Trail Tips: Injury Prevention Paddy January 3, 2019 All Michael Caeserta from the team at Balmain Sports Medicine takes us through some common injuries that we face in the world of long distance bushwalking and outdoor trekking. With his many years of experience as a Physiotherapist, Michael explains various injuries, prevention strategies, ways take care of your muscles on the trail for thru hikers, as well as tips to keep your body safe and fit as we get older and continue to adventure. We had the pleasure of sitting down with Michael and asking him a few questions we thought would help our customers! Here’s what he had to say: What are some common injuries that can arise from long distance bushwalking? Injuries that can arise from long distance bushwalking can be divided into two categories, “Acute Sprains/Strains” and “Overuse injuries.” I would have to say that overuse injuries are most common. Within this, those seen most frequently in my experience are (in order): ITB friction syndrome Patello – femoral pain Patellar Tendinopathy Plantar fasciitis Achilles tendinosis Gluteal Tendinopathy/ trochanteric bursitis Are there injury prevention strategies that people can take on in order to prepare for their adventure? People participating in long distance trail walking historically focus more on the aerobic capacity/endurance aspect of training whilst skipping strength work. There is still a belief amongst a lot of people that strength training will make you slower by bulking you up and reducing your efficiency. To use cars as an analogy, it’s like everyone thinks strength training will turn them into a V8 and thus make them burn through their fuel quicker. The evidence is, however, quite the opposite! What we know from research is that strength training can actually increase your running economy (you can have a look at this recent study)! In simple terms, this is an ability to use less fuel at the same pace. Furthermore, strength training allows your body to cope with load better. You can think of load as the total amount of work and stress your tissue can handle. Therefore tissue adaptations from strength training equates to a reduction in injury risk. If we look at the most common “overuse” injuries above, they are all injuries to soft tissue, and as such, this is something we definitely want to be doing. As important as any training: listening to your body and resting when you need it! For everyone looking to get started on their strength training journey here are a few tips and exercises to get you going. Please remember that there is no recipe and everyone will be starting somewhere different. Moreover, if you are a beginner or have a pre-existing injury it is always best to get a qualified health professional to help you get started. Frequency: Studies have shown benefit for training strength as low as x2 per week so this is the best place to start for a beginner. Think about setting this around your aerobic training days so that your body has adequate time to recover and adapt. Type of exercise: If you are going to be training only a few times per week then you want to get as much out of each strength routine that you can. Therefore I would go for compound exercises, which are exercises that train more than one muscle at a time with some specific exercises for the more common injuries. These can include: Double leg squats Lunges Deadlifts Step ups Bulgarian squats Single leg calf raises Crab walks I would start off with 3 sets of 12 to begin with, making sure you work consistently with very good technique whilst achieving a modest level of fatigue at the end of each set. Are there injury prevention strategies that can be done on the trails for long distance thru hikers? When discussing injury prevention strategies, most if not all of the work should be done prior to an event. This includes adequate training to support strength and aerobic fitness. It also includes correct recovery and nutrition leading up to an event. However we do know that static stretching has a short term benefit in increasing muscles’ flexibility. Therefore, it probably has some benefit to be done during an event, especially if you begin to feel tightness or cramping within an area. This in combination with adequate hydration and nutrition can help you perform at your peak whilst tackling a trail. Some examples of areas to stretch are: Quads / Hamstring Hip flexors / Glutes Calf (long & short therefore bent and straight knee) Posterior chain All of these stretches can be done in sets of 5 reps x 30 – 60sec each. Where’s your next long distance bush walk? What do we need to be aware of when carrying loads for long distances, and what are best practices to prepare for these adventures? Carrying a heavy backpack increases the requirements of postural and core muscles. During long distance trail walking these muscles already have a high endurance demand in order to navigate uneven terrain, up/down hill etc. As such, you increase your risk of injury to the neck, back, and pelvis. Doing exercises which strengthen core and postural muscles can help increase core muscle endurance and tolerance to load. A great way to do this, as previously mentioned, is strength training (gym based). Focussing on whole body compound exercises as they have the greatest recruitment of “core” muscles. These include dead lifts and squats. Pilates is another form of exercise that helps to strengthen these muscles with a big emphasis on control. The advantage of this is that it is low impact, therefore allowing someone who is building up cumulative fatigue and working with injuries to reduce the total impact on their body. The advantage of wearing a properly fitted pack is simple; you reduce your risk of injury and fatigue! Therefore, if you are unsure get someone who understands backpack fitting to help you. Remember to do your best to minimise pack weight and only take with you what is essential and leave luxuries at home! Here is a picture to help you get started with fitting your pack correctly and obtaining good posture. Pack fitting posture Please know that all at all Paddy Pallin stores we have the training and equipment to properly fit your pack for you. Whether you are purchasing a new pack or have a pre purchased pack you would like to have properly fitted, come down to your nearest Paddy Pallin store and we can help you make the most out of your gear! Have your pack properly fitted at Paddy Pallin! Photo by Lachlan Gardiner What are some common injuries that occur among older people or people who are trying to get back on the trails? The most common injured area for the older individual taking on trails is the knee. This includes both patella-femoral pain and ITB friction syndrome. This is due to a number of reasons but mostly likely a combination of degenerative changes in the joint, an increased strength deficits (especially for individuals who have been sedentary for some time prior) and greater biomechanical errors (which in essence is a combination of motor control and strength). I never like to put older athletes or individuals in a category; however, generally speaking as one ages there is a decline in tendon quality and increased joint/cartilage wear and tear. As aging is a normal process that everyone encounters it is important to assess your situation and health individually and formulate your exercise regime around this. Your approach with training should be to start easy and progress your load and difficulty slowly. In this way you are able to modify training and treat injuries before they become worse. This may be increasing your training volume by less than 10% per week which in turn mean you would need to start training for an even so that you have adequate “ramp up” time. As we cannot “train” joints or cartilage strength training is just as, if not more important in older individuals. Stronger muscles allow for better control and less stress around joints. However, we need to train smarter when we are older. Here are a couple examples of “modified” exercises. It’s important to note, if you have pain when training it’s best to speak to a qualified health professional and get an individually tailored program. Squat – can be modified into a wall squat. This position decreases forces though the patella-femoral joint and if done between 0-90 degrees decreases compressive load though the meniscus. You can add resistance by holding dumbbells. Modified squat explanation Single leg calf raise: this can be modified by performing the exercise on a level stable surface. This reduces the end of range compressive load though the Achilles tendon and thus will be kinder to people who have had issues within the calf/Achilles region. Modified single leg calf raise explanation Best of luck! Michael Caserta Have you ever run into physical trouble on the track? Or felt worried that you might develop an injury when taking on your next outdoor pursuit? It’s important to ensure your body will be able to handle the activity you will be pursuing, and that you’re aware of potential injuries and doing your best to prevent them. For individualised programs, injury prevention strategies, as well as treatment, head to the trusted team at Balmain Sports Medicine! #ExperienceIsEverything #PaddyPallin Leave a Reply Cancel Reply Your email address will not be published.CommentName* Email* Website Notify me of follow-up comments by email. Notify me of new posts by email.