Treating the Triathlete

Triathlon injuries fall into two main categories: traumatic and repetitive stress.

Traumatic injuries for triathletes include sprains, tendon ruptures and fractures, abrasions from falling off a bike, and even puncture wounds from running from the swim exit to bike transition. These injuries are not unique to triathlons, and are commonplace in most podiatry practices.

The most common triathlon-related injuries are caused by repetitive stress. These are the “too much, too soon, too fast” injuries. One study of training patterns and injury rates showed that for non-elite triathletes, the likelihood of sustaining an injury is lowest when training for a total of eight to 10 hours per week, specifically cycling for five to six hours and running for three to four hours weekly. Time spent on swimming training does not appear to affect injury risk. Less training or more training increased injury risk. A common training tip is that it is better to be 15 percent under-trained than 1 percent over-trained. The literature supports this common sense approach as well.    

One might think swimming is relatively free from podiatric injuries but keep in mind that many triathletes will train with flippers on their feet and can actually aggravate a foot or ankle injury with these training aids. Flip turns can also be quite traumatic to an already injured foot or ankle. Do not forget to caution an injured athlete to be less zealous with turns. Cycling-related injuries are often due to poor bike fit and shoe gear. If the saddle of the bike is too high or too low, and/or the cleat of the bike shoe is too far forward on the pedal or too loose, Achilles tendonitis, patellar tendonitis and iliotibial band syndrome can occur. If the cycling shoes are too tight or not wide enough, Morton’s neuroma and metatarsalgia are not uncommon. Get a professional bike fitting or a Retül (Retül Studios) computerized fitting of your bike to prevent and/or treat these injuries.

Running is by far the culprit of the most triathlon-related injuries. Studies relate up to 78 percent of injuries as overuse. A review of the literature shows little agreement on the “most common” injury but shows an injury rate of up to 75 percent of runners. Training time and errors seem to lead to the greatest number of injuries. Here is a practical top ten lower extremity injury list for discussion:

1. Stress fractures

2. Blisters

3. Subungual hematoma

4. Achilles tendonitis

5. Plantar fasciitis

6. Metatarsalgia/Morton’s neuroma

7. Iliotibial band syndrome

8. Patellar tendonitis/chondromalacia patella

9. Medial tibial stress syndrome

10. Sacroiliac joint dysfunction

 Excerpt from Podiatry Today

https://www.podiatrytoday.com/keys-treating-common-triathlon-injuries

Author: Mary Beth Crane, DPM, MS, FACFAS