The Injured (tri)Athlete Protocol

In medicine, we have a protocol for everything. If someone comes in with chest pain, there is a clear, logical, stepwise flowchart to follow that tells you what to do and when to do it, who you should be calling, and what the options are for ongoing treatment.

When you’re faced with a problem in general life, there are no such protocols to follow. You’re out on your own. As athletes, when we become injured the first thing that we usually do is ignore it and keep trying to train, until we reach a point when we can no longer train. Then we start googling our symptoms, we find comfort in telling anyone and everyone who will listen about our injury in the hope that someone will come forward with advice on who we should see or what we should do. Sound familiar?

I’ve decided to put together a brief guideline to how to deal with basically any sports injury, with a focus on musculoskeletal problems. This guide is effectively a roadmap for someone who is dealing with an injury of any stage- but is more effective if used early on. If I have forgotten anything or if you can think of something else useful then please let me know!

 

Step 1: Go to see your GP. 
Hopefully you will already have a doctor that you see regularly, and if you don’t then I really suggest finding one. It’s important to have a good GP and not to just keep going to a 24hr clinic. If you’re an athlete then it’s a good idea to find someone who is also an athlete/ is fit or has a special interest in womens health (for the girls) or in sports or young peoples health. GP as a first port-of-call is important, because if you have anything that is serious, they will send you straight through to get imaging, which prevents a delay in getting appropriate care. This is also why it’s important to see someone you know and trust- because you don’t want something serious to be missed.

 

Step 2: See a (GOOD!) physio
Get the doctor from step 1 to write a referral to see a physio that they trust and recommend. Usually if doctors have been around in the area for a while then they will have sussed out the best physios in the region- which can be a great timesaver! Alternatively, ask around the local athlete community for people who have had similar injuries to you and have had success with particular people. Advice for picking a physio: you should immediately feel like they have it all under control and they are interested in you and your injury. They should outline a plan that is ongoing for your recovery and be able to tell you what they expect you to be achieving in a particular time period. IMPORTANT: If you have seen no obvious improvement in your injury state over a period of two weeks, you need another opinion. That goes for any practitioner (physio/osteo/chiro/acupuncture etc). Usually within the first couple of visits your physio is able to assess where your imbalances are and decide what might have caused you problem and, if you are in a position to do so, they will prescribe a series of strength exercises to get started on…DO THEM!!

 

Step 3: Massage
This step is pretty dependent on what the nature of your injury is, so check with your people from step 1 and 2. Massage can help with relaxation and can loosen up the tight spots that might be causing an imbalance. Find someone who is able to locate these spots and get into them, nothing worse than an hour of being lightly patted, am I right? Another one to ask around about. As your training takes a back seat it can be a perfect time to work on getting more massages and it is also a great body-based activity that makes you feel like you are actively helping heal yourself rather than just sitting on the couch. It can be a great stress release too, if you are someone who likes to swim/bike/run your life worries away!

 

Step 4: Sports psychologist
I think sports psychologists are really under utilised by weekend warriors and age-groupers because we think that they are the domain of professional athletes only. Most of us that get into this sport generally have some degree of emotional instability and our sanity is largely tied up in the ability to train like a maniac every day of the week. A lot of us either use training sessions to let out pent up anger or frustration, we use the euphoric buzz of an exhausting session like a drug hit, many of us use triathlon as a major part of our identity and can sometimes base a lot of self worth on our performance in training and racing, and quite a lot of social support and friendship comes from our training groups. As a result, when an athlete finds themselves unable to train, they undergo a kind of self implosion and have no way to rid themselves of the frustration, sadness and sense of loss they feel.

A sports psychologist, whether in person or via Skype, can help you to restructure your goals, deal with the emotional challenge of losing a major coping mechanism for life’s stressors, and to set challenges to improve your mental strength. Working with the negative self talk that inevitably accompanies time off training i.e “everyone is getting getter while I’m here getting fatter by the minute”/ “I’ll never be able to get back to the fitness level I was at,” can really set you up with some great mental strategies that you can then use in your training going forward. One of the most worthwhile things to do with a period of injury/non-training time is to see it as an opportunity to improve your mental game. There are a heap of tools to use in order to develop a deeper insight into your psychological strengths and weaknesses, and working on these skills under the guidance of a trained professional can not only give you something to do when you can’t train, it also teaches you valuable skills for future racing and life in general.

A lot of us might see this as an unnecessary expense, but with all the money you’ll be saving not buying spare tubes/socks/extra food you’ll have a few spare $$’s worth investing on your mental health.

 

Step 5: Stay in touch with friends, family, training buddies and coach!
Yes, people are sick of hearing you talk about your injury. Stop bringing it up with all your friends and family- unless they ask how it’s going. Tell your GP/physio/psychologist/coach about it all because they’re the ones who can actually help you fix things. Spend time chatting about anything else with friends, tell them about the awesome books you’ve just read (can recommend James Patterson, good for an adrenalin rush and really interesting, clever reads), ask them over for dinner to try out a new recipe or get together for a movie. One of the things I really enjoyed was going down to join the post ride brekky and coffee even if I wasn’t on the ride. Some people will really have trouble with this but it definitely will help you to keep in the loop and get out of the house to socialise on the weekend now that your Saturday is not taken up by a 6hr ride. DO NOT sit at home and mope. I have a 48hr rule on this, you can cry and complain and scream and eat ice-cream or whatever you fancy for 48hrs, wallow in your own self pity as much as you please. But after 48hrs has gone by you have to pick yourself up and get on with controlling what you can control, and working on the things you can do- rather than crying about the things you can’t. Keeping your coach in the loop is also important, so they know you haven’t completely fallen off the perch. Get them to work with your physio to develop a return to sport plan that everyone agrees on. Tell them if you’re struggling and ask for help if you need it- chances are they have seen athletes go through things like this many times before!

 

Step 6: Do the strength work, and make a thing of it
When I was diagnosed with a re-fractured leg after 12 months, I wasn’t even allowed to take the stairs at work for the next 6 months. I couldn’t do squats or lunges, and was left doing isometric holds whilst lying down as my only form of “on-land” training. It’s easy to think you’ll just do them at home watching TV, which then turns into just lying on the floor watching TV. Making a big deal out of going down to the gym and really focussing on whatever minor exercises you’ve been set not only helps you psychologically feel like you’ve done a training session (great for type A athletes), but you will actually get more strength benefit from consciously putting in the work. Trust me!

 

Step 7: Keep a record of your experiences
Writing down some of what you’re going through or things you are learning can be really helpful for looking back and appreciating how far you are coming in your recovery. It can often seem like you are barely making any progress, but looking back on previous entries can help to remind you what you have achieved. You can either do this in a private journal or in a public forum. I have used my Instagram as a bit of a diary for recording my progress back from injury. Social media in general is a great way to connect with other people going through the same thing and for me it has been a really amazing and unexpected source of support and encouragement. The Insta-tri community is truly amazing!

 

Step 8: Remember- it’s not a life sentence and its not life threatening
No matter how awful it might seem, you have to remember that everyone has been injured at some point and often people have their best performances after a return from forced time off. It’s also important to remember that however bad it may seem, a musculoskeletal injury is not that bad in the grand scheme of things life can throw at you. Indeed, just because someone else has a worse problem as you doesn’t mean your problems are any less valid, but there are definitely people in the world with far less in life than we have. To be able to participate in sports in the first place is a huge blessing, and one which we should be very grateful for. Your time off is simply your turn to sit on the bench for a while and learn a bit more about who you are and what makes you tick outside of the sports that you do. 🙂

 

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