Triathlon: running injuries

Monitoring training, performance, biomarkers, and psychological state throughout a competitive season: a case study of a triathlete

INTRODUCTION

Ironman triathletes undergo high workloads during competition preparation which can result in nonfunctional overreaching or overtraining syndrome if not matched with adequate recovery.

PURPOSE

The purpose of this case study was to observe changes in physiological and psychological status over the course of a competitive season in a free-living triathlete.

METHODS

The subject was a 41-year-old triathlete competing in three 113.1-km events. Over the course of a 40-week period, the participant arrived at the laboratory every 4 weeks and underwent body composition testing via air displacement plethysmography, a blood draw for analysis of various biomarkers, and a treadmill-based lactate threshold test. Workload during training and competitions was monitored via a wearable heart rate-monitoring device.

RESULTS

Throughout the season, training volume remained high (12.5 ± 3.4 h/week) and body mass and fat-free mass (FFM) continuously decreased, while biomarkers including cortisol, testosterone, and markers of immunological status exhibited minor changes. Laboratory performance remained relatively consistent, while competition performance continually improved. Following the completion of the competitive period, training volume decreased, FFM remained below baseline levels, free cortisol increased, and both free and total testosterone decreased.

CONCLUSIONS

Workload and recovery seem to have been properly managed throughout the season, evidenced by minimal fluctuations in endocrine and immunological markers. The reason for changes observed in testosterone, cortisol, and body composition following the last competition is unclear, though it may be attributed to changes in stressors and recovery practices outside of training. It is recommended that athletes follow a structured plan during the transition period into the offseason to ensure recovery of physiological state and to set up a productive offseason.

Triathlon-related musculoskeletal injuries: a study on a Portuguese Triathlon Championship

BACKGROUND

A triathlon consists of 3 modalities: swimming, cycling and running. Its higher training frequency, the environmental factors and extrinsic factors (technique and equipment) may lead to injuries. This study aimed to determine injury epidemiology in triathletes, as well as their type, location, mechanism of injury, and risk factors.

METHODS

The sample was constituted of 174 triathletes who participated in the Triathlon Club Portuguese Championship, being 131 (75.3%) male, aged 18 to 70 years old (36.09±11.03). The measurement instrument was a questionnaire concerning the characterization of the population and aspects related to the modality and injuries.

RESULTS

One hundred and twenty (69%) athletes reported one injury since the beginning of their practice, and 95 (54.6%) had an injury in the previous year, with a total of 130 injuries. There were 2.39 injuries per 1,000 hours of triathlon training. The most common injuries were muscle contusion (31.5%) and inflammatory injuries (19.2%), located in the knee (22.3%) and the leg (18.5%). Overtraining (43.1%) was the mechanism that led to the highest occurrence of injuries. Fourteen (10.8%) injuries occurred during swimming, 23 (17.7%) during cycling, and 93 (71.5%) during running. No statistical significance was observed between the risk factors analyzed and the occurrence of injuries.

CONCLUSIONS

Triathlon practice is associated with a high prevalence of injuries, being contusions, knee, and overtraining the most common type, location, and mechanism of injury respectively. It is necessary to create injury prevention strategies, including specific training and suitable materials for use by athletes.

Elite 100-km road ultramarathon runners: characteristics and musculoskeletal injuries

BACKGROUND

Currently known data about ultramarathon medical issues has been collected from all combinations of ultramarathon race types (road, trail, etc.) and the population in those studies consists of mixed elite and recreational athletes. There are few studies concerning injuries related to musculoskeletal system injuries in ultramarathon runners.

METHODS

The study was conducted on total of 77 elite ultramarathoners based on a questionnaire-based survey. We studied the elite male and female athletes who participated in the 30^th IAU 100-km World Championships held in Croatia, in 2018.

RESULTS

Ultramarathon runners have higher percentage of lower-leg injuries and rehabilitation of those injuries tend to last longer as ultramarathon runners show specific training habits with less days off and hold a permanent, full-time job and often with a higher academic degree. Furthermore, also the mean age is higher.

CONCLUSIONS

Ultramarathoners have a higher percentage of lower-leg injuries than runners who do not run distances beyond a marathon. In addition, rehabilitation tends to last longer. This may well be correlated also to their specific training loads with fewer days off and training whilst holding a permanent full-time job. Often, they also hold a higher academic degree with years spent in the education system which might influence their mindsets on the medical issues they encounter. Also, being older may also have a bearing on injury occurrence and rehabilitation time.

A Primer on Running for the Orthopaedic Surgeon

Long-distance running has become increasingly popular during the past decades. Many running patients pose questions to their orthopaedic surgeons regarding risks, benefits, and running techniques. This article identifies 11 running-related questions that patients may ask and provides information to help answer those questions. This review discusses data on the health benefits of running, common running injuries, the relationship between running and osteoarthritis, recommendations regarding running after orthopaedic surgery, running shoes, and other questions that may arise when treating the running athlete.

Cross-Sectional Investigation of Stress Fractures in German Elite Triathletes

Triathlon is a popular sport for both recreational and competitive athletes. This study investigated the rates and patterns of stress fractures in the German national triathlon squad. We developed a web-based retrospective questionnaire containing questions about the frequency of stress fractures, anatomic localisation and associated risk factors. The survey was conducted as an explorative cross-sectional study. Eighty-six athletes completed the questionnaire. Twenty athletes (23%) sustained at least one stress fracture. All documented stress fractures were located in the lower extremities. Factors associated with a higher risk for stress fractures were female gender, competitive sport prior to triathlon career, Vitamin D or iron deficiency, menstrual disturbances and a high number of annual training hours. Disseminating knowledge among athletes and their professional community in order to raise awareness about early symptoms and relevant risk factors could help to improve prevention and reduce the incidence of stress fractures.

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

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Zusammenfassung. Wir berichten über einen 52-jährigen Ironman-Triathleten, der über länger anhaltende Schmerzen im Bereich des linken Gesässes klagte. Therapeutische Bemühungen bei Verdacht auf ein blockiertes Sakroiliakalgelenk bleiben erfolglos. Ein MRI des Beckens zeigte dann eine Fraktur des linken Os ilium. Aufgrund der Bildgebung gehen wir von einem zweizeitigen Geschehen aus mit Frakturbildung nach Manipulation.

The postpartum triathlete

The postpartum period in a woman's life is filled with numerous changes, including physical changes, changes in sleep habits, and learning how to best care for a newborn. A common goal among postpartum women is to either begin or resume an active lifestyle, which often includes physical activity such as running, biking and swimming. The postpartum athlete may discover barriers that prevent her from returning to or beginning an exercise routine. These obstacles include muscle weakness, fatigue, depression and physical changes that require exercise modification. The physical therapist is well-suited to properly assess, treat and manage the care of the postpartum athlete. Postpartum athletes wishing to begin or resume training for triathlons require special consideration, as the triathlete must balance training to compete in three different sports. The purpose of the paper is to identify the unique physical and physiological changes that occur to the female during the postpartum period. In addition, injuries that are more commonly seen during the postpartum period will be discussed. Recommendations for beginning or resuming an exercise program will be reviewed. Lastly, sport-specific training for the postpartum triathlete, including challenges presented with each triathlon component, will be discussed.

The impact of triathlon training and racing on athletes' general health

Although the sport of triathlon provides an opportunity to research the effect of multi-disciplinary exercise on health across the lifespan, much remains to be done. The literature has failed to consistently or adequately report subject age group, sex, ability level, and/or event-distance specialization. The demands of training and racing are relatively unquantified. Multiple definitions and reporting methods for injury and illness have been implemented. In general, risk factors for maladaptation have not been well-described. The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete. Most injuries 'causing cessation or reduction of training or seeking of medical aid' are not serious. However, as the extent to which they recur may be high and is undocumented, injury outcome is unclear. The sudden death rate for competition is 1.5 (0.9-2.5) [mostly swim-related] occurrences for every 100,000 participations. The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes. During heavy training and up to 5 days post-competition, host protection against pathogens may also be compromised. The incidence of illness seems low, but its outcome is unclear. More prospective investigation of the immunological, oxidative stress-related and cardiovascular effects of triathlon training and competition is warranted. Training diaries may prove to be a promising method of monitoring negative adaptation and its potential risk factors. More longitudinal, medical-tent-based studies of the aetiology and treatment demands of race-related injury and illness are needed.