Category Archives: Injury

Illness and injury breaks – Do we ever really learn?

I did a 17k pool swim with Gábor at the end of April. It went fine but the next day I developed a head-cold. I doubt they were related as I’ve never been sick after a long pool swim previously and I’ve done quite a few over the past three years, but it was co-incidental, I think.

Inhalers_MG_3667-resized-resizedI’ve mentioned previously that I have asthma, which could be considered mild in that I have a generally good understanding and control of it and the triggers, and make sure to use a steroid preventer while pool training. I very rarely get a head-cold, maybe once a year. Not so mild however  should an asthma attack develop. Like many asthmatics (I hate that word, it leads people to make incorrect assumptions), a head-cold or ‘flu may lead to a bacterial chest infection, which always signals trouble for those with asthma. This inevitably means a drop in lung function and aerobic capacity, and therefore swimming capability. And I did indeed develop a chest infection within three days of the head-cold. A course of antibiotics swiftly followed, I recognise the symptoms by now and don’t hesitate. Swimming was out for over a week. But when I returned the first day, I felt fine. However I deteriorated again within a few days, my lungs feeling like they were full of broken glass.

The symptom for me while swimming is always first a light tickle in my throat, then a mild cough, which will increase in intensity and urgency as I swim further and longer, until I am coughing underwater and struggling to take in enough air to breathe. It’s always a losing battle so I’m better off to just stop. I almost never do this in time for some stupid reason.

The next two weeks were typified by feeling recovered, going to the pool and then deteriorating in the next day or two and then having to break again. it also led to a second course of antibiotics and oral steroids.

This isn’t to share my medical history but is just a long intro to the short lesson that like a lot of people used to training, and maybe especially swimmers, the thing I often struggle the most with, is taking a necessary break for illness or injury. Whereas at other times when I am actually healthy, I might not feel like training at all.

I have gotten used to both training hard and needing and taking weekly rest breaks. I think rest breaks are the most difficult thing for athletes to learn and taking breaks because of illness and injury, like on this occasion, are the second most difficult. (Overtraining is a whole other subject, and one that is too often invoked). I took my initial enforced break because I actually couldn’t swim. I had thought I got the timing right of returning but when I did return and that didn’t go well, that’s when I made the mistake trying to continue training. At that point, it was difficult to know how much more time to take on the second or subsequent break and consequently I probably prolonged my recovery. I know I lost at least 60,000 metres from my target over the course of those three and a half weeks, which is how long it took before I was sure I was recovered and could start swimming properly again.

And then when I could swim again, my conditioning felt like it had reverted to that of early winter. Not really because of the break, but more because of the deterioration in lung capacity. And therefore needing to repeat all the winter work required to get fit once again, not a pleasant prospect.

One of the reasons we struggle to take a break is because it’s tough to look at what training you’ve already completed and know that you are going to lose some or maybe even a lot of your gains. I don’t think I have any particular advice here, just that even with experience, getting the timing right can be difficult as illnesses can take individual recovery trajectories and it’s sometimes very difficult to estimate the time off and the recuperation necessary.

That’s the thing isn’t it? We all keep making mistakes, and we all keep learning.

HOW TO: Theraband work for shoulder strengthening

I’ve been picking up pain in my left shoulder for the past couple of weeks again, so I’ve just started doing a little Theraband work, good old swimmer’s shoulder.

Therabands are just large elastic (latex) bands, categorised according to resistance/strength, which can be used to isolate and work specific muscles. The colour indicates the amount of resistance. Their great advantages over using dumbbells or free weights are the muscle isolation ability and not least their portability and vast flexibility in isolating muscles.

I’m just using a medium green band and I’m concentrating on shoulder adduction (inward), abduction (outward), internal and external rotation and rotator cuff. Door handles make great anchor points when needed, and many exercises don’t need any anchor.

Here are some examples of great swimming specific Theraband exercises. One of the great things is you will see the muscles being worked and may find a more suitable way of doing these for yourself.

Rotator cuff strengthening:

External rotation (also for rotator cuff strengthening).

Internal rotation:

Shoulder adduction. You can also reverse the direction of this (abduction) by using a door handle, and going diagonally up and out.

Shoulder abduction.

Triceps stretch (the latter half of the front crawl pull is a triceps extension). Another variation of this is put the lower had as high up the centre of your back as possible and extend the overhead arm.

Shoulder dislocation, one of my favourite exercises, when I remember to do it. I used to do this one with a rolled up towel also.

[http://www.youtube.com/watch?v=Annb0cpxwzM]

 

 

Related articles:

Shoulders, the swimmer’s bane. (loneswimmer.com)

Stretching for swimming. (loneswimmer.com)

Asthma – sometimes you can’t figure it out

Feel fine and normal, go the pool, get asthma attack after 2 k and have to stop.

Come home to find email request for asthma advice from another swimmer.

Write long email with said advice, based on personal experience.

Go back to pool same day for another try, get another asthma attack, and come home again, feeling crap and like a complete liar after said email.

Feel crap next day, and go to pool for very low impact swim. Get in water and start getting faster as swim progresses.

Bloody asthma.  Oh, and on three wednesday’s running.

Endurance Recovery

Part of the design of Eilís’ training regime was to enable quicker post-Channel recovery.

Given the extra work I had to do during the swim, the six hours extra duration over what I was expecting, I wasn’t sure how long before I felt recovered. Jen was definitely back before me.

I was also injured afterwards. And tired for at least three weeks. I would generally feel fine, but when I tried anything remotely strenuous, the tank was empty.

But the shoulder is now about 90% recovered, and only sore while swimming, and not very sore at that. Last week I got to the point where I wanted to swim,so I went back to the pool. And with easy days of only an hour, it’s enjoyable in a way it wasn’t back during much of the Channel training regime. My speed is even more mediocre. My aerobic capacity is not what it was not so long ago.

But I am recovered, I think. At least I won’t embarrass myself at Sandycove too much next Saturday. Eilís’ training proves itself again.

There’s an endurance sport adage that I came across in an old running book. For an endurance event you can do approximately two and half times your longest training event.

However, if you want to do it regularly OR want to recover well, then you must train longer.

My shoulder, 2 days later

I’ve been asked about the shoulder more than a few times.
Here’s a photo we took 2 days after. It hadn’t turned black yet so it’s hard to see that the bruising stretches about halfway across my left pecotral muscle or over the top of the shoulder. You also can’t really see the swelling. Dee said you actually couldn’t see any shoulder indentation!

Still, it’s getting better. Very sore and weak on a (cold, 12C!) lap of Sandycove yesterday, it felt better today on a short swim at the Guillamenes today, (15.5C!).

A few minutes after getting on the boat…

Taken in Force 5 winds while the boat was being thrown about the place, so it’s a bit blurred.

I’m bloated from the previously mentioned Third Spacing of Fluids. (This actually passed within a few hours due to urination.)

Anti-fouling paint from under the boat.

Channel grease and accumulated dirt.

Ocular orbits swollen and white from wearing goggles.

Weird Open Water swimmer’s tan.

Kevin Murphy, King Of The English Channel, seated beside me (and Hoffy’s legs).

Proudly (should I have noticed), wearing my Swim Ireland Irish hoody.

I’m not falling asleep there, I’m trying to concentrate on not throwing up. I didn’t succeed. :-)

Adhesive Capsulitis aka “Frozen Shoulder”

So, after being home a few days and with continuing pain in my left shoulder and biceps, I took a visit to my GP. He was effusive in his praise, (which was weird, given how the man has looked after me for the past nine months especially).

Having talked here before about impingement and rotator cuff problems for swimmers, he diagnosed Frozen Shoulder. It sounded makey-uppey to me, I’d never heard of it, but apparently it’s fairly common, the clinical term is Adhesive Capsulitis, affecting 1 in 50 adults during their life, with (usually) no known triggering factor.

Apparently the sac around the head of the arm gets inflammed and “sticks” in the joint. The pain is associated with tearing the capsule away from the joint.

It usually affects the non-dominant shoulder, as with me. It normally lasts for… up to three years, usually with slow onset, prolonged (nine months) period of pain and prolonged recovery.

Anyway, though I can’t find any mention of acute onset in Cochrane or in relation to swimmers or marathon swims, it sounds like what both Lisa and Paul (Hoffy) also got after their Channel swims. And I think they were both non-dominant shoulder also.

My arm and shoulder were immobile for about three days, with some recovery after a massage in Dover. Pain at night was significant but lessening a little now, though I still need anti-inflammatories to sleep.

A visit with Vinny Power last night, my usual sports masseur, was good news however.

My range of motion is restricted, (I can’t swim :-( ), what’s especially noticeable is I have almost no internal rotation on my shoulder. (Ability to put my arm up behind my back). However I can now lift my arm out to 90 degrees from my side and even now partly raise it over my shoulder.

Remediation is passive and active stretching, heating and ice and regular visits to Vinny. I really hope I’m back before the Sandycove Challenge. Helvick looks unlikely, I’ll have to settle for being guest-of-honour (i.e. getting a free burger!) if they remember me.

For stretching I simply only have to raise my arm out to the side to 90 degrees, then face my palm forward and continue raising as hig as I can.

I notice most things that I now do, I’m compensating with my upper back and scapular. I’m also doing gentle single arm press up against a wall. Vinny warned me against my tendency to stretch too often or to stretch into pain, which I usually think will heal me quicker). Sometimes everyone else knows me better than I do.

Still, Vinny’s words were; “your degree of recovery in such a short period of time is extraordinary. It’s completely down to your awesome conditioning”,

i.e. Eilís training programme saves the day yet again.

HOW TO: Tennis Balls And Tights

Most of us suffer occasionally from “muscle knots” in the back, strictly “myofascial trigger points”, maybe caused by digging in the garden or lifting something heavy or turning awkwardly etc. In these cases the muscle contracts and doesn’t release. I got one last night after spending a few hours working at a table with an airbrush.

These knots can last a few days. Icing, electrotherapy & massage work to release the stress.But what if you can’t get at them or there is no-one around to help?

A tennis ball suspended in a an old pair of tights or vegetable net and hung over your shoulder and down your back is very useful for accessing these knots. Leaning back against a wall will allow you to position the ball exactly. A tennis ball has just the right circumference and stiffness to allow you work most those knots outs or take the worst out of them until it’s time for your regular massage to address them properly…

(Lying on the tennis ball on the ground will work as well but you won’t be able to complete the same range of movement around the knot.)

HOW TO: Core Exercises, Part 1

About 10 years I was snowboarding in Switzerland when I took a typical newbie fall on my coccyx. It took a few months to get better.
At the time I was doing a lot of running, having “retired” from competitive cycling in the mid-nineties and having looked for a while for something to fill the physical gap, as surfing wasn’t enough.
Like many cyclists I initially hated running. I wasn’t a great runner but after a few years I did find that mental space that many runners find and began to enjoy it.

However , a few years later I had another accident in Switzerland, this time also involving snow and ice, but also an inflatable tube and a high-speed launch into mid-air ending up landing in the middle of a mountain road on my back.
(I have a weakness for throwing myself off things, I can’t explain it). :-D
This time my back took longer to heal, required physiotherapy and left me with a weaker lower back. Standing or sitting straight up became difficult, and I finally developed a respect for those people with back problems.
I continued running for about a year, until one day about 4 miles out I felt what seemed like my spine “contract”, like it had suddenly been compressed and had to walk home slowly in agony.
I went back to various exercises but the one that helped me mostly recover was the ““. (Mostly because I wasn’t able to go back to running completely. Too much remaining lower back problems). Hence taking up swimming.

Anyone who watched much of the swimming during the last Olympics may recall many of the swimmers mentioning that they added Cores exercises to their training.
My experience of doing some Pilates a year ago was how impossible they seemed at first, and yet how quickly the benefits were felt.

Of course, I didn’t stick to doing them. :-(

Next, I’ll update with the Core Exercises Coach Eilish gave us.

Shoulder pain – the Swimmer’s Bane

When I started swimming OW long distance, my first long distance swim was Clew Bay, a 12km in the West Of Ireland.
(Boat drop onto an island out in the bay, guided swim into Newport Town, through the islands…you’d get lost without a boat guide).

A week later I started to have shoulder soreness, especially at night, while sleeping on the shoulder.

It dragged on for months gradually getting worse. I took an extended rest, but it didn’t do the trick. Visited a Doctor and Physiotherapist before finally visiting a sports masseur, and getting it sorted.

Rotator Cuff Impingement, aka ” shoulder problem”.

This is a problem for all swimmers but long distance swimmers in particular.

There is a lot of information from various sources about this, but not all of it useful…

The cause -
Constant movement of the arm over the head can cause inflammation on the rotator cuff tendons from movement over the shoulder. It’s typical to swimmers, tennis-layers and apparently baseball players.

The symptoms -
The problem typically expresses itself by pain, soreness or tenderness in the posterior deltoid, i.e. the soreness is at the bottom of the deltoid, where it connects with the upper arm and feels like it’s around the bicep area 6 or 7 inches down the arm.
You may also have pain at night particularly while lying on the arm.
You’ll probably feel fine while swimming. It may be adduction or abduction, i.e if someone provides contrary pressure to you arm while pressing outwards (abduction) or pulling in and across (adduction).
You can take a break for a week or two, thinks it’s gone, but it comes back. Anti-inflammatories help but again the problem comes back.

So you’ve already got it. What do you do?

Physiotherapists will give you various exercises, to strengthen the underused muscles, the external rotator, which helps balance the shoulders. My experience was this was a very slow and not very effective remedy, as I still had the problem.
Visiting a Sports Masseuse though, had a big impact. One weekly massage for a few weeks COMBINED with regular icing of the area. I was able to keep swimming and the problem has never returned seriously. If it flares up, I just start icing for a few days in the morning and night for abut 5 minutes per shoulder, occasionally using “Deep Cold” gel also.

The mistake I made, and which I see repeated all the time, is to increase the mileage too quickly.
USMS, the American College of Sports Medicine etc, recommend a weekly mileage increase of no-more than 5% per week.

In my case for the Channel, I’ve been building up mileage for 3 years. Sure you could do the training in a year, but the risk run of recurring shoulder problems would be far higher.

One further thing. I said all swimmers above. I regularly meet people with the problem who are are recreational swimmers, doing 800 or 1000 metres 3 or 4 times a week. But once they have the problem they think heat and swimming makes it feel better, so they can have it for a long time. I met one guy last year who’d had the problem over a year, after swimming about 500 metres continuously one day on his holidays in warm water. Two visits to a sports masseuse and he was sorted.

In the meantime, make sure you are either doing your external rotator cuff exercises or adding backstroke into your sessions (each word is a different link).