Welcome back. It has been quite a bit longer than I said it would, but I guess better late than never right?
In our previous article titled “RECOVERING AND AVOIDING INJURY”, we discussed a number of ways the athlete can recover from workouts or races and also avoid injury. Discussed were rolling, stretching, icing, heating and compression sportswear. This article will give an overview of the various pains which can be addressed by those recovery techniques. Now that most of you are well into your triathlon season, you could very well be experiencing some of the below pains and issues.
The following pain issue locations will be discussed: Piriformis muscle, IT Band, Quadriceps, Hamstrings, Calf, Achilles tendon, Peronius brevis tendon, Plantar fasciitis
Location:
The piriformis is located in buttocks area.
Common Pain:
Piriformis syndrome occurs when the piriformis muscle irritates the sciatic nerve. This shows up commonly as pain in the buttocks. It can also come in the form of lower back pain.
Stretching, massaging and icing are good ways to ease the pain. Strengthening core muscles such as abs can avoid piriformis syndrome, too. Time off from bicycling and running can go a long way.
Location:
The IT band runs along the outside of the thigh. It starts at the top of the hip and ends at the outside of the knee.
Common Pain:
The pain is most commonly felt at the outside of the knee. It can be as bad as a sharp pain like a knife sticking into your knee. The pain can also carry up the outside of the leg.
I have run since I was 6 years old, and didn’t know what IT band pain was until my late 20s when I started long distance running and triathlon training. Often, pain in one area can be due to problems in another area. For example, your IT band might be tight because your gluteus maximus is tight. Stretching and foam rolling that muscle may help to ease the IT band pain. Remember the old song, “….the knee bone connected to the thigh bone…..” The same often goes for muscles. Finding those really sore spots in your IT Band and rolling them out can go a long way. Wikipedia gives a great summary here of IT Band symptoms. If you scroll down towards the bottom of that link, there are some good treatment suggestions.
Location:
The quadriceps is a group of four muscles on the front of the thigh located above the knee.
Common Pain:
A strain can occur when there is a tear in one of the muscles. The pain can be anywhere from slightly uncomfortable all the way up to an intolerable wave of pain from a full tear. Depending on the severity of the strain, bruising and swelling can occur.
Quad pain can occur for a number of reasons. An easy way to increase your chance of quad pain is to skip warming up before workouts or races. After a ride on the bike, you can often feel the pain in the quads if you pushed it hard and stood up on the uphills.
Again, the RICE method can be greatly helpful along with the use of Ibuprofren. Time off the feet can go a long way. Careful stretching can reduce the pain, too.
Location:
The hamstring is a group of tendons located at the back of the thigh, just above the knee and below the buttocks.
Common Pain:
A strained / pulled hamstring is the common occurrence. The pain can range from slight soreness to being hard to even walk. When slight pain, people may refer to it as being “tweaked”. When I used to lift heavier weights, which included squats, I strained my hamstring once to a point which felt like a piano wire ready to snap. That is when it becomes hard to walk. Click here to see more info on hammy pulls – note that the images are typical of the more severe strain or pull. This is something that hopefully does not occur in longer distance exercise.
With hammies, time off can really help. If not, it can turn into a nagging injury which is really hard to fix. The RICE method applies here, too. Many times, hamstring pulls and pains can result from an imbalance between the quads and hammies. It is important to exercise both.
Location:
It is basically the back of the lower leg. It is made up of two main muscles – the gastrocnemius and soleus. The top of the calf attaches just above the knee and also to the Achilles tendon.
Common Pain:
Pain can often occur in the form of a strain. Pain in the upper part of the calf is likely tearing of the gastrocnemius while pain in the lower part of the calf is tearing of the soleus.
RICE, again, is a good approach to dealing with calf pain. Even using some sort of compression can help, too. Compression socks are quite popular for recovery. There are different takes on whether the sleeve or the full sock should be used. I’ve heard that full socks are recommended for recovery when sitting inactive, because they encourage better blood circulation. But there are many opinions out there on that. I don’t have full socks. I only use the sleeves when I’m moving, i.e. walking around or doing a recovery jog or spin. And, yes, time off of the legs can be very helpful, too.
Location: The Achilles tendon is located at the back of the heel and leads up about 6 inches to the middle of the calf.
Common Pain:
Achilles tendonitis is felt at the back of the leg towards the heel. It can feel like a rubber band about to snap from tightness. The tightness is often more noticeable when getting up in the morning.
Causes of this are often overuse and degeneration. Running too many miles too soon is a common cause. Tight calf muscles are another indicator of why you are experiencing pain in the tendon. Even bone spurs can rub against the tendon and cause pain.
As with plantar fasciitis, time off along with rest and icing can help greatly to reduce the pain. Stretching the calf is one of my favorite ways to work on the tendon. Leaning against the wall with one leg out behind you with the foot pointed towards the wall works well. Bending the knee downward can help to get even more of a stretch on the Achilles tendon. To take it a step further, stand on a stair step, ledge or stack of books. Put only your toes on the ledge and let your heels drop. This will really stretch the tendon well.
Location:
The peronius brevis tendon connects on the outside of the foot about midway between the heel and smallest toe. It carries back around the talus (ankle bone), leads up the outside of the lower leg and connects just below the calf.
Common Pain:
Soreness shows up along the outside of the foot, all around the bottom of the ankle bone and leading up the outside of the lower leg. It can feel like a bruise. Turning the foot on its outside with slight downward pressure can reveal the pain even more.
This injury can make trail runs on uneven surfaces very unpleasant. The soreness is often caused by overuse. Simply stretching and foam rolling can help to avoid visits to the doctor for cortisone shots or purchasing of orthotics.
Location:
The Plantar fascia is a ligament located at the bottom of the foot. It is a tissue supporting the arch of the foot running from the heel to the area between the toes.
Common Pain:
Plantar fasciitis shows up as an aching to stabbing heel pain. This happens when the tissue has tears. The pain is most often felt in the morning when one wakes up, because the ligament tightens up. It can also be noticed when walking up stairs or standing for a long time.
Causes can include any of the following: pronating too much (feet roll inward when walking), tight achilles tendons, walking/standing/running for long expanses (esp. hard surfaces), high arches or flat feet, and even shoes that are worn out or don’t fit. From the standpoint of a triathlete, it is typically the run which causes plantar fasciitis.
Rest is usually the best approach to fixing this problem. Yes, stopping your workouts sometimes sounds almost unthinkable, but trying to push through an injury will likely only prolong the time it takes to get better. You may be able to continue your swimming and even some biking, but taking time off from the run can go a long ways to recovery. Other ways to reduce the pain include icing the heel and stretching the calf. Orthotics are another option, too.
We hope these articles have provided information which has helped you in some way. The end goal is to get you back in the water, on the bike and running the trails and roads. We wish you the best of luck in injury-free training and achieving all of your goals.
