cause of injury. Coaches or instructional books are the best way to go about this, depending on your budget.

Mental Crash

Avoid a mental crash mid-race with our tips on nutrition.

Sometimes a race can be going exactly to plan and you feel on top of the world. The next minute your head is full of negative thoughts: ‘you can’t do this’, ‘you’re a rubbish runner’, ‘why do you bother?…’ This morale slump is common in long events and is often a result of low blood sugar and fatigue. Mental strength plays a huge part in success in triathlons and employing the right strategies can help you through this. “Low blood sugar is the most likely cause,” says Kevin Currell, sports nutritionist at the English Institute of Sport, “or it could be general fatigue: you’re getting tired and hormones are telling your body you’re knackered.”

FOUR STEPS TO AVOIDING THE CRASH

  • Get your nutrition right. Apart from anything, a good fuel strategy will help you perform better. Keep your blood sugar even .“You need 60g of carbs per hour spread out, so 20g every 20 minutes,” says Currell.
  • Be prepared for it. In a long race – anything over Olympic distance – you won’t feel ‘up’ every second, but knowing you’ll face a slump and survive helps. Going long in training is a good way to be ready for this.
  • Have a mantra. Many pros use self-talk to get through tough patches – you’ll need one ready, as you’re unlikely to think of one once you hit a slump. Try simple phrases like “I can do this” or “I’m strong”.
  • Set realistic goals. If you train for a sub 12-hour IM but are secretly hoping for sub 10, you’ll be disappointed by half way. Have three times in mind: your ‘dream’ time, your ‘good’ time, and your ‘satisfactory’ time.

Muscle Strain

Avoid one of sport’s most common injuries – muscle strain.

Muscle strains happen when muscle tissue is over-stretched as a result of becoming overloaded, at which stage a breaking point is reached and it tears (or partially tears). Grade involves only a small tear to less than 5% of the muscle fibres, requiring two to three weeks rest and gentle stretching and massage to realign the new scar tissue; grade involves a partial tear of more fibres, requiring four to six weeks’ rest, stretching and re-strengthening; and grade involves a complete rupture that may require surgery and up to three months of rehabilitation.

FOUR WAYS TO PREVENT MUSCLE STRAINS

  • Warm up and warm down properly. Increasing muscle temperature by one or two degrees before serious exercise reduces the risk of muscle strains. Sessions should last at least 20 minutes and involve stretching.
  • Increase and maintain your muscle strength through weight training and traditional exercises. This lets your muscles function in a controlled way, which reduces over-stretching and overloading.
  • Sort out your technique. An inefficient or unorthodox running, cycling or swimming action can put pressure on certain muscles and lead to a serious strain, which could put you on the sidelines for weeks.
  • Check your diet. You need to make sure you eat enough carbs before and during a race to aid muscle contraction. A shortage of them will cause your muscles to fatigue and be more susceptible to injury.

Neck Pain

Riding in an aero tuck can lead to neck pains.

Triathletes tend to be especially prone to neck pain due to the low aerodynamic position adopted on the bike, which means the rider is continually craning their neck up to look forwards. After riding for prolonged periods this can create tightness, pain, muscle spasms and, in some cases, even make it almost impossible for the rider to hold up their head. This aching is especially likely to occur in longer races such as Ironman-distance, where the neck is already fatigued from the swim, or where an incorrect fit on the bike means an excessive reach to the handlebars. However, it is a problem that can also occur while training or competing in shorter- distance races, so it’s important to be mindful and take some steps to prevent its onset.

FOUR WAYS TO HELP PREVENT NECK PAIN

  • Make bars higher – losing a few seconds is a small price for staying pain- free. Try increasing spacers or use a steeper stem to raise the bars so that you don’t have to crane your neck.
  • Move around as you ride – you might think you’re better off staying aero (even up hills), but getting out the saddle means your neck is resting on your back rather neck muscles.
  • Increase distance gradually – don’t go from sprint to Ironman in one jump, get used to doing more miles in the aero position, changing your bike fit in small increments if you need to.
  • Strengthen neck muscles – neck extension exercises, where you put your hand on your forehead and gently apply resistance while you move your head to your chest is a good one.

Overtraining Syndrome

Pushing yourself too hard in training can give you serious health problems

We all know how addictive training and exercise can be, and it’s easy to think the harder you push yourself, the more rapid improvement you’ll find in your fitness and performance levels. To an extent this is true, but training too hard and not giving yourself time to recover can result in overtraining syndrome. This condition is more serious than you might think and can result in constant tiredness, a damaged immune system, depression, weight loss and disturbed sleeping patterns. It will also see you line up at the start burned out and unable to do yourself justice. Take these steps to ensure you don’t suffer.

FOUR WAYS TO PREVENT OVERTRAINING SYNDROME

  • Space out your races sensibly – having too many goals and too many targets close together throughout the season puts you under pressure to train constantly, and won’t give your body time to recover.
  • Make sure you have rest days – allow at least one day of complete rest per training cycle. For most people this is one day per week. It’s important to do nothing on these days. Plan other non-sport activities to distract you.
  • Vary your training schedule – never do two identical sessions in a row. Alternating between high intensity speed training and low intensity endurance training is a good way to balance things out.
  • Keep an eye on your nutrition – maintaining muscle glycogen levels during periods of heavy training combats fatigue. Topping up carbohydrate levels within 30 minutes of training is essential.

Piriformis Syndrome

This muscular problem is a real pain in the butt

Incredibly difficult to diagnose, piriformis syndrome often presents with a constant, dull pain and tingling in the middle of the buttock, lower back or upper leg. The piriformis is a deep muscle threaded through the rear of the pelvis. If the muscle is caused to spasm, its proximity to the sciatic nerve can cause the nerve to become irritated, resulting in the pain felt by sufferers of the syndrome which might spread right down the leg on the affected side. The spasming can be caused by a variety of activities, from overstretching while running to sitting for long periods or tight hamstrings. Piriformis syndrome is particularly difficult to overcome as the muscle is situated so deeply in the buttock so stretching alone won’t help. It takes a plethora of combined treatments to make a full recovery.

FOUR WAYS TO OVERCOME PIRIFORMIS SYNDROME

  • Excluding sciatica or other potential causes for the pain is key to diagnosis. Your doctor should be able to examine you and find the spasming muscle to confirm that you have piriformis syndrome.
  • Physiotherapy is important for piriformis syndrome: the stretches that help reduce spasms need to be done under professional guidance, while massage can also be valuable.
  • A multi-treatment approach is often needed, with anti-inflammatory injections, strengthening exercises, heat, cold, ultrasound and electric stimulation all elements of successful treatment.
  • Due to the complexity of the problem and its many treatments, it’s crucial that you follow the instructions of your doctor or physio closely to get rid of piriformis syndrome for good.


Plantar Fasciitis

This foot injury can lead to knee pain and surgery – so know your enemy.

Ever Felt tightness or pain along the sole of your foot? If so you’re probably suffering from one of the most common injuries that afflicts runners and triathletes in their droves. The condition is plantar fasciitis, caused by inflammation of the plantar fascia – the thick connective tissue that runs from the heel to the metatarsal bones and supports the arch of the foot. The main cause of plantar fasciitis is sudden weight gain, but in athletes it’s repetitive strain from running. One symptom is pain as you take your first steps after a night of rest. People who suffer from this are likely to develop knee pain, so you must get treatment.

FOUR WAYS TO COMBAT PLANTAR FASCIITIS

  • Wearing the right running shoes is the easiest preventative step. Having your gait measured electronically can reveal flaws in your stride, and specialist shoes provide support to the arch of the foot.
  • Stretching your calf muscles and your plantar fascia before and after exercise increases the strength and flexibility of the connective tissue and reduces the chance of plantar fasciitis.
  • If you are getting regular pain, wearing a night splint is an excellent way of relieving it. The splint will stretch the calf muscles and plantar fascia overnight, reducing tightness in the morning.
  • Total rest is a last resort, but often necessary to avoid surgery. Pressure on the plantar fascia makes the problem worse, so resting until you are
    pain-free is frustrating but effective.

Post Ironman Blues

A big race can be a huge height to come down from.

The feelings of excitement, satisfaction and elation after finishing an Ironman can soon give way to depression, isolation and disappointment after the race. This is known as the Post-Ironman Blues. All of a sudden there’s nothing; no life-changing goal on the horizon, which can lead to you feeling a bit empty. This is compounded by the immediate freeing up of hours normally spent training and can create an emotional slump. There are also chemical factors involved. The race creates massive amounts of adrenaline, and the stress and anxiety hormone cortisol is also released into the body. Exercise is directly linked to the production of endorphins, so a sudden lapse in exercise regime can create a withdrawal effect.

FOUR WAYS TO BATTLE THE BLUES

  • It’s OK to relax, enjoy life and not worry about about training or that takeaway curry. You’ll deserve the rest and you can use the extra time to reconnect with family and friends.
  • By the end of your Ironman, your body will be addicted to endorphins. Swimming is a gentle way to recover and maintain activity levels, but remember to rein in your normal intensity.
  • Surround yourself with family, friends and likeminded athletes who appreciate what you have done. Sharing thoughts and feelings can help you move past the race.
  • Remember that beneath the hype and expectation an Ironman is only one race and one day of your life. However, if the feelings of unbearable sadness continue, go and see your GP.

Postural Hypotension

Stay free from dizziness after your swim.

Have you ever felt disorientated when you exit open water after the swim? Well it happens to us all from time to time. It’s known as postural hypotension – in layman’s terms, dizziness – a common condition among swimmers and triathletes. When you stand up quickly from a lying position the pressure at the head is low and the pressure at the feet is high, which leads to symptoms of dizziness, light-headedness and nausea. This can take you by surprise, as you’re unlikely to feel the effects until you head towards Ton race day when you’re powerless to stop the problem affecting your race.

FOUR WAYS TO FIGHT POSTURAL HYPOTENSION

  • Hydration. It may seem simple, but proper hydration is crucial if you want to perform at your best. Keep taking in a mixture of water and sports drinks right up to race time, and continue to take on fluids as you go.
  • Compression suits. Even blood flow combats postural hypotension, and these suits ensure blood runs evenly through the body. Most tri suits are compression fit, and long-legged swim suits are available too.
  • Practise water-to- bike transitions. It’s crucial to be prepared for race day, so make sure you have got your swim-to-bike routine fully practised, whether it’s in open water or in the pool. Make it second nature.
  • Breathing techniques. Using techniques such as the Valsalva and Frenzel manoeuvres (see healthline.com) regulate the pressure in your head as you exit the water. Practise them with caution first though.

Restless Leg Syndrome

This inherited condition will sap your energy, damaging races

Inactivity is difficult enough for most triathletes without sleep being disrupted by the feelings of gnawing tingling and leg jerking that characterise restless legs syndrome (RLS). The condition, which affects more than five million people in the UK, occurs at night or when at rest for long periods of time. RLS causes insomnia, fatigue, slow thought processes, anxiety and even depression. More than half of all RLS sufferers inherit the condition and researchers believe an imbalance of dopamine – a chemical in the brain used to control muscles – could be the problem, as levels drop towards the evening. Another possible reason for RLS is low iron levels, which accounts for about 20% of cases.

FOUR WAYS TO COMBAT RESTLESS LEG SYNDROME

  • Establishing a sleep pattern will help ensure your body is ready for rest. Try to avoid naps near bedtime and get your body used to getting up and turning in at the same time every day.
  • Studies have shown regular exercising during the day may reduce symptoms of RLS. However, exercising too close to sleep can have the opposite effect, so plan sessions wisely.
  • Relaxing before bed can be a great preventative measure, so try having a warm bath, reading or listening to some calming music – but avoid eating late, caffeine, tobacco and nightcaps!
  • If problems persist get yourself checked out by your GP. A simple blood test will let you know if your RLS can be treated with iron supplements or if more investigation is needed.

Road Rash

Wave goodbye to those painful skin abrasions.

Every triathlete has fallen foul of the dreaded road rash at some point. For those unfamiliar with the term, it refers to the unpleasant skin abrasions – or grazes, as your mum would call them – usually picked up by crashing your bike or stumbling while running. The abrasions are caused by the friction of soft skin hitting a hard surface, which means layers of skin are rubbed off. Most abrasions are not that serious and rarely break more than a couple of layers of skin, though high-speed bike crashes and full-throttle falls while sprinting can lead to deeper cuts. If this happens, it’s best to get it checked out medically – a deep cut may need stitches.

SAVE YOURSELF FROM SKIN SCRAPES

  • It’s impossible to prevent a case of road rash. But wearing protective clothing (such as below-knee tri suits, jogging bottoms or long-sleeve tops) helps, as longer trousers or shorts won’t come to your rescue.
  • After any road rash injury you should clean the wound. This prevents dirt and grime getting in and causing infection. It will sting a bit due to nerve ends in the skin being exposed, but soap and water will do.
  • While cleaning the wound, check for deep cuts that need greater medical attention. Cuts that bleed for more than 15mins after applying pressure, or that have edges that pull apart, will need stitches.
  • Cover the cut with a semi-permeable dressing. This will protect the wound and keep it moist, which is better for the healing process, as it helps new skin form. Change the dressing every few days until the wound heals.

Runner’s Knee (IT Band Syndrome)

Runner’s Knee is one of triathlon’s most common injuries and can put you out of action for weeks or months if it’s not dealt with properly. Here’s how to spot and treat runner’s knee.

Saddle Sores

Discomfort from this is common for cyclists – and triathletes are no different.

A quick poll in the office revealed all of the Triathlon Plus team had suffered saddle soreness at some stage. Spending lots of time doing hard physical exercise in an unnatural position on a small seat means that it’s hardly a surprise that our thighs and derrieres have endured the discomfort it brings. It’s considered a beginners’ ailment, but can affect experienced riders if they have changed their apparel, saddle or bike. Saddle soreness includes chafing, from constant rubbing; boils, from a lack of hygiene; inflammation of the thighs and buttocks; and skin ulceration, where chafing causes lesions in the skin.

FOUR WAYS TO FIGHT SADDLE SORES

  • Invest in a decent saddle. There are no shortcuts here – you will get what you pay for. Take advice from an expert, make sure it fits your own shape, and remember the lightest isn’t necessarily the best.
  • Check your saddle’s position. If the saddle is too high then you will be moving side-to-side with every single pedal stroke, which will cause discomfort. Setting it too low is equally problematic.
  • Pick a high-quality chamois. This is your saddle’s first point of contact with your skin, so is critically important. The more expensive the better – what’s the point buying a top saddle and scrimping on the chamois?
  • Stay hygienic. Make sure you get out of your sweaty cycling shorts as soon as you finish your session. Never wear them twice without washing them – they are a breeding ground for bacteria.

Sciatic nerve pain

Shoot down this sharp pain by loosening your glutes and back muscles.

It’s often associated with middle aged people, but sciatic nerve pain is more common than you would think among sportsmen and sportswomen. Pain is caused by pressure on the sciatic nerve, which runs from the lower back right down the leg. With triathletes, it’s likely to be caused by tight glutes or tight muscles in the back, although it could be due to a slipped disc. Pain down the leg and pins and needles are the most obvious symptoms; and pain in the lower back and potential muscle spasms, too. The pain gets worse as the day goes on. You may also feel pain in your lower back when pressing into the affected area.

FOUR WAYS TO TREAT SCIATIC NERVE PAIN

  • Complete bed rest in the initial stages, usually with a lengthy course of high strength anti-inflammatory painkillers such as ibuprofen – prescribed by a doctor.
  • Muscle spasms can be countered and also prevented with the application of heat. This can be in the form of a hot bath, or via the use of a back brace that helps retain body heat effectively.
  • A sports injury specialist can help with lingering and acute cases. They are able to provide treatments like mobility exercises, massage and even ultrasound. It’s well worth the money.
  • Strengthen the core muscles around the spine to prevent a recurrence. Examine your technique to check you aren’t applying extra pressure on your back when running or cycling.

Seasonal Affective Disorder (SAD)

Combat the winter blues with these tips to lighten up.

According to recent research, one in four people in the UK suffer from Seasonal Affective Disorder (SAD). The World Health Organisation recognises it as a condition that is seen between October and April, when there’s a reduced amount of natural light, which causes a chemical imbalance in the brain. Melatonin, a hormone that causes drowsiness, is prevalent on dark winter mornings and dull gloomy days and can cause people to suffer from the symptoms of SAD. These include sleep problems, overeating, depression and a lack of energy – all of which can play havoc with your training regime.

FOUR STEPS TO LIMIT THE EFFECTS OF SAD

  • Try to make the most of the limited daylight on offer in the winter months ­– sit by a window at work and go outside on your lunch break. If you’re at home, go outside in the fresh air for a walk as often
    as possible.
  • Book yourself a winter holiday somewhere sunny to escape the gloom, but keep in mind that it’s brightness that will make the difference rather than heat. It’ll also give you something to look forward to.
  • Maintain a healthy, balanced diet and continue to exercise regularly, preferably in the open air. Eating the right foods gives you extra energy, and exercise will help form regular sleeping patterns.
  • Invest in a light-therapy product, such as the ones available from Lumie (www.lumie.com). These are medically proven to combat the effects of SAD and thus boost your winter performances.

Shin Splints

Avoid one of running’s most awkward and persistent injuries.

Every triathlete spends many hours running on roads, and repeated exposure to hard surfaces can lead to an injury that all athletes fear – the dreaded shin splints. Symptoms include pain over the inside lower half of the shin, swelling, redness, lumps and bumps on the inside of the shin bone and pain at the beginning of exercise that eases off as you go. Uncomfortable, persistent and notoriously awkward to treat, the best way to combat shin splints is to take every precaution to ensure that you don’t suffer from them in the first place.

FOUR WAYS TO PREVENT SHIN SPLINTS

  • Wear the right running shoes. If you find you get shin splints it could be because they’re too supportive and bulky or they’re not supportive enough. See a podiatrist to see if this is the root of the problem.
  • Train off road. Running on grass and trails stops your foot slapping down as heavily as it will on road. This puts your tibialis posterior (the deepest calf muscle that supports your foot arch) under less strain.
  • You should also try to strengthen calf muscles. You can do this through simple, gentle exercises like walking up and down hills, walking on your toes, on your heels and with your feet turned in and then out.
  • Be sensible when increasing your training. It’s widely advised that you don’t increase your total running distance by more than 10% each week. More than that and you risk overworking muscles.

Snapping Hip

This ailment can be painless or painful – but needs treatment either way.

Do you feel or hear a pop or snapping noise when you flex and extend your hip while running? If so, you’re probably suffering from snapping hip syndrome. In rare cases the snap isn’t accompanied by pain, but treatment should still be sought.The injury can be caused by problems with the iliotibial band. If this gets inflamed, it can cause the snapping effect when sliding across the greater trochanter (the bony point at the top of your hip) during each running stride.Other factors are overpronation and a weakness in the hip abductors. Acute cases are often the result of other underlying problems, such as damage to the cartilage.

FOUR WAYS TO COMBAT SNAPPING HIP SYNDROME

  • Rest is always the treatment you should try first. Give yourself at least two weeks away from running. If the problem hasn’t eased considerably, then try other methods.
  • Direct your focus on gentle stretching and strengthening the muscles around the hip and the thigh. Slow lunges and lying hip stretches are good places to start.
  • Consult a sports injury specialist. They can perform special massage techniques on the muscles and also give you some pelvic exercises that you can carry out at home.
  • Surgery can be necessary in some cases. The procedure usually involves the release of the hip muscle tendon and the advised recuperation period is a minimum of two months.

Sprains

Treating sprains is more than just a case of ice ice baby.

A sprained ankle is the bain of many an athlete and can really mess with a training or race programme, so it’s important to recover from them quickly. You get ankle sprains from a sudden sideways or twisting move in your foot. You can sprain your ankle really easily while training or competing – all it takes is an awkward step or an uneven surface. These types of sprain most commonly occur to the lateral ligaments on the outside of the foot. The ligaments are structures that control excessive movement of the joint. When an ankle sprain happens, the ligament is stretched too far, and is either partially or completely torn.

FOUR STEPS TO RECOVER FROM A SPRAIN

  • When you get a sprain, treat it with RICE: REST for one to two days. Pack the sprain in ICE for 20 minutes at a time and elevate it. COMPRESS it with a bandage from the foot to the ankle. Then ELEVATE the ankle.
  • Keep the ankle mobile. Ankle ligaments form scars when they heal, and this tissue is tighter and messier if your ankle has been immobilised, so you will be more prone to injury in the future.
  • Do Achilles stretches three times a day. Lie on your back, take a towel and loop it around your toes. Pull the ends of the towel, moving your toes toes upwards – you should feel the stretch in the back of the ankle.
  • Build up the ligaments again by balancing on the injured ankle leg for two or three minutes at a time. Once you can do this easily, try balancing with your eyes closed, or throwing and catching a ball against a wall.

Stitches

Banish that niggling pain stabbing in your side.

It may seem minor, but a persistent stitch can ruin a race. Nobody quite knows what it is exactly that causes a stitch (or to give it its fancy medical name, ‘exercise related transient abdominal pain’ or ETAP) but it seems to have something to do with what you eat just before you exercise. “Studies suggest that the timing of the pre-event meal seems to be related to the onset and severity of ETAP,” says sports physician Dr Alex Napier. “Studies also confirm that consuming reconstituted fruit juices, and drinks high in carbs (over 6-7%), shortly before and during exercise triggered the symptoms.”

FOUR STEPS TO AVOIDING A STITCH

  • Strengthen core muscles that may be affected by a stitch by exercising the obliques, lower back and abdominals. Try a different breathing style such as grunting while breathing out to force the diaphragm out.
  • Exercising on a full stomach should be avoided. Don’t eat for two to three hours before an event and stay away from drinks loaded with carbs. Stay hydrated by drinking little and often throughout the race.
  • Increase the intensity of your exercise gradually, and stop or slow down if stitch strikes. Include fast running in your workout regime or shorter sprints within longer jogging sessions.
  • If stitch does occur, relax, slow down your breathing and try not to think about the pain. If it’s really bad, stop, lie down and bring your knee up to the chest on the side where the stitch is.

Stomach Distension

Overbreathing in the water can destroy your race.

A bloated, sick feeling after exiting the water is something many triathletes have to overcome while on the bike leg of a race. It’s commonly believed that this is due to swallowing too much water during the thrashing bustle of the swim, but it’s more likely to be due to taking in too much air. As you breathe in air travels through the mouth, down the oesophagus and into the lungs, with excess air entering the stomach. This air is last to leave the body during exhalation and as it’s also unlikely that there will be food entering the stomach, bacteria to help break it down is limited. These factors – combined with the rapid, laboured and often snatched breathing during swimming – can create a build-up of air leading to distension of the stomach and nausea. Getting your breathing technique right will you help avoid this problem.

FOUR WAYS TO OVERCOME STOMACH DISTENSION

  • Over-inhalation often happens when exercising at higher intensities, when you are less in control of your breathing. Practise in open water to avoid panicking and over-breathing.
  • When you’re not breathing in during the swim, you should be breathing out. This helps rid the stomach of air but also allows a more natural in-breath with enough air to feed your muscles.
  • When breathing out, be sure to breathe through the mouth as well as the nose, otherwise you’re likely to be sucking in more air than you’re exhaling, which can lead to the bloated build-up.
  • If you’re bloated after swimming, let the vibrations of the road on the bike help your body rid itself of excess gas before throwing back the gels, otherwise you are likely to feel sick.

Stress Fractures

Running impact can lead to breaks.

Stress fractures in the foot are usually caused by the feet’s weight-bearing bones cracking because of the pressure of repeated strikes against hard surfaces that you incur when running. They typically crop up in the metatarsals – the five long thin bones on the top of the foot – but the calcaneus (heel), talus (ankle) and navicular (sandwiched between the talus and four other mid-foot bones) are also at risk. Not only are such fractures painful, they will also require six to eight weeks of recovery before you can even begin to train again, so it’s best to try and avoid them in the first place – here are some tips to show you how.

FOUR WAYS TO HELP PREVENT STRESS FRACTURES

  • Increase your running gradually. This avoids too much stress before your body is used to it and is important if you’re just staring out, as it takes time to build strength in muscles around the foot.
  • Wear the right footwear. Cushioning your feet is important, so have your running gait analysed and pick a pair of shoes that do the most to correct anything in your stride.
  • Run on grass. Mixing up the surface you run on to add softer ground into your training gives your feet a day off from concrete and the uneven ground promotes strong stabilising muscles.
  • Think of your distance. If you’re doing a long event, bear in mind that after a couple of hours the training benefit tapers off and the chance of injury increases, so plan your sessions wisely.

Swimmer’s Ear

Keep your lugs safe from this common infection

Swimmer’s Ear, also known as otitis externa, is inflammation of the outer ear and canal and, as the name suggests, is particularly common among swimmers and triathletes. Open-water swims are hazardous as the condition can be brought on by exposure to unclean water, while the trapping of water in the ear canal after swimming or showering is another common cause. Symptoms include pain, redness, discharge from the ear and itching. Itching is particularly problematic, as scratching the infected area can lead to broken skin and much worse symptoms. The ear canal may even swell and then become closed, so your hearing will be affected.

FOUR WAYS TO PREVENT SWIMMER’S EAR

  • Keep water out of the ear canal by wearing earplugs when swimming. These must fit snugly and comfortably and mustn’t scratch or break the skin. The most effective ones can be rolled into a ball to fit.
  • After swimming or showering, mix equal parts of white vinegar and rubbing alcohol, and place a few drops in each ear before allowing them to drain out. This helps to keep the ear canal dry.
  • Clean your outer ear carefully. Do not insert anything into the ear canal, as this may worsen the condition by disrupting the layer of wax inside your ear that protects against harmful bacteria.
  • If you end up contracting swimmer’s ear, keep it completely dry until symptoms have disappeared. This means no swimming or diving (even with caps or earplugs). Flying can also be harmful.

Swimmer’s Shoulder

This injury will keep you out of the pool – so keep it at bay.

Known as impingement syndrome to doctors and medical boffins, swimmer’s shoulder can occur when the tendons in the rotator cuff are weakened due to overuse – most common in people who do a lot of throwing or a lot of front crawl. If left untreated, the condition can lead to a total tear of the rotator cuff, which could result in several weeks of painful and frustrating rehabilitation or, in extreme cases, surgery. Symptoms include pain at the front and side of the shoulder during your swimming stroke, and pain in the shoulder when you lift your arm more than 90 degrees or when the arm is held to the side and turned outwards. So how can it be treated?

FOUR STEPS TO BEATING SWIMMER’S SHOULDER

  • Rest. An obvious one, but the only initial option to avoid tearing the rotator cuff. Three to four weeks is generally recommended after
    you are diagnosed. Frustrating, yes, but worth it in the long run.
  • Ice therapy. Wrap ice in a wet tea towel and apply regularly to the painful area of the shoulder. You can combine this with non-steroid anti-inflammatory drugs (NSAIDs) for pain relief in the initial rest stage.
  • If the pain is not too great, try weight training to regain strength in the muscle. To prevent further injury make sure you do a high number of repetitions (15-20) with light weights (maximum of 2kgs).
  • Surgery. This would involve a tightening of the lax capsule that surrounds the shoulder joint. This really is a last resort, but recommended for people who have had pain for six months or more.

Tarsal Tunnel Syndrome

This foot injury is common in flat-footed athletes.

Ever wondered where your tarsal tunnel is? It’s the area that runs along the inside of your ankle and is home to several nerves, ligaments and tendons. When any of these, usually the tibial nerve, become inflamed, pressure builds up inside the tarsal tunnel resulting in pain in your toes and a tingling sensation in your heel. In acute cases it can lead to pain all over the affected foot and a build-up of fluid in the tarsal tunnel. The injury is common in regular runners. One of the main causes is flat-footedness, where the flattened arch puts increased pressure on the nerves and muscles. So if it’s something you think you might have, check your stride with a running specialist.

FOUR WAYS TO TREAT TARSAL TUNNEL SYNDROME

  • Check your footwear. Wider fitting shoes and trainers with arch support will help combat the effects of flat-footedness and reduce the chance of developing the injury.
  • If this doesn’t work, the use of orthotics to address flat-footedness can also be undertaken. This involves correcting the arch of the foot to increase mobility by using shoe inserts.
  • Anti-inflammatories will help reduce the swelling in the nerves, ligaments or tendons and allow them to move more freely through the tarsal tunnels.
  • In some cases of tarsal tunnel syndrome, surgery is the only option. The operation involves the cutting of the laciniate ligament to increase the amount of room in the tarsal tunnel.

Torn Rotator Cuff

Swimming can be a major cause of this nasty injury

Triathletes Are prone to rotator cuff tears, as the injury is often brought on by repetitive stress. Swimming front crawl is one of the major causes, putting triathletes in a vulnerable position. The rotator cuff is a group of four muscles that come together to act as tendons, keeping the top of your arm in your shoulder socket, helping you lift and manoeuvre your arm freely. When these muscles are torn, the pain can be excruciating and it will put a stop to your swimming. There are two forms of tear – acute and degenerative – and it’s the latter that swimmers mainly suffer from. Symptoms include pain at night when resting on that shoulder, pain when lifting and moving, and a cracking sound when rotating your arm.

FOUR WAYS TO TREAT A TORN ROTATOR CUFF

  • As soon as you feel pain you should discontinue swimming and avoid movements that exacerbate the injury without ceasing movement in the affected arm entirely, as this could potentially lead to frozen shoulder (adhesive capsulitis).
  • Seek medical advice if you suspect a tear. In the meantime, anti-inflammatory drugs such as ibuprofen can help reduce pain and swelling. In extremely painful cases, you may have to be prescribed a steroid injection.
  • Consult a physiotherapist, who will be able to advise you on the correct strengthening exercises to complete your rehabilitation and reduce the chances of it reoccurring. The injury may be due to poor technique, so once fit again, invest in some video analysis to correct any potentially injury-inducing problems.
  • In acute cases, surgery may be required. The good news here is that surgery to repair a torn rotator cuff has a 94% success rate. You’ll need recuperation time, but it should fix the problem.

These articles were originally published in Triathlon Plus magazine. Save time and money by having every issue delivered to your door or digital device by subscribing to the print edition or buying digitally through Zinio or Apple Newsstand.

You’ll find loads more triathlon news, reviews, training info and insight at triradar.com

Visit our Facebook page at www.facebook.com/TriathlonPlus and follow us on Twitter @TriathlonPlus.