Back In MotionMount Gravatt

Picture this. The day has finally come for you to go back to the gym after a 6-month long hiatus while gyms were shut over lockdown. You use to squat around 80kgs in your working set, but you think to yourself, “I haven’t been to the gym in quite a while, I should probably push for more than that.” You remember a coach you had in high school telling you to always warm up and cool down before sport, but you are really pressed for time today. You walk out of the gym with your legs like jelly, feeling good. The evening comes and the muscle soreness kicks in. The pain gets progressively worse over the next 48 hours, to the point where you can’t even bend your knees without pain. You’re too sore to return to the gym again for at least a couple of days, and now you feel like you’re back to square one.

This story is something I have seen quite frequently in the last couple of months in my consulting rooms since gyms re-opened and sport recommenced. What could our protagonist have done differently to avoid the risk of injury in the future when returning to activity?

1. Steadily increase your workload

This is arguably the most important point I’ll make today. I’m going to say it again, just for emphasis: steadily increase your workload. You should not feel like you are pushing yourself anywhere close to your limits for at least 2-3 weeks. If you feel like you are bludging a little with your intensity early on, this is a good thing and will allow your body with ample time to adapt. Evidence suggests that reducing your load to 70-80% of your original load/ability will help to reduce the risk of injury. So in our protagonist’s circumstance, she should be aiming to squat around 60kg in her working set, for at least the first few weeks. It is important to ease back into your sport or workouts for the following reasons:

• The detraining effect from not training - we are simply not physically able to perform at the same level after a period of reduced training. A decline of between 2-4% in cardiovascular, metabolic and neuromuscular performance has been reported in elite athletes as a result of detraining or lack of activity¹.
• Spikes in the acute:chronic workload – training in the current week is significantly higher than it has been over the last month, which research tells us can increase injury rates by 5-7 times².

2. Allow sufficient time to warm up/cool down

Ah, you’ve heard just about every coach/trainer/physio/health professional you’ve ever had try to emphasise the importance of warming up/cooling down and you may or may not have taken their advice. But there is some pretty solid evidence to suggest that both of these have a positive influence on injury risk minimisation and improving performance.

Benefits of Warming Up

• Warming up can enhance performance by improving blood flow to the muscles, improving oxygen efficiency and allowing for faster muscle contraction/relaxation. A 2010 systematic review showed that the warming-up improved performance in 79% of the criterions examined.³
• Warming up is also great for injury prevention⁴, as it promotes blood flow to the muscles, making them less likely to rip, tear or twist in a harmful way during your workout.

Benefits of Cooling Down

• Reducing Delayed Onset Muscle Soreness (DOMs) – a study undertaken by California State University found that moderate intensity cycling after strength exercise helped to reduce DOMs⁵.
• A cool-down is also instrumental to injury prevention as it helps to expel the build-up of lactic acid and harmful toxins which can cause muscular pain and stiffness the day after activity. 

Warm-ups and cool-downs should last for 10-15 minutes and be in the form of gentle cardiovascular exercise and/or stretching activities.  

3. Optimise your recovery

A 2018 systematic review revealed that active recovery, massage, compression garments, immersion, contrast water therapy and cryotherapy induced a small to large decrease in the magnitude of DOMs.⁶ Of these, massage was shown to be the most effective in reducing DOMs and reduced fatigue. So if anyone asks, you’re not treating yourself to a massage, it’s the physio’s orders.

Sleep is also a very important part of recovery and has been shown to reduce the risk of injury. Getting fewer than eight hours sleep per night was associated with almost twice the risk of injury than more than eight hours of sleep over a 21-month period.⁷ Additionally, sleep is important to improve recovery and healing if an injury is sustained.

4. Treat any niggles

During iso, you may have been working from home or taken up a different form of exercise since you weren’t able to complete your usual sport or go to the gym. If you have any lingering issues because of this, be sure to consult your physiotherapist before returning to your regular routine. Contact the clinic today on 9836 1126 to discuss how we can help you return to peak performance.

References

1. Mujika I, Padilla S. Detraining: loss of training-induced physiological and performance adaptations. Part I. Sports Medicine. 2000 Aug 1;30(2):79-87.
2. Bowen, L., Gross, A. S., Gimpel, M., Bruce-Low, S., & Li, F. (2020). Spikes in acute:chronic workload ratio (ACWR) associated with a 5-7 times greater injury rate in English Premier League football players: a comprehensive 3-year study. British Journal of Sports Medicine, 54(12), 731-738. Retrieved from https://bjsm.bmj.com/content/54/12/731
3. Fradkin, Andrea J¹; Zazryn, Tsharni R²; Smoliga, James M³ Effects of Warming-up on Physical Performance: A Systematic Review With Meta-analysis, Journal of Strength and Conditioning Research: January 2010 - Volume 24 - Issue 1 - p 140-148 doi: 10.1519/JSC.0b013e3181c643a0
4. Woods K, Bishop P, Jones E. Warm-up and stretching in the prevention of muscular injury. Sports Med. 2007;37(12):1089-99. doi: 10.2165/00007256-200737120-00006. PMID: 18027995.
5. Tufano JJ, Brown LE, Coburn JW, Tsang KK, Cazas VL, LaPorta JW. Effect of aerobic recovery intensity on delayed-onset muscle soreness and strength. J Strength Cond Res. 2012 Oct;26(10):2777-82. doi: 10.1519/JSC.0b013e3182651c06. PMID: 22739325.
6. Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B. (2018). An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Frontiers in physiology, 9, 403. https://doi.org/10.3389/fphys.2018.00403
7. M Milewski et al. Chronic Lack of Sleep is Associated with Increased Sports Injuries in Adolescent Athletes.  J Pediatr Orthop. 34(2):129-133, 2014.