I received an email from an athlete who had been experiencing chronic pain in a particular body part for two weeks. She looked at the issue from a number of angles and attempted to deduce the cause of the problem. She ultimately settled on what she thought had caused her problem in the first place. Her question to me then had to do with what she should do now, since the pain has persisted. As you'll see below, her question to me wasn't so much whether I agreed with her deduction as to what caused the problem or specifically how I might advise her to help heal the painful area. It simply asked what I thought she should do now, now that (I gathered) she decided not do the activity that was causing the problem and now that she has chronic pain she needs to heal and/or let subside, while still wanting to train.
What's HOT: She's asking questions.
What's NOT: Her ultimate goal.
From her POV:
1) She accepted that she got hurt.
2) She blamed something.
3) She attempts to master how to deal with the hurt.
4) She asks what she should do NOW that she's hurt.
From a Performance POV:
1) Never accept the hurt. Use it's onset as a clue that something is not right - immediately.
2) Blame yourself. Take responsibility - a necessary component of creating change.
3) Aim to master never hurting yourself.
4) Ask about what to do in order to NEVER experience chronic pain or injury.
Note: The answer below is not any more or less important than the info she's already gathered on her own. It is simply is something for her to add to her own equation along the journey of realizing her own body's max performance potential. Below is just a few words and takes the angle I know I'm best at offering information about, using the limited information given. She is the one who must create the action, her reality, from all that she knows...and what she knows is always better than what any other single resource alone can offer along the journey.
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QUESTION:
Hey Jessi! I am a triathlete and I have recently been experiencing bad shin pain in my left leg. I have not been running a lot - just biking, swimming, and strength lately - so I know it's not due to running. I have also been training for a couple of years now so I don't think it's an overuse thing. I surmise that it is due to the bike on the gym that I am using. SInce it has been raining so much in the last week in Socal I have been riding on this bike in the gym for about two weeks and the pain definitely began about a week ago. I read that it might be due to my feet not being flat -essentially just bad form. Since the pain has persisted, what should I do? I am thinking maybe just swim and do non-weight bearing exercises like the elliptical and core training for the next couple of weeks...what do you think? Also, I have been pretty good about icing it and taking anti-inflammatories. Thanks so much! LB
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ANSWER:
Hi LB! Let’s see...
Where exactly is the shin pain? On the medial or lateral aspect of your Tibia (inside or outside aspect of your shin bone)?
I’d say you’re right that your mechanics as you rode on that particular bike may not have been ideal, but I’d wonder whether its your body (you mention your feet) or simply the position/motion that the bike has you in, which I imagine is not the most adjustable. I’m wondering a few things. Does it have toe straps? Are you having to pull up more with your shin muscles than you’re used to on your own bike or making some compensation in the pedal stroke due to something else. Where is the pedal placed in relation to your footbed? I found myself moving my foot around on a stationary bike pedal the other way to be able to connect my glute to the pedal better than it would’ve otherwise had me if I shoved my foot in to the cradle as it seemed to be designed to be.
The Big Picture...Better Body Awareness...
Better body awareness will always allow you to avoid any piece of equipment “doing” anything to you. The goal would be to head it off at the pass before it got to be painful and certainly chronically painful. For example, by now, I’m like the Princess and the pea when it comes to movement. Put me on something and if I can’t move the way my body likes/needs to move, I quickly feel like something is off – and adjust accordingly - or avoid it completely. Body awareness is not rocket science but takes a few things, most importantly the mind. A couple basic questions I often ask myself when sitting, standing, swimming, biking, running, etc:
First, can I keep my spine/hips in a neutral position and stablize my spine from my shoulders to my hips IN this position (that a machine or other equipment or position might be putting you in) -- if not – no good.
Second, can I move my limbs, including my joints, where and how needed to do the movement as efficiently as possible. One great example of this is shoes. Often, shoes limit the muscles and joints of the foot from moving as they were designed to move in order to allow for most efficient total body movements. Other muscles in the body compensate for this, increasing the potential for chronic pain and injury and minimizing movement efficiency. Often the pain shows up in an area(s) of the body removed from the foot, and we attempt to treat that area without understand the underlying antagonist - many times an untrained nervous system (the body's communication system.) Must use it or you'll lose it. True. Typically it's not the weak parts that feel the pain, it is the areas that compensate for the weak parts that are screaming out.
Third, can I engage, move and transfer power with my glutes (when required - as in cycling and running.) If I can’t something’s wrong – with my body OR the position OR the equipment. Again, not good.
Getting more aware of what each of those positions/activations should feel like is key, because if those components are in control – and your focus is on them – they are a huge indicator of anything not quite right. They can and will help you avoid any motion that’s not proper. By now I know enough about my body, have enough body awareness, to know that my muscles/movement are stronger than any bike equipment or bike position you put me in at this point, meaning, for example, I will move the way I must move, regardless of whether my bike seat is turned a 1/4 inch off of center. I’ll feel that and it will be annoying, sooner than my body not being aware and inadvertenly making a compensation, that ends up in my hip, and shows up as knee pain, etc etc. That’s just one example of course, but...I can’t help but mention all that to help you keep your mind working – as you already are – to ask why and get to root of it. The key is there aren’t a million answers for every type of pain producing scenario such as the one you presented. Rather it's important to use the checklist above of how things “should” look and feel and if any one of them is not being adhered to in movement, you can attack or avoid it immediatly versus trying to figure the problem out from the outside in.
You are doing the right things to recover from whatever damage is done right now...active recovery and rehab. As the pain subsides, then revisit your training program. Until then there is always something to work on, and core strength/stability and any cardio is great, as you mentioned. If I were you, I’d hop back on that bike for a few min, quiet your mind, look at your alignment, feel the pedal stroke and where you might be working muscles that you normal aren’t (or shouldn’t be.) Could be any number of things – that you might see or feel. Use it as much of a learning experience as you can. It's not about the bike in this instance, it's about you. So even if you never get on that particular equipment again, figuring out that feeling so you can avoid it down the road, is important. Nothing is insignificant.
Functional Training's role in the ultimate goal...
Don't just do it to get through it, use it. Yes, it will make you stronger, more powerful and more efficient, but most importantly it can play a huge role in getting to know your body and getting to know the feeling that you should feel when everything is moving/connecting through your body’s movement as it is meant to. One effect will be – that anything else – anything that takes you out of a proper movement pattern or muscle activation sequence within a dynamic motion such as cycling, running or swimming -- will feel more foreign and less powerful and you’ll start to make adjustments toward max efficiency quicker and more reflexively than before.
Remember, the more aware you are the more you are. Move well!
