We understand that some combat athletes at the elite level have had specific access to training facilities during this period of lockdown. For many amateur and recreational athletes, however, the period of isolation has likely restricted training options. As restrictions gradually begin to ease, there are some important points to keep in mind when returning to training to prevent the likelihood of load-related injury.
Whilst the COVID-19 pandemic is still wreaking havoc across the globe, some parts of the world, including Japan and Australia, are beginning to ease restrictions and reintroduce certain services. These changes will likely allow individuals to partially or fully resume their normal sports and fitness practices. Current literature regarding secondary health consequences of the COVID-19 have so far been focused around inactivity (1), and whilst the health benefits of resuming physical activities are obvious, and many of us, particularly competitive athletes, are eager to resume normal training processes, there are some important considerations when it comes to avoiding overuse injury.
All types of physical activity impose stress on both the tissues (muscles, bones, ligaments, tendons, etc.) as well as the multiple systems (neural, cardiovascular endocrine, etc.) of the body. It is the adaptation that follows this stress that allows us to improve different aspects of our fitness. In order for these adaptations to occur, there needs to be the correct amount of training stimulus. If this stimulus is too small, the exercise modality will be ineffective. If it is too large, the tissues and systems may become compromised, and this is where we can sometimes get into trouble. When we have gone for a certain period of time without performing an activity, our body’s optimal loading zone changes, so that the correct amount of stimulus required to cause adaptation without overloading the system is now less. If we then go back to performing the same type, volume and intensity of exercise that we were doing before, we may risk sustaining an overuse injury. The diagrams below, courtesy of UK physiotherapist Adam Meakins, illustrate that optimal zone of activity and how going outside this zone can start to cause problems.
Sports performance professionals have for a long time focused on workload management. Runners will no doubt be familiar with the 10% rule, and researchers in recent times have discussed the concept of the acute:chronic workload ratio, whereby increases in current training load outside a certain range compared to your average workload may increase your risk of overuse injury. The first to explore this concept were Gabbett and colleagues, who found that a training load outside a 85-135% range in comparison to the average load over the previous 4 weeks to significantly increase injury rates (2). What is particularly interesting is that the injuries that were thought to occur as a result of this change in training load in some cases didn’t eventuate for 1-2 months after the load change (3).
Many individuals who have been unable to participate in their regular physical activities for a period of time are likely to throw themselves back in at the same volume and intensity as prior to the break, or maybe even with greater vigour due to having missed the enjoyment and social interaction of the activity, or possibly even due to feelings of guilt and concern over being inactive for so long. As alluded to above, many competitors will also be up against the clock when it comes to preparing for their next contest. When one returns to sport or exercise after injury or severe illness, it is somewhat inferred that this return needs to be performed as a gradual process, however in the absence of physical impairment, a more-is-better approach is too often adopted.
Even for those who have continued exercising, we need to consider the impact of varying exercise modalities on injury risk. If, for example, a person who is a regular swimmer starts running due to their pool being closed, then resumes a high-load of swimming as soon as the gym reopens, the unaccustomed load may put excessive stress on the upper limbs.
Here are some simple tips to decrease the likelihood of post-lockdown return to activity leading to an overuse injury.
- Rather than jumping straight back into your previous exercise load, think about return to activity more as a medium-term process. Think 4 weeks ahead and plan on building back to your previous load within this time. Then start at approximately 50% of this load and build up gradually.
- Try to build up the volume quicker than the intensity. If performing resistance training try to stay further away from failure with each set. With performing cardiovascular training try to perform slightly more steady state exercise and build back up to more interval work. With skills work try to start with more technique practice and drilling, gradually building up to more intense pad work and heavy sparring.
- Spend more of your gym time warming up and cooling down. That way you are still getting your gym time and movement in, but not working quite so hard the whole time. Mobility is likely to be compromised during periods of inactivity, so spending more time on mobility interventions is likely to lead to better long-term progress.
- Also consider the total load on the system. Things such as increased stress, decreased sleep, dietary changes, etc., all contribute to total systemic load. If there are other changes to your lifestyle involved with a return to the office, consider a slower return to exercise to avoid system overload.
Remember that in order to make fitness gains we want the minimal effective dose, that way can continue to build up our training load over time, and still progress. If we do too much too quickly, we may hit a ceiling too quickly and find it more difficult to progress. This is the case not only when beginning a certain type of exercise but also after a long lay-off.
The whole world is looking forward to a gradual return to normally, and for many, resuming regular exercise habits constitutes a big part of this. For competitive athletes, a return to the training environment in some ways will restore part of their identity and re-focus their drive and motivation. We always maintain that exercise is like medicine, and needs to be dosed properly for optimal outcomes. Just applying a little patience and intelligence to your exercise programming will pay off in the long run and allow you to optimise your training outcomes and competition results, safely and healthily.
References
- Lippi, G., Henry, B. M., Bovo, C. & Sanchis-Gomar, F. Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19). Diagnosis 1, (2020).
- Hulin, B. T., Gabbett, T. J., Lawson, D. W., Caputi, P. & Sampson, J. A. The acute: chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br. J. Sports Med. bjsports–2015 (2015).
- Rogalski, B., Dawson, B., Heasman, J. & Gabbett, T. J. Training and game loads and injury risk in elite Australian footballers. J. Sci. Med. Sport 16, 499–503 (2013).