By: Alix Ungaretti, PT, DPT, CSCS

Cap and goggles at the ready, bike staged, and sun blazing. Triathlons are an exciting event, be it a relay or individual event. USA Triathlon – the sports governing body – sanctions more than 4,300 races every year with nearly 400,000 members. It is composed of athletes of all ages and abilities. The sports saw a resurgence in popularity prior to the pandemic with many of the new participants joining the events without any endurance background or experience. With triathlons being endurance-based (although there are sprint options, they are still technically endurance events), overuse injuries are bound to happen.

Overuse Injuries in Triathlons

Overuse injuries are the most frequently reported injury at any level of triathlon participation.1 Typically, overuse injuries are seen in the knees, low back, and ankle/foot. Most injuries are sustained during the running or cycling phases of the triathlon. Swimming rarely results in injury, since the training commitment for swimming is lower compared to the time spent cycling and running.

Common injuries associated with overuse are:

  • patellofemoral disorders (knee pain),
  • iliotibial band friction syndrome (IT band pain),
  • tendinopathies of the knee, foot, and ankle,
  • as well as plantar fasciitis.

Overuse injuries result from tissues being stressed and loaded for longer periods of time. Those who are newer to participation in longer-distance events, such as a triathlon, are at increased risk of injury as the soft tissues have most likely not been loaded under long-duration conditions as required by triathlons.

Training to Combat Overuse Injuries

One of the best ways to combat overuse injuries is through strength and mobility training. Not only do you get the injury prevention benefit, you also can enhance performance. Something to emphasize is the prescription of exercise – how many sets and reps for each exercise? What are the goals of each exercise? Which energy system are you working on? Is an active recovery session being implemented? Sleep hygiene? Nutrition? Training doesn’t stop after you finish your run, bike, or swim – it’s a 24-hour, 7 days per week process.

In order to see success on the clock, developing a good strength and conditioning program is beneficial for your health, and better yet, your performance. Three sets of 10 reps for every exercise only does so much. It does help with strength, but it fails to replicate the actual sport itself.

Whether you are working on preventing an injury, or rehabbing from an injury, or even just training for performance, various sets and reps should be included to address the various energy systems our bodies use, as well as to stress the functional energy systems that are required during race time:

  • Strengthening programs should have days dedicated to developing absolute strength, which would entail 2-5 sets of an exercise with lower reps, of 5 or less, with maximum effort used on each rep.
  • Hypertrophy (muscle growth) or general strengthening is also beneficial. This is applicable to pushing off the block or wall during the swim, or pedaling uphill with powerful strokes. Exercises emphasizing this include 2-5 sets of 8-12 reps, requiring 45 seconds to 1 minute of movement to complete the exercise.
  • Endurance training is key for triathletes. Endurance training can be done by performing a few sets of high reps and low loads. The reps can be prescribed by number of reps, or time to complete the task (i.e., complete latissimus pull downs for 3 sets of 1 minute, or complete 50 yards of lunges, etc.).

When working with triathletes, one of my favorite ways to prescribe endurance exercise is via distance or time, as triathlons are based on distance and time. Replicating the sport helps promote performance and healing. This goes with rehab programming for triathletes, or any athlete for that matter.

Physical Therapy for Triathletes

To take things a step further, consulting with a physical therapist or Spooner FIT trainer is a great idea to treat, mobilize, and strengthen the different muscle groups that might be overused in sport. For example, the soleus muscle and rotator cuff muscles are endurance muscles – they are active for longer periods of time under lower loads. These muscles should be trained as such, however, every muscle requires some amount of absolute strength! When recovering from an injury, various rep and set prescriptions should be utilized.

Rehab is not a break from training; it’s an opportunity to make sure you are training the right way. Performance enhancement through exercise should not be excluded from your physical therapy – our goal for you is to help you achieve your goals, whether that means assisting in recovery from an injury, or improving your overall performance.

Schedule an appointment with a Spooner therapist or FIT trainer today to maximize your performance for your next race!

References:

  1. Rhind, J., Dass, D., Barnett, A. & Carmont, M.(2022). A Systematic Review of Long‐Distance Triathlon Musculoskeletal Injuries. Journal of Human Kinetics,81(1) 123-134. https://doi.org/10.2478/hukin-2022-0011