Injured and recovering with P.R.I.C.E

I don’t know whether it’s been the cold weather over winter or maybe the increase in exercise for the start of 2012, but there seems to be a lot of people around me that are getting injured(including myself!). Not only are there a lot of injuries at the moment, many of them seem to be injuries to the spine or pelvis. So I decided to write a blog about injuries, prevention and using the P.R.I.C.E protocol for the recovery process.

I’m using the back as an example as there are so many people with back issues at the moment and an osteopath once said to me “It’s not about ‘IF’ you get a back injury; it’s ‘WHEN’ you get a back injury!”. What he went on to say was that the spine is so complex and allows so many different movements, that without the correct posture all the time(which lets face it, doesn’t happen often enough!) it’s only a matter of time before wear and tear takes its toll and a back injury occurs. Many people lift heavy objects for a living and even those that don’t, still lift heavy things around the house from time to time, but are we lifting with the correct posture? Are we bending through the knees and not the back, letting the legs take the strain? The answer is…..generally no!!!

Many people don’t know the correct technique and those that do, rarely use it until it’s too late. That is why so many people suffer from slipped discs(also known as prolapsed/herniated discs) which can be very painful. I have added a photo of an MRI scan taken about 8 years ago of my spine, after an accident during a football match that I hobbled away from with a broken arm and two prolapsed discs. In the photo I am pointing at the two discs that have degenerative changes which can be seen by the lack of white in them compared to the rest and if you look closely, you will see the two discs protruding from the back of the spine at the curve. This caused a lot of pain down my sciatic nerve at the time and not the kind of pain that anyone would like to experience.

I do a lot of lifting in my job and even with the right technique/posture, if I don’t look after my back and concentrate on strengthening it, I occasionally get lower back pain. So if that can happen to a personal trainer, what about the people who aren’t generally as fit or strong as a personal trainer? How do they prevent this kind of thing from happening?

There are a number of ways in which we can help ourselves to prevent injuries happening like this. Unfortunately mine happened in a freak accident. I wasn’t in control of the situation and it wasn’t a direct injury from bad posture or technique at the time, but a lot of people are in control of it and neglect to do the right things. Injuries of other areas of the body can also be prevented with a little common sense and again, the right posture or technique can be a crucial part of it.

Starting with the posture, we are all guilty of slouching into comfy sofas or having the wrong posture when sitting at a desk or even when driving a car. All of these examples are things we can control.

Thinking about the way we sit and trying to keep a neutral spine like the second picture, can help prevent back pain and disc problems. Another area in which we can all improve, is the way we pick up heavy objects……

 

Bending through the knees and picking up heavy objects correctly can go a long way to preventing back problems. By bending through the back instead of the knees, this puts a lot of unnecessary pressure on the lower back which will eventually lead to an injury and lower back pain. Both of these examples are things that can be controlled.

Unfortunately not everything in life can be controlled and therefore injuries will happen; that is inevitable, especially if you are an active person and involved in sport. Knowing what to do once you’ve got injured is the next step on the road to recovery, so here is the P.R.I.C.E protocol for you to follow…..

Protection/Prevention: Protecting yourself against further injury or preventing further damage to an area that is already injured is the first step. Strapping an injured area or using padding to protect the area is a good place to start.

Rest: Resting an injury gives it time to heal. Don’t underestimate how important it is to rest for the body to repair properly.

Ice: Icing an injury helps to reduce swelling and pain but be careful not to ice for more than 10-15 minutes maximum or it can have the opposite effect. Also, make sure ice isn’t applied directly to the skin or an ice burn can occur; keep a thin layer between the ice and skin. Ice should be applied for at least the first 72 hours after the initial injury and every 2 hours when possible.

Compression: Compressing the injured area can prevent swelling and reduce swelling that has already occurred. It also helps with the first step(protection/prevention).

Elevation: Elevating the injured area above the level of the heart(if possible) reduces the amount of blood which flows to the area and therefore prevents more swelling. It also helps the lymphatic system flush the swelling away with the aid of gravity.

By following the P.R.I.C.E protocol, it can make recovery time much less than without the knowledge of what you are supposed to do. This protocol can be followed for any injury, not just the back that I have used as an example in this blog.

I hope this blog has been useful in teaching you what to do in the event that an injury has occurred. I also hope that by seeing a real MRI scan and hearing how easy it is to injure your body just from incorrect posture, that you think about your posture more each day and where possible you use the correct techniques to hopefully prevent an injury that is very common and one that I’m seeing a lot of lately.

Thanks for reading and good luck in taking good care of your body!

Fail to Prepare; Prepare to Fail!

After using the phrase ‘Fail to prepare; prepare to fail!’ this week, I thought it would be a great place to start when writing my blog. As I’m in the process of training for the London Marathon in 2012 I find myself back in the same mindset as I was as a footballer, not leaving anything to chance and making sure every training run is prepared for properly. It made me think about how others prepare themselves for their sports or just for training in general. I’ve come up with a few questions and tips that might help you train and perform to your best…..

  • Are you eating the right foods before training or the main performance? 

TIP – What you put into your body prior to training/performing will provide you with the energy you need to perform at your best. If you don’t eat right, don’t expect to perform to your best! High carbohydrate foods before hand should leave you with the energy to perform at a good level without feeling tired/drained. I tend to eat foods like, chicken, pasta, rice, bananas, toast and cereal. The size and type of food depends on the time of day I eat it and how long I have before the performance. Ideally, a big meal should be eaten 3 hours prior to the performance or smaller, lighter foods such as toast for anything closer to the performance. Remember to leave enough time for your food to go down and start the digestion process or it will sit on your stomach and make it uncomfortable to run or move when performing.

  • Are you drinking enough of the right fluids before and during training or the main performance?

TIP – Very similar to the tip above, the fluids that you put into your body prior to and during training/performing, will prevent you from becoming dehyrated and will replace lost salts from sweating. Drinking plenty of water before training/performing will help the body be at its best. If you feel dehydrated the damage is already done! It only takes 2-3% of water loss in the body before endurance starts to suffer and your performance also suffers. A little bit more(5%) and it effects the mind making it hard to concentrate and the body continues to suffer with pace slowing down. Keeping hydrated is vital! Isotonic drinks are a good tool during training/performing as they replace lost salts and also have a high concentration of carbs to keep the energy levels up. If possible, try to take plenty of fluids with you during your training/performance and keep drinking small amounts at regular intervals. It’s easier for sports like cycling for obvious reasons that you can connect a drink to your bike, but I’ve been known to hide drink bottles in a quiet place on a route I plan on taking a long distance run, so that I have a drink at certain stages of that run. Don’t neglect drinking fluids and make sure they are the right fluids, not fizzy drinks, tea, coffee etc as they are diuretics and will only dehydrate you more!

  • Do you have the right equipment and clothing?

TIP – This is a very important tip! Having the wrong equipment or clothing could be costly, not just because of comfort but because you can risk injury. Until you know a sport, it’s very difficult to know what you might need, so make sure you speak to the right people and get advice on the essentials from people who perform in that sport or know their stuff. An example: Until running long distances, you might not have ever thought about blisters, chafing, correct trainers for your gait etc, but all of them can make the difference between performing at your best and a very uncomfortable event. Clothing such as 1000 mile blister free socks, lined shorts, vaseline or other lubricants to prevent chafing and correct trainers(sometimes fitted with orthotics if necessary!) are a must. Sometimes it’s trial and error but there are specific sports shops that can advise you if you need help. How about riding up a steep hill on your bike and the gears keep slipping? Again something that can cause an injury if you’re on a road amongst traffic and can really make your ride much more difficult. Maybe it’s about the right foot wear in a football match. Do you have moulded boots for hard grounds and studded boots for soft weather grounds? It’s not just the equipment/clothing it’s also the colour! I have recently been on a training run in the clothing you can see in the picture to the right which looks fine until you know I went out later in the day and misjudged the time. I ended up running in the dark in black clothing without any reflectors on. I rarely make mistakes like this and there were no problems on the run, BUT there could have been and next time I might not be so fortunate. I have learnt from my mistake and it’s a good mistake to highlight as an example of the title of this blog.

So in conclusion, don’t leave things to chance! There are many more tips I could give you about performing to your best but the blog would go on all day, so I’ll save it for another day. The higher the level you perform at, the smaller the margins are. Not drinking enough, eating the wrong foods at the wrong time, wearing the wrong clothing and using the wrong equipment and generally not preparing for your performance could be the difference between being a winner or a loser! What would you rather be?

Consistent or Consistently Inactive?

The Findings:

After recently returning to full training from a calf injury, that meant not running for 25 days, I have witnessed first hand(again!) what a break in fitness training can do! The great thing about technology is being able to compare data and doing exactly that has shown me in black and white the differences between regular, consistent exercise, to irregular, inconsistent exercise. After seeing what it can do to someone like myself that is in the fitness industry for a living and loves to keep fit, I thought it might be a great idea to share my comparisons with others that exercise a lot less, to show the effects it can have on the body and change a few people’s mind sets towards regular exercise.

The facts:

I run 10 miles at a time 2-3 times a week with 1-2 resistance training sessions in between, consisting of full body weights and core exercises. The last time I ran(when fresh) before getting injured, was Sunday 10th July. Since then I have not been able to do any impact exercise so I’ve been limited to CV on a bike and weight training. Because of this I knew my fitness would suffer but I wasn’t sure how much until I returned from injury. My first run back from injury(without pain) was on Thursday 11th August, 32 days apart. The differences in pace, time, and most importantly heart rate are quite amazing!

Here is the comparison(make sure to click on ‘more detail’ for a thorough comparison):

http://connect.garmin.com/activity/comparison?activityId=105655672&activityId2=98138179

If you look at the difference in max and average heart rate between the two, the latter run was higher by 12 beats per minute, making the heart rate zone much higher and the body having to work much harder even on a flatter course. If this is what can happen to the efficiency of the heart of a personal trainer in 32 days, whilst continuing other forms of training in that time, imagine what it can do to the average person that neglects their body and the exercise they do to keep it in shape over months or years of irregular, inconsistent exercise. If the heart takes that short a time to become that less efficient, take a moment to think about the strain it will have on other organs of the body and the body’s performance as a whole. Even the smallest jobs could seem epic if the heart has to work so hard to make it happen, so here are a few tips to make sure you keep your body working as efficiently as possible.

The Tips:

  1. When starting to exercise, try to get into a routine that the body recognises. Build it up so that you workout at least 2-3 times a week for an hour at a time.
  2. Everyone needs a rest to let the body recover and as I’ve mentioned before, the rest is just as important as the actual workout, but don’t leave it too long between workouts. As you can see from the stats above, if the gaps are too big between exercise, the body’s fitness will suffer and you will feel like you’ve taken a step backwards every time you start exercising again.
  3. Lastly, keep things fresh by mixing up what exercise you do, this way you will be less inclined to put it off as you are bored of your routine. By doing this you will keep your exercise routine fun, consistent and your body working efficiently for as long as you put the hard work into it.

I hope these three tips help you keep your body fit and healthy. If you have come across the same break in exercise and experienced the same fitness struggles, please leave your stories and let me know if this blog has helped you!

Listening to your Body

Learning about exercise, fitness and what to do to reach your goals is a never-ending learning curve. Everyone has an opinion and there are many that are controversial. It can be quite confusing hearing lots of opinions and advice from different people and even when we know our stuff, we all still make mistakes. I’ve recently made a big mistake at which I should have known better and it’s important we learn from these mistakes. We can listen to as much advice as possible from people who know more than us, but the most important thing, is to listen to our bodies when it comes to how we feel when training. Sometimes we can get complacent after exercising regularly and that can be a dangerous place to be, as I found out recently. When we commit to exercise we all like to push it hard and see results, but sometimes that’s not the way to go. The rest and recovery is just as important and sometimes more important than the actual exercise. What none of us want is to burn out and end up injured!

I was recently running on my usual 10 mile route and I could feel my right calf was tight. I’d been training hard for a couple of weeks before hand and wanted to keep pushing myself. My body was trying to tell me that it was time to stop and recover but I didn’t listen. When I felt my calf tightening I should have cut my run short, gone home and rested for a few days to let my body recover, but I didn’t and thought I could just get through until the end. I took my body one step too far and after a few quick successive sharp pains I felt a ‘ping’ and the damage was done, I had pulled my calf. I have pushed my body to the limit so many times before that I got complacent about my fitness level and ignored the signs. We all have a limit, we just need to know when to stop!

When we exercise and continuously push our bodies to the limit, we actually tear tiny muscle fibres. These muscle fibres are so small and there are so many of them that it’s not noticeable, but over time they rebuild and cause scar tissue, what most know as knots in the muscle. If we don’t give our body time to repair and recover, these small tears can be far worse and that is when more serious injuries occur. Muscle pulls/strains are common because of many reasons but they can be prevented with a little common sense and just by listening to our bodies and having a rest when we feel we need one!

Here are some signs that might help you prevent an over usage injury………

  • Dehydration –  The body is made up of 70% water. If the body gets dehydrated, normal functions will suffer including muscle performance. Generally, if you feel thirsty or you have a dry mouth, the damage is already done, you are already dehydrated. If you feel this way, make sure you drink plenty of fluids and you feel ready to exercise before trying to push yourself. Don’t ignore it and try to exercise as dehydration can be very serious.
  • Tiredness –  When you are tired mentally or physically, the reaction times slow down and concentration levels drop. If you don’t concentrate on a run, bike ride or many other activities, or you just react slower than normal, it may be the difference between putting your foot in a pot hole or seeing it earlier, dodging it and avoiding an ankle injury. If you feel tired, rest and make sure you have recovered fully before exercising again.
  • Tightness –  If you are contemplating a weights or CV session but a certain muscle or area feels tight, it’s tight for a reason. Don’t push through it and hope it eases off, as it can be far worse like a muscle pull, such as the one I’ve experienced through doing exactly this! Be sensible, let the muscle recover and make sure it is fully warmed up, stretched and feeling ready to exercise before you exercise again.
  • Illness –  If you are recovering from an illness, make sure you have recovered fully before trying to exercise. Your body’s immune system is down and exercising at this point can increase the risk of injury or further illness. There are some minor illnesses like a basic headache that exercising can actually help with. It helps to dilate the blood vessels in the body so the blood moves more freely with less pressure in the head, hence easing a headache, but if the body has an infection or virus, bacteria can thrive when the body temperature is raised therefore prolonging the illness. I suggest you take the extra few days to recover and make sure you are on top form to be able to push yourself hard, when you get back to feeling 100% again.

The key to preventing injuries is to be smart. If you’re in any doubt and you just don’t feel quite right, don’t risk it. That doesn’t mean don’t exercise just because you can’t be bothered, but be sure you are fit and able enough to perform to a good intensity and get the best out of whatever exercise it is you have chosen.

So, next time you want to exercise, let your body speak to you AND make sure you listen! Enjoy your workout : )

No Pain, no gain?

Throughout my football career I put on a brave face through many injuries, some minor and some more serious, but in a competitive sport like football, it is important to play through what you can so you don’t lose your place in the team………or is it? I believed, when I was young, that I would be frowned upon from pulling out of training or competitive games because of an injury. Unfortunately, there were times when this was true because some of the managers in football only want one thing……to win! Most only care about what happens right now and don’t really worry about what an injury might mean to your future.

The more injuries I had and the older I got, the more I realised it was up to me to protect my body when it needed protecting, or my career would not last the distance. Unfortunately, the damage was done in my early years, by putting my body on the line one too many times for people who weren’t concerned with my future and in the long run I paid the ultimate sacrifice, an early retirement. The injuries I sustained over the years were just too much to continue playing a professional sport and that is why I am where I am today. Hopefully my experience of injuries and playing through the pain of broken bones, cartilage tears, arthritis to name a few, can help others not to make the same mistake. So, there are times when the saying “No pain, no gain!” couldn’t be further from the truth.

This picture shows a head injury that has left me with a scar across my forehead for the rest of my life! I was also playing with a broken hand!

Recently I’ve had a few people ask for my advice about injuries they are having problems with. It seems that a lot of people don’t know the basic protocol after the initial injury, so this blog will give you all you need, to help you speed up the recovery period of less serious injuries, such as sprains and strains(if in any doubt over your injury, medical advise should be sought).

Here are a few simple pointers that will help speed up the recovery process. When ever possible always follow the PRICE protocol:

  • P = Protection. Protect yourself from injury as best as you can (eg. wearing shin pads etc) but if the damage has already been done, the same principles apply; Protect the injury from further damage by stop playing or using padding to support the area.
  • R = Rest. Being brave and playing on is not always wise! Rest is important to let the injury heal no matter how big or small it may be. This can be the difference between a speedy recovery or making the injury worse and adding weeks or months to the recovery period.
  • I = Ice. Applying ice to an injury reduces pain and inflammation/swelling. It should be performed for 15-20 minutes maximum every couple of hours. Be careful not to ice for longer than 20 minutes as it can damage the tissue further rather than help it. Also, it is advisable not to put ice/ice packs direct to the skin to prevent ice burns which can be very painful! The next two steps can be performed at the same time as icing an injury to aid recovery.
  • C = Compression. Keeping an injury compressed with bandages will reduce swelling or prevent the injury from swelling further, if swelling has already occurred. You can compress at the same time as icing for added benefit. If the compression causes pins and needles, throbbing or cuts circulation as it feels too tight, take the bandage off and compress the area again but not as tight.
  • E = Elevation. By keeping an injured area elevated above the level of the heart as much as possible, it reduces swelling and lets any swelling already built up in the area track away to the nearest glands making the area less stiff and helping recovery. Again, it is a good idea to elevate an injury whilst icing.

This is a sight no one wants to see. One I can't actually remember!

So there is the basic protocol. Obviously more serious injuries will need medical treatment but this protocol will always be used along the line at some point.

Remember, no pain, no gain is not always the answer when it comes to injuries. Pain is your body’s way of telling you something is wrong, so ignoring it can only make an injury worse. Don’t let a pain you have ignored turn into an injury that can cause more serious problems later in life!