Training for a Triathlon or Ironman?

Whether you are training for a sprint triathlon or an Ironman, training for three different sports can put a variety of different strains on your body.  Each sport in itself can lead to injury, but together the risk of injury is compounded.  Below we will talk about common injuries in triathlon training as well as preventative tips and treatment options.

Achilles Tendonitis

The Achilles' tendon is a strong tendon that attaches to the back of your heel and is one of the most common myotendinous injuries in triathlons. It can be injured as a result of both biking and running. In biking this is most often due to a poor bike fit or old cycling shoes.  Pronation can occur through the pedal stroke fatiguing the gastroc muscle and putting strain on the Achilles tendon. Getting a proper bike fit and making sure your shoes are newer and appropriately fit can help decrease the risk.  While running a tight gastroc complex, tight hamstrings or a weak core can contribute to Achilles tendonitis. Athletic shoes that are worn down or allow for too much pronation can also lead to fatigue of the gastroc muscles.  Wearing the proper shoes, orthotics, and stretching will help decrease risk of Achilles tendonitis. Early recognition of Achilles tendonitis is key. Even if the pain starts intermittently it can become severe and debilitating. Rest and physical therapy can be keys to return to activity.  Also, a good time to work on your swimming!

Iliotibial Band (IT Band) Syndrome

The IT band is a long strap of connective tissue that extends from the hip down the outside of the leg and connects to the side of the knee. While the IT band is not directly attached to the feet, IT Band syndrome can be caused due to instability of the feet.  IT Band syndrome can be caused by both biking and running. An improper bike position or an unstable run gait can cause IT band syndrome. Making sure your bike and shoes are properly fit, as well as orthotics, can help prevent IT Band syndrome.  Rest and physical therapy will help to treat IT Band syndrome and get you back to activity. 

Stress Fractures

Stress fractures are a common overuse injury.  In triathletes these most commonly occur in the metatarsals, but can also occur in the tibia, calcaneus, and cuboid.  The increased risk of stress fractures can be correlated to a rapid increase in training volume and shoe gear.  Early signs of a stress fracture are persistent pain and swelling.  Early on a stress fracture can be difficult to diagnose.  Slowly increasing your activity level, proper shoe gear, and orthotics can help decrease the stress on your feet. Rest and immobilization are the most definitive treatment for stress fractures.  Cycling indoors with a steel/carbon fiber shoe insert or swimming are alternative training options…however, a stress fracture can lead to a displaced fracture, so proceed with caution. 

Morton’s Neuroma

A Morton’s neuroma is an inflamed and enlarged nerve in the ball of your foot. This is an injury in both cycling and running. Early signs can be numbness of the toes in shoes with riding or running a long distances. There may also be pain in the ball of the foot. This sharp pain can worsen with tight shoes and pressure on the ball of the foot.  Making sure your shoes fit appropriately, including wearing a wider shoe or an insert with a metatarsal pad, can help prevent neuromas.

Plantar Fasciitis

The plantar fascia is a thick band of tissue that attaches to the heel.  Plantar fasciitis is when the fascia becomes inflamed most commonly at its insertion point.  This is a common overuse injury that is most contributed to the running portion of a triathlon.  Increase in training, improper shoe gear, and tightness of muscles can be common causes of plantar fasciitis.  Stretching, proper shoes, and orthotics are great for prevention of plantar fasciitis.  If you come down with plantar fasciitis rest and physical therapy are very helpful in getting back to activity. 

Other common injuries to look out for are subungual hematoma, blisters, shin splints, and patellar tendonitis. 

While the above injuries may plague various parts of the foot and lower leg most injuries can be treated similarly. The keys to prevention and treatment are a proper bike fit, up to date and properly fitting shoe gear, functional foot orthotics, and physical therapy.  If something doesn’t feel right or the pain is continuing, seek treatment.  At Castle Rock Foot and Ankle we are here to help with any sports injury needs.  Call our office at 303-814-1082 to make an appointment. 

Author

Dr. Ronnie Pollard In her professional life, Dr. Pollard is a Board Certified podiatric physician specializing in lower extremity diagnoses, treatment, and after care. Dr. Pollard completed her undergraduate degree at the University of Denver before attending Midwestern University where she graduated as a Doctor of Podiatric Medicine. After Midwestern, Dr. Pollard completed Denver's rigorous 3-year Highlands Podiatric Residency Program and has amassed thousands of hours of surgical and clinical treatment experience. Dr. Pollard takes a family focused approach to her practice making sure that her patients are comfortable, confident, and prepared for the treatment plan that she recommends and is sure to adjust strategies based on patient feedback as they heal.