When will injuries likely occur?

Posted on September 2, 2009 by CoachJay

In USATF coaching education a graph is presented that shows volume and intensity that is similar to the graph below (from the American Journal of Sports Medicine).

From the American Journal of Sports Medicine

I’m not sharing this graph to start a discussion about the graph itself and the theory of periodization that underlies the graph (though you are welcome to discuss the validity of the graph in the comments section). I’m sharing the graph because I received an email this week from a coach who has been using the Lunge Matrix (LM) warm-up with his athletes. If you’re not familiar with the warm-up please take a look at the video below.

The coach then told me that they had added the LM to their daily warm-up and they were having lower leg problems, saying “we’re plagued with lower leg cramps, spasms, and pain. At first I just attributed it to the ubiquitous, new-runner “shin splints”, but now even my experienced runners are starting to have serious pain, tightness, and discomfort.”

This email saddened me, especially since the LM is one of the elemental aspects of training in my worldview and something that is supposed to protect against injury. I spent some time writing a response and I will share my email response in the comments section below.

What I want to do is use this email as a way to focus our attention on a simply question. If you were to look at a one year macrocycle of training, when will injuries likely occur? Think about it for a moment before you read on.

USATF coaching education was the first time I was espoused to the concept of “cross-over”, the point where volume and intensity cross one another and the need to be careful at that point in training cycle. Mark Wetmore calls the first two weeks of school the “danger zone” because that is where injuries often begin. He would highlight it in red as a reminder to keep the workouts conservative in the hopes that his charges would be able to train injury-free.

It saddens me that I’ve received three emails in less than forty-eight hours from HS coaches who have athletes who are either injured or are on the verge injury. Obviously each coach is in a different situation with different constraints and realities, yet I would guess that in most programs there are some common themes that are leading to this problem.

1. The intensity has gone up since the start of organized practice, primarily due to athletes wanting to see where they are in the team hierarchy.
2. The stress of a new school year, while innervating for the student, negatively impacts the athlete’s ability to recover between training bouts.
3. HS athletes, when not meeting their coach, rarely do the training the coach assigns exactly as the coach assigns it.
4. Talent and desire will allow a runner to “keep up” in practice, yet only an experienced coach will be able to tell if the athlete is running controlled in the workouts or is running close to race effort.
5. Volume and Intensity are the two primary variables in training design, yet it takes experience to bleed them together into a training plan that allows athletes to run injury-free.

That said, I don’t know how those themes may be impacting the teams coached by the accomplished trio of coaches who emailed me this week. Obviously I don’t have any specific answers for them, but hopefully having laid out five of what are no doubt dozens of themes relating to early season cross country injuries/issues, I can help these coaches and their athletes…’cause right now I feel bad for the coaches and sad for the athletes.

I will close with this. I emailed a small group of coaches and physiotherapists I respect to get their thoughts on the LM and the lower leg issues. Below is one comment from a college coach and one from a physiotherapist. Both provide an insight into this issue and I appreciate them taking the time to write.

From a college coach:

When kids get hurt in the first couple weeks of practice I normally assume that the training that I am prescribing is too much of a jump from what the kids accomplished in the summer. This is fairly common. I tend to believe that the athletes have done some percentage of the totality of what I have asked them to do. Unless I have seen the training I can not assume that everything was completed. It is unlikely that any one routine or exercise is the culprit in an injury scenario. Injuries are often a result of a mismatch between preparation and prescription. Most coaches are very good at what they do so more often than not we need to look at athlete preparation as the culprit……..

From a physiotherapist:

I love the lunge matrix warm-up routine, I think it is a good dynamic way to actively stretch most of the muscles in the lower quadrant. So I don’t necessarily think that it is the main factor causing the lower leg cramping/pain/tightness. If anything, it should be helping to alleviate those types of problems. Hydration may be an issue, but if not, the athletes may be lunging too far in the various planes during the progression. If too much dorsiflexion at the ankle is occurring causing overstretch of the calves, then a reflex contraction in the calves (specifically the soleus) leading to the spasms may be occurring. Too much dorsiflexion at the ankle will occur during a lunge if the athlete lacks proper hip extension when lunging while the knee touches the ground. Also, in the backward lunge exercise, the athlete has to rely on the hamstrings to perform deceleration of the hips as weight is transferred to the front leg. If the hamstrings fail to efficiently perform deceleration, then too much weight is transferred to the front part of the front foot causing excessive dorsiflexion at that ankle as well. Additionally, the athlete’s may not be properly warm when performing the routine. What is his reasoning for the 300m jog, 100m walk series? Do all his athletes do this, or just the beginners? The more experienced athletes may need to do a continuous jog for the warm-up as opposed to stopping every 300m and walking to adequately prepare the muscles for the dynamic stretch routine. Finally, although he may be watching his athletes perform these exercises to make sure their form is correct, maybe suggest not having them touch their knee to the ground as this will also increase ankle dorsiflexion causing additional stretch in the calves. Hope this helps.

This entry was posted in Coaching, For Everyone, Training and tagged cross country injury, early season cross country injuries, injuries, lunge matix, volume and intensity cross-over, volume and intesity. Bookmark the permalink.

billzeebub

I doubt very much that the LM is the root of the problem.

If these kids have just returned to practice, after a summer of 'run when you feel like it', then it wouldn't surprise me if suddenly being hit with the combination of daily training and a brand new lunge routine has been a horrible intro to the xc season.

This routine should have been introduced over several weeks, not just thrown at kids as a daily routine, as it's stressfull at first. I stick to the rule of 'progressive not agressive' when introducing new elements to the program. Even warm up routines should be introduced slowly, until each individual is happy and completing the routine correctly without supervision.

In the coaches defence, i don't think the lack of supervision during the summer helps very much. As a club coach in the UK, i find it odd when i don't see my group for a whole week, let alone a few months during summer break........although i'm sure that a few of them secretly wish that this was the case;)
Is there EVER any structured training during the summer, or are coaches not allowed to train the kids in person during the holidays?
KP

Great comments. Especially from the physio. The exercises are most likely not the problem, it's the form when the kids do the exercises, or their rush to get through all "the boring stuff" so practice can start, or the volume of the LM that they are doing that CoachKedge mentioned. As an athletic trainer at the small college level I see the same thing this time or year with the new kids on the team: great runner, horrible athlete. When I have to instruct them how to properly do a squat or lunge you know there is a problem. The introduction of this type of work, and having it eased into your existing program will pay dividends. But like all dividends you may not see them in the first year or two.
CoachKedge

Jay,
In addition to the LM routine you taught us we are currently doing two other routines for gereral strength. One is a modified version of what you call mertyl or mertle (sp?) which is a 10 - 12 minute series of planks, side planks, a supine holds, and a prone torso thrust (looks as racey as it sounds). The other is an abb routine that has a series of exersises with a set of push up during the 60 second recovery.

Between the three we hit pretty much every muscle (front, sides, back) from the chest on down to the knee.

We don't worry about when we do each one - hard day, easy day, etc... We just cycle through them - one per day unless we are wiped out from a real hard repeat session.

-Adam
pointzone

Coach Kedge

I would be very interested in taking a look at your general strength variations if you would feel comfortable sharing it. youngp@rcs.k12.tn.us

Good luck this season.
bartsessa

Jay,

I agree on all your points regarding why kids are getting injured!! Your 5th point is so spot on as well that I wish to add to it. Excuse me if I’m longwinded..............

In our information age and with the wealth of info you are providing I fear that a number of coaches are jumping on the Jay Johnson wagon (one that I have been pulling along for years as you know). By that I mean they have laid out a nice summer training schedule that many of the kids have followed and prepared for the season it includes not only the running but the non-running activities that we are trumpeting!!!) Unfortunately my experience shows that even the most enthusiastic group of kids will drop portions of the summer plan and that usually is the ancillary work.
NOW that the kids return in shape and all parties are enthusiastic the addition of the GS work, hurdle mobility drills and LM and LL programs have added too much too quickly and that could be leading to some injury problems.
It is very challenging to balance the ancillary work to the appropriate level for each individual. As you know I am a huge proponent of all the work (not just for the physical benefits, but also because they are great team building activities and we are all trying to build a great cross country team), but at this time of the year more then ever, for all the reasons already state by you we need to be very sensitive to the differences in how kids prepared throughout the summer, not just how they Time Trial or look in the tempo runs!!!
And it is certainly easier to determine if an athlete is overdoing the length or pace of a run, and very difficult to pinpoint what is the right amount or intensity of the ancillary work!!
We are all good a seeing a form flaw or pace that is no longer a threshold run or weather conditions that are not safe and being able to make an adjustment to protect them, but once again the little things sneakers, recovery foods, sleep and ancillary work these are places that can be more difficult to monitor and we are prone to overdo it, and this can lead to injury.
Your videos feature a highly trained profession athlete in Sara who has spent years building a base to be able to do what she does and we as coaches need to be sure we keep that in mind when we have new kids OR have not been hands on throughout the summer to monitor every workout.
With that said, I believe the work is critical to the success and longevity of the modern high school runner who no longer grows up spending every day after school from kindergarten to middle school plating unorganized sports down the block with the neighbors until it is dark!!!! (Ahh I miss those carefree times!!)

Sorry for the long response.... in short some may being doing to much too soon, it’s that simple
Bart
Davide

Hello Jay,

I gave a look to the schedule of exercises as you were suggesting on RunningTimes and I noticed that you suggest to do more GS exercises on hard days.
What is the reason behind that?
many thanks
Davide
CoachKedge

Jay,
We've incoperated the lunge matrix to our early season general strength routine. We've been doing it 2 days a week for about a month now and are very pleased with it. I'm finding that the strenght development is helping with running (and walking) posture as well as gate efficiency. We may change it up in our next cycle of training but will certainly keep a component of the matrix in our plans.

A few pieces of advice I'd give is start with low reps (maybe even as low as 4 on each leg for the 5 different lunges). We're only doing sets of 6 on each leg for the 5 lunges. I found it best to do them 1) after warm up, 2) before the run. With any good plan that adds something new the rules should be 1) ease into them and 2) find the best place for them in your training cycle.

-Coach Kedge, Albuquerque Academy
Frank58

I think that that the LM is really helping our team.
Our team is definitely in that 2 week "danger zone," and in previous years we've had kids drop like flies. This year is different (so far), and I have to think that, as coach Dalby mentioned, its because we do a specific long warm up that contains a 10 minute easy run that includes about 4 x 100m easy backwards running mixed in, a lot of active stretching, ancillary work, form work, some balance, and plyo-sprints. This usually takes at least an 1/2 hour (closer to 45 mins), unless we are on a easy or medium day and then the we do the aerobic warm-up and were done in 20-25 minutes.
We have a couple of our athletes complaining of posterior shin splints (flattest feet ever!), another with some Achilles soreness from a misstep on a rough rocky road. The team is tired and sore though, the head coach that I assist is kind of "old school" and the athletes don't see a lot of recovery days, it seems like the weekly schedule is medium hard, hard, medium hard, hard, medium, and then: "lets have a time trial on Saturday!", almost all of the kids take Sunday completely off. We do almost all of our work on soft surface, and at least one fast day barefoot, so that is a plus. 2 out of 5 mornings, workout is in the pool, swimming and water running (aqua jogger).
The post workout plan coach Jay suggests (GS and cool downs, big 10) work well for us. The kids have bought into most everything, though losing static stretching was hard for most of the kids (they do love to sit and talk). I'm a firm believer that traditional static stretching should be abandoned.
The LM is a very good tool, it's really important to keep the knee on top of the ankle and not drive over the toes, as the physio said.
Frank D.
stevemagness

I wouldn't think the LM would cause the injuries, but just throwing out some ideas, how many weeks into the LM are they? How accustomed to general strength work are the athletes?

If they're not accustumed to the LM and somewhat weak, could it be somehow fatiguing certain muscles then when the athletes go for their run/workout those pre-fatgued muscle become injured or aren't doing their jobs as well which is causing an injury. Not a likely scenario but it's really the only thing I could even come up with for lower leg injuries and the LM.

Of course, it's just as likely that it has nothing to do with it. Injuries are a fickle thing.
Davide

Hello Jay,

I definetely agree with the analysis you did.
Particularly I experienced that the mix volume/intensity is the main reason for generating injuries particularly for HS runners and/or masters (like me).
I bought your DVDs related to general strenght and our running group adopted them according your suggestions (we are using back and pedestal routines) after run sessions and after almost one month we are really seeing improvement in strenght. One stupid questions: how may series of exercises do you suggest per routine?

many thanks
ciao
Davide
CoachJay

Not a stupid question at all. I will write a separate post about this and we'll update the RunningDVDs.com site later this fall.

In the meantime the progression of general strength exercises I did for Running Times will be helpful as it simply breaks down your running into easy days and hard days and then has a prescribed number or reps that changes every two weeks.

http://runningtimes.com/Article.aspx?ArticleID=16625
Coach Jonathan Dalby

I would be very surprised if the exercises were the cause of the lower leg problems. As a team we use similar types of work to the LM almost everyday. The only complaints I usually get come within the first week or two from new runners that have never done this type of work before. I also have to take into account that most of these new runners (usually freshman) have never consistently run more than a day or two a week and have to adapt their bodies to running. Depending on the kid this could take anywhere from 3 weeks to 3 months it seems!

I am my no means an expert on the topic of ancillary work, but could some of the lower leg problems be the result of not doing any kind of balance or foot work to strengthen the leg bellow the knee? Since introducing this kind of work to runners I've coached over the past year the amount of shin splits, arch, feet and other lower leg problems has reduced dramatically. I know it may seem like a lot, but I like to have the kids do anywhere between 20 to 30 minutes of flexibility and ancillary work before each run (this includes LM type training). So far the payoff has been worth it to see kids stay injury free.

What I'm finding to be true more and more is that the kids that really need this more than anyone else are the incoming freshman that are still growing. If it takes an extra 20 minutes before and after practice each day to keep the young pups healthy I think it's worth it! I just with I would have learned this lesson a little better before this XC season started. I already have some young kids banged up and am now having to go back and spend the extra time on this kind of work to keep them healthy.

Just my thought for what it's worth...
CoachJay

Here is the email I wrote in response to the coach's original email.

Wow. I'm so sorry to hear that they kids are having problems with shin splints.

My first thought is to stop doing the things from my site and do what has worked so well for you in the past. But then my next thought is that of all of the things that I've done with athletes, the LM is elemental and something I would recommend athletes do. The final thought is that Wetmore always talks about the first two weeks of school being the "danger zone" in training, the idea being that everyone training together raises the intensity of workouts. If the LM was a new stimulus when school/practice started then it might be that the intensity (or volume?) of training is part of the problem.

The lunge matrix (LM) is something that I've done with kids at CU as well something I do myself before every run and I've never seen any of the issues you mentioned, but rather glutt and quad soreness in the first 7-10 days. The LM is something I've taken from Gary Gray PT and he's worked with hundreds of athletes. When I put those two things together - the fact that athletes I've worked with have not had this problem and the fact that Gary Gray is arguable the best PT for athletes in our country it makes me think that the LM may not be the root of the problem.

I would be happy to share your email on my blog and see what others have to say as there are some physical therapists and chiropractors who now read the blog and can give insights that I cannot. It would be interesting to see what they have to say about the lunges and how the anterior tibialis and other lower leg muscles are involved.

Again, I'm sorry to hear that your team is struggling and I hope I can be help.

When will injuries likely occur?

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