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The good news about triathlon is that cross-training between three sports helps build a
balanced body and may reduce the risk of overuse injuries common to single-sport athletes.
The bad news is, doing three sports opens you to a wider variety of injuries—especially
if, like many triathletes, you’re driven to excel (and overdo). Fortunately, you can
stay healthy by applying common sense and some injury-prevention knowledge. Here are the
six injuries most common to triathletes—and how to avoid them.
- Rotator Cuff Tendinitis (or Tear)
“Swimmer's shoulder” is often used to describe many problems such as muscle
strains, pulls, and tendinitis. Rotator cuff tendinitis is frequently caused by pool
workouts that are too long or too hard, an imbalance in shoulder muscles, or poor stroke
form. Inflammation occurs because of microscopic muscle tears and stress on the four major
shoulder muscles that run together, known as the rotator cuff. Pain is usually localized,
though it may radiate down the arm. Indications of rotator cuff tendinitis: stiffness and
difficulty extending your arm at a 90-degree angle, weakness when lifting the arm, and
pain at night.
- Prevention:
Don’t increase your distance or interval workout in the pool too
quickly. Work on developing balanced strength in your shoulders by weight training your
biceps, deltoids, pectorals, and trapezius muscles.
- Lower Back Pain (SI Dysfunction)
One report found SI Dysfunction to be one of the three injuries most common to multi-sport
athletes. The sacroiliac joint (SI) is major joint connecting the back and hip. Unlike
other joints surrounded by muscle, the SI relies predominantly on ligaments for support.
When these ligaments become irritated, whether by a structural or muscle imbalance, the
result is SI dysfunction. Pain is usually in the lower back, just above the hip. It is a
dull ache, but can become sharp if training continues. Sometimes the pain radiates to
other areas of the back and hip.
- Prevention:
Locate and correct any structural imbalances in your running or
cycling motion (such as those caused by leg-length discrepancy). A certified
sports-medicine physician should be able to help you locate imbalances and suggest ways to
correct them or limit their impact. Check your aero position on the bicycle—is it
uncomfortable and causing back pain? If so, better to sacrifice a little aerodynamics for
greater comfort and health. Also, identify and strengthen any weak muscles that may cause
lower back problems. By implementing a lower-back stretching and strengthening regimen
when you’re healthy, you’ll avoid most back problems.
- Hamstring Muscle Tear
This may occur suddenly while running or cycling, particularly during an intense session,
such as an interval workout or a finish-line sprint. Downhill running is another possible
cause. The tear is usually caused by tight hamstrings, often due to over-training or
muscle imbalance. Hamstring muscle tears often occur at the tendons near the knee or hip,
though a tear in the central portion of the hamstring is not uncommon. The pain is usually
sharp and in a specific area. Muscle spasms may occur as well. “Recurring hamstring
problems usually stem from a muscle or structural imbalance between the hamstrings and
muscles in the thigh and buttock region,” says Lisa Alamar, a certified structural
therapist.
- Prevention:
Though hamstrings will always be weaker than quadriceps (the big
muscles in the front of your thighs), most sports physicians recommend hamstring curls and
other strength-training exercises that will give you better muscle balance. (Hamstrings
should be at least 60 to 70% as strong as the quadriceps.) Frequent stretching of the
hamstrings is also recommended.
- Iliotibial Band Syndrome
The iliotibial band is on the outer side of your leg, stretching from the hip to the knee.
Common to both runners and cyclists, iliotibial band syndrome is an inflammation caused by
the iliotibial band tendons rubbing against the outer bone of the knee. The pain is
usually on the outside portion of the knee, but irritation may occur anywhere between the
knee and the buttocks. Though the pain is not disabling, unless corrected, this injury can
persistently ruin your workouts. “Iliotibial band syndrome is a relatively minor
injury that should be treated by solving any mechanical problems, calming the muscle,
increasing flexibility, and improving strength,” says Robert P. Nirschl, MD, an
orthopedic surgeon. In minor cases, massage may also prove an effective
treatment.
- Prevention:
Implement a regular stretching and strengthening program, with
emphasis on the outer thigh and knee muscles. Also, don’t run on worn-out shoes; the
wear on the outside of the heel may cause this nagging malady.
- Achilles Tendinitis
The Achilles tendon, at the back of the ankle where the large calf muscles attach to the
heel bone, is vulnerable to microscopic tears and inflammation from the repetitive motion
of running. Achilles tendinitis may be caused by overpronation or by shortening of the
calves brought on by excessive hill running or overtraining. The pain is localized with
general tightness in the ankle area. Another sure sign is intense pain when walking on the
balls of your feet or your toes.
- Prevention:
Use a good pair of running shoes with a stable heel, and watch for
wear along the outer edges of the heel. Avoid steep hill climbing and running on hard
surfaces. Stretch the Achilles tendon, calf, and hamstring muscles before and after you
run. The best prevention is strength training for all the lower leg muscles, a vulnerable
part of the body that is subject to high stress from running.
- Heel Pain (Plantar Fasciitis)
The plantar fascia is a ligament that runs through the arch of the foot. During the impact
of running, the ligament is stretched each time the body’s weight is distributed
throughout the foot. Plantar fasciitis is caused by overtraining, foot imbalances, or
running on hard surfaces or in worn-out shoes. All these may overstretch and strain the
ligament, resulting in tiny tears that lead to inflammation. The pain and area of
tenderness are underneath the foot, at the front of the heel. Usually the onset of pain is
gradual, but increases with continued running. A common symptom of plantar fasciitis is
intense pain when awakening in the morning, especially with the first few
steps.
- Prevention:
Most running coaches recommend the use of orthotics (special shoe
inserts), even if you don’t have foot problems. Also, stretch the plantar fascia.
Avoid running on hard surfaces, and don’t run in worn-out shoes that have little or
no cushioning.
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