Stretch and go: Dr Phil Kieran on sports injuries

Head, shoulders, knees and toes — some simple precautions can help safeguard vulnerable body parts from injury as we exercise more than ever before, writes Dr Phil Kieran

NIGGLING FEELING: When training for an event, it’s important to listen to what your body is saying and to prioritise rest days. Picture: iStock

EXERCISE, exercise, exercise — over the past five to 10 years this message has been unavoidable. As a GP, exercise is probably the one thing I most prescribe. I recommend it to patients with high blood pressure, those with anxiety or depression and people who feel tired all the time.

Indeed, there is good evidence that exercise is an effective treatment for a whole range of medical conditions (for anyone interested have a look at a YouTube video titled 23 and ½ hours, it’s nine minutes well spent).

This drive towards more exercise means that, hopefully, we will live longer and healthier lives going forward, and looking at the number of events springing up around the country we can see that people are listening.

I would be willing to guess that a good portion of you have done, are planning to start, or at the very least, have a friend who does some form of organised exercise like triathlon or 5k running. Marathons used to be the realm of the elite athlete but now more and more of us are taking the plunge and giving it a go. What I end up seeing a lot of though is injuries that occur when people jump into exercise too enthusiastically.

It’ll never happen to me…

2013 — I was out for a run, training for the Dublin marathon. About seven miles away from my apartment, things were ticking along nicely. I was keeping a good pace, the sun was (believe it or not) shining and there wasn’t too much traffic ruining the views.

My right hip started to get a tiny bit sore but I thought it would loosen out as I ran. Two miles later, I was leaning against the side of a bridge not able to move that hip properly and on the phone to my wife asking could she collect me on her way home from work. I figured my marathon hopes were finished but thankfully, after seeing a physio, I managed to get back on track (or close enough). What I had was an injury called iliotibial band (ITB) syndrome, which at the time I knew next to nothing about. But boy did I learn.

Upward trend

Participation in organised races in Ireland has increased dramatically over the past 10 years. From 2009 to 2014, the numbers competing in triathlon increased 120% and this upward trend has continued unabated, according to a 2017 report from Triathlon Ireland. On a local level, given that Parkrun and adventure races are springing up everywhere, it’s safe to say more people than ever are getting out and getting active.

This is a very promising sign. However, week in week out I see young fit men (and women less frequently) in my surgery with pain from the new sport they have taken up. They seem to get injuries, like the children’s song, in their head, shoulders, knees and toes, all down to overuse and stress injuries.

The symptoms I experienced are fairly typical of ITB syndrome but just as common as this are feeling a dull ache behind your kneecap after a run or cycle which can be patellar tendonitis, stiffness and heat in the back of your ankles which could be Achilles tendinopathy (very common if your running up and down hills) or a dull ache in the top of your foot which can be a stress fracture. If any of these are familiar stop exercising and talk to your GP or a phsyio.

How do I avoid injuries?

Right, that’s it! Exercise is dangerous! I’m not doing it again! If it sounds like I think that’s the case, nothing could be further from the truth, I would encourage everyone I know to be more active but it’s important to do two simple things:

  • 1. Listen to your body
  • 2. Do a bit of research.
  • Tuning into your body can be a bit trickier than it sounds. To get the most out of any training regimen you need to be pushing your body past what is comfortable. Fitness or strength is your body’s way of adapting to a demand which exceeds its current comfort levels, so you will be pushing yourself. However, what a lot of people overlook is rest days. These should form an integral part of any training programme.

    The body accumulates micro injuries during training which it then adapts to overcome (thereby getting fitter/stronger). However, if it isn’t given the chance to repair these injuries you’re asking for trouble.

    Many people think if they are dedicated and push themselves hard seven days a week they will perform better than those who only exercise four to five days a week. This is not true and will just lead to one of the injuries listed above. I have read more than one professional sports star stating that they take rest days as seriously as any day in the gym.

    Research doesn’t need to be exhaustive and in a lot of sports it’s probably easier (not to mention more social) to join a club. One of the big benefits of joining a club is accessing the collective knowledge of people who have been doing a sport for a long time without injuring themselves. Whether it’s cycling, swimming, running or all three, a club will help you stay motivated on those dark February days and reduce the risk of injury significantly.

    Even with injury risk, the benefits of exercise massively outweigh the risks. In fact, a well-used phrase by sports medicine doctors is that ‘the biggest risk of any exercise is not starting it’.

    Super endurance sports (Ironman and ultra-marathons, specifically) need to be taken very seriously and we all need to be sensible about what we can do but if you apply the two simple ideas — listen to your body and do your research — no sporting achievement should be off the cards.


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