RESILIENCE DURING DIFFICULT TIMES – RECOVERING FROM INJURY

The aim of training should be to maximise the training stimulus to ensure adaptation, whilst minimising injury risk, but sometimes injury is inevitable. When we exercise, there will always be a risk of injury, athletes place huge demands on their body, which at times outweighs its physical capabilities. An injury in sport can be defined as:

“Any physical complaint, sustained during training or competition that causes: a reduction in future training time or competition and/or an athlete to seek medical attention”

Loughborough University, 2017

Over our years of exercising, we have both experienced injury, which has not only set us back with our training, but caused us to seek medical attention. We have learn’t to take into consideration the modifidable risk factors associated with exercising and want to share some hard learn’t lessons we have had, to illustrate how you can minimise your injury risk when training.

ANTERIOR CRUCIATE LIGAMENT RUPTURE

We were fortunate enough to attend Kent College Senior School in Canterbury, which gave us the opportunity to emerse ourselves in a range of sports. As a sixth form student, I captained the school first team rugby, played externally for Ashford and East Kent, went to the gym every day and attended strength and conditioning sessions led by ex-Welsh rugby professional, Matthew Robinson, which to this day, I still use to motivate myself when I’m feeling lazy, because nothing compares to continuous 50 metre sprints at six oclock in the morning.

It was 20th April 2015, only two days after a Welsh rugby tour with Ashford, followed by my Duke of Edinburgh gold exhibition in Snowdonia, 5 days of trekking up and down mountains with a 20 kilogram rucksack (because I don’t know how to pack light) and living off ASDA smartprice chocolate bars (because I had no understanding of nutrition and was too broke for ready-to-eat camping meals). I was playing monday night 5-a-side football, following my rugby training, when I chased the ball, made contact with an opposing player, felt my knee buckle inwards and fell to the ground. I did not realise at the time, that this anterior translation of the tibia, relative to the femur was the mechanism of an anterior cruciate ligament (ACL) tear.

ACL Injury Mechanism – Anterior Tibial Translation and Excessive Valgus Forces at the Knee

Sixteen years old, with the pressures of performing and not realising the extent of my injury, I continued to play sport on my damaged knee for a year, with a change in direction causing it to give way and me to fall to the ground in excruciating pain. Over time, the pain became worse, the knee would lock (which I soon realised was a torn medial meniscus) and at times I wouldn’t be able to walk for days.

It was only when I got an ultrasound scan that I realised the extent of my injury, a now fully ruptured anterior cruciate ligament and a torn medial meniscus. In 2016, a year of physiotherapy later whilst waiting for an NHS appointment, I had the surgery, which was then followed up with another year of physiotherapy. It was during this time, not being able to do sport, with no choice but rehabilitation exercises every day, that I joined a gym and my love for fitness began.

Anterior Cruciate Ligament Rupture and Medial Meniscus Tear – The day of the surgery and several weeks later

LESSONS TO LEARN

  • AVOID OVERTRAINING – At the time I was exercising twice a day, every day
  • KNOW WHEN TO STOP – I played sport on an injury that caused me pain, always put your health first

BICEP TENDON RUPTURE

Saturday 1st December 2018 was my first and last time competing for the Loughborough gymnastics development team. I had self taught calisthenics for several years now, confident I would impress on the rings, but not so much on the floor, where I lacked elegance, flexibility, presentation and anything gymnast-like. I was nervous, being the first person to perform on the first event, the rings. I had trained the night before (below) and every day in the week leading up to the competition, perfecting my back lever, the most challenging part of my routine, which I had only learn’t a few weeks prior.

Back Lever – The night before the competition

My nerves meant I rushed the warm up, I wanted my longest back lever hold so I had the chance of at least winning the rings and avoiding negative points after my floor routine. I stepped onto the podium, with false confidence saluted the judge and dropped down onto the rings. The routine started with a comfortable ring muscle up, this was followed by a L-sit hold, then a forward roll, pulling myself up, I tucked my legs over my head, straightened my body and supinated my hands, an attempt to get a longer hold. I immediately heard a rip, which James later confirmed sounded like a coat unzipping, instinctively knowing something was wrong, I dropped off the rings, looked down and saw that my bicep had moved up my arm.

Ring Routine – The night before the competition

I immediately recognised from my sport injuries lecture that I had Popeye sign, the sign of a distal bicep tendon rupture. The pain I experienced was surprisingly minimal, but my heart dropped as I knew that I would require surgery and a long time away from heavy upper body training.

Popeye Sign – 10 minutes after injury, the bicep has disattached from the radius of the forearm and moved up the arm

Only a week later I had surgery, to repair the distal bicep tendon attachment, where the bicep attaches to the radius bone of the forearm, surgery in the case of this injury was immediate, because waiting too long can lead to the formation of scar tissue, resulting in a permanently reduced range of motion at the elbow.

LESSON’S TO LEARN

  • ALWAYS WARM UP PROPERLY – I didn’t because I felt nervous and rushed
  • REST SUFFICIENTLY – I trained the same exercise every day leading up to the competition and the biceps the night before
  • EXERCISE CORRECTLY – In an attempt to get a longer hold, I actively supinated my hands, putting excess stress on the bicep tendon
  • BE FLEXIBLE – I was told a few months prior to my injury that I lacked flexibility in my biceps, not ideal for a back lever or gymnastics training

STAYING MOTIVATED DURING DIFFICULT TIMES

Neither time, when I ruptured my ACL or my bicep tendon, did I let this effect my motivation to stay fit and healthy. With my ACL, the day after surgery, I trained chest (shown below) and did some pull ups, despite being on crutches. With my bicep, I trained the day after I had surgery, with my arm in a large cast.

Don’t let an injury become an excuse not to do any exercise, most of the time, if you are careful you can work around your injuries. With my ACL, I trained every muscle, including my right leg, whilst doing physiotherapy exercise on my left side. With my bicep tendon, I trained every muscle, including my left arm, whilst doing physiotherapy exercise on my right side.

Cross Education – Training the non-injured side can actually produce training effects on the injured side

Don’t let ‘what others might think’ or what others say stop you from pursuing your goals. Many people told me I shouldn’t train a single side because it would make me ‘lop sided’, with little knowledge that this is simply not the case. Once you have sustained an injury, you have two options:

1. To stop training altogether and start back at square one after you have recovered (due to the training principle of reversibility)

2. To engage in rehabilitation exercises, light activity, work around your injury and train the non-injured side, which keeps your fitness high, making it easier to return to activity and has shown to actually produce training effects on the opposite side due to cross-education, helping you stay stronger over all:

“Research has proven that with a unilateral extremity injury, training the opposite side can produce training effects on the injured side”

Ruddy and Carson, 2013

MINIMISING INJURY RISK

In summary, to minimise your risk of injury, look to limit the modifidable risk factors, those that you can control through your behaviours, for my injuries these included:

  • Overtraining
  • Playing on an injury
  • Inadequate warm up
  • Insufficient rest
  • Improper exercise technique
  • Lack of flexibility

These are all factors that I’ve changed/am looking to change, to reduce my risk of subsequent injury in the future. Take the time to consider if any of these may affect you as well as any other potential risk factors relating to your activity that you can change.

Overcoming Difficult Times – Then VS Now

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