By: Taylor Weglicki, PT, DPT
Strength sports are constantly in flux. New methods and coaching styles apply pressure for change more than ever before. ‘The Hybrid Athlete’ is a welcome change to this realm, introducing a framework for training that allows many athletes to complete amazing feats. Successfully completing a 500 pound squat and running a 50k is just one of many accomplishments we can observe from the hybrid athlete camp. As more lifters study the hybrid principles, I see more injured athletes appearing in my contacts after improperly applying the newly learned knowledge. With the rapidly increasing application of this training, the sport of powerlifting is adopting these new hybrid concepts (often to the lifters detriment).
It is not the methods that are at fault with these athletes. Rather, the rapid accumulation of volume and stress on an ill prepared system results in overwhelmed tissues and subsequent injuries. In an effort to facilitate the improved health of the athletes not under our coaching tutelage, this author shall outline the common issues, frequent injuries, and danger signs as well as the necessary steps needed to correct the problems. In doing so, athletes will be able to recognize the signs and symptoms of the common injuries before reaching critical mass, and thus allowing continued improvement (instead of rehab time).
Powerlifting as a sport is one of high neural and force output, requiring the athlete to lift three times for three separate lifts. The addition of endurance work to a powerlifter’s programming facilitates meet day performance by increasing overall work capacity (1). Problems arise when these same lifters attempt to apply the max effort mindset to lower intensity endurance work. Poor understanding of pacing, increased upper body tone and tightness, and inefficient form mechanics combine to create significant trauma forces in the Powerlifter turned runner. The maximum effort style of powerlifting thus negatively affects the lower intensity efforts of endurance running.
Perhaps one of the most effective methods to combat this “go hard or go home” mindset is the application of heart rate training zones. Most lifters are shocked to learn just how rapidly their heart rate climbs with easier endurance work. In the strength athlete mindset, if it’s not hard, it’s not working (though one could argue endurance athletes are the exact same). However, it is the adherence to the heart rate zones, especially Zone 2, that helps prevent overload injury to the Powerlifter who is introducing endurance work into their training.
GROUND REACTION FORCES
The ground reaction force of the foot strike is, in the author’s experience, one of the key factors in injury management and prevention with lifters newly introduced to running. Initial impact of heel strike begins the transmission of anywhere from 3-10x the athlete’s bodyweight in force through the musculoskeletal systems depending on what study you read. Of primary concern is the vertical loading rate, or how rapidly force is applied to the system from initial foot strike to maximum force at mid stance (2). It is not a particular stretch of the imagination to see how an untrained and heavier lifter would be prone to injury based just on poor gait mechanics and lack of control. Couple the impact force with poor eccentric loading control, over striding, and the go hard mentality, the Powerlifter has a long battle to fight to make sure he or she doesn’t introduce injury to the training equation.
From a biomechanics standpoint, one can utilize a number of cues to help reduce the strain. First, focusing on “running quiet” will naturally cause most athletes to shorten their stride a bit, resulting in more mechanically favorable force distribution. The athlete will typically reduce stride length, thus decreasing foot slap and over striding, allowing the structures involved to appropriately distribute force. Many in the endurance world will recognize this pattern as the “ultra shuffle”, as its use is common amongst athletes running distances greater than 50 kilometers in an effort to conserve energy.
In addition to cuing, the running shoe industry has made some amazing advances in technology since the author left in 2012. Many of the newer shoe products are not only light, but surprisingly durable for the heavier lifter. It is the author’s opinion that every new runner should have a gait analysis prior to introducing running to a program to ensure optimal shoe fit, provide appropriate protection to the feet and lower extremities (and to keep people from trying to run in basketball shoes).
*Of note, all clients receive a gait analysis as part of their on boarding process with CHP.*
INJURY SYMPTOMS TO AVOID
Most athletes, at some point in their career, will experience some form of pain or injury. What many athletes fail to realize is that signs and symptoms typically begin appearing well before the massive trauma of actual injury occurs. Some of these symptoms are more urgent than others, and so the author will address these first.
“Shin Splints” or rather any discomfort noted on the anterior shin area, are one of the most frequently reported symptoms of a newly minted running powerlifter. While some athletes may actually experience compartmental swelling along the anterior tibialis, tibial bone pain tends to be the more common presentation of pain. Bony pain is particularly alarming, as it may be an indication of potential bone damage via stress reaction or potentially stress fracture. If noted, it is the author’s recommendation that the athlete seek medical opinion before progressing the training further and risking more serious injury.
“Achilles Tendonitis” is yet another frequently described, but often mislabeled diagnosis with regards to irritation and pain within the dense tendon inserting along the posterior ankle. With soft tissue dysfunction, it is important to address the mechanical PROBLEM (i.e. mechanics, poor mobility) vs the symptomatic result (pain, increased calf tightness for protection). However, it is important to note that any sudden burning, tension release, or snapping of the Achilles tendon warrants immediate medical attention. The author experienced such sensations during his running career, and his refusal to seek medical treatment at the time has led to significant dysfunction with running and movement in his current sport.
Managing training run volume, proper footwear, and efficient gait mechanics are crucial to ensure the newer runner is able to enjoy the benefits of the extra aerobic training without incurring the possible injuries.
INJURY SYMPTOMS TO MANAGE
Following the more severe symptoms to avoid, the hybrid athlete powerlifter will more frequently encounter symptoms of the “aches and itis” variety. While not as severe and potentially sport threatening initially, if left unchecked this type of injury can progress into something more severe that could threaten your competitive season.
Notable in the management arena is Iliotibial Band Friction Syndrome (IT Band Syndrome for short). A quick internet search will likely produce articles and advice ranging from “stretch it” to “foam roll it” without ever addressing the primary cause of symptoms. Anatomically, the Tensor Fasciae Latae (which is the muscle that terminates into the IT band) acts as a weak knee extensor and hip abductor. Since the running athlete will produce frequent knee extension, one might wonder how the abduction component comes into play.
It is the author’s clinical opinion that the lifter often runs into difficulty with fatigue of the hip abductors, not weakness. These muscles simply lack the muscular endurance to withstand the rigors of shock dispersion with running, though they likely have plenty of strength for impressive squats and deadlifts. Higher rep work and single leg variants prove useful as training additions to help manage this condition.
*As an aside, please for the love of all things holy don’t stretch and foam roll the IT band and expect to make changes. Studies demonstrate that it requires extraordinary force to lengthen the tendon 1.6mm (3). The athlete simply can not exert the same force with any stretch or foam roll technique. *
The final symptom the author treats most frequently in newer hybrid athletes is some variant of plantar fasciitis. Much like shin splints, this is typically a blanket term for arch pain felt closer to the calcaneus. Actual plantar fasciitis involves disruption of a very tough and dense band of connective tissue that is responsible for facilitating arch function and toe off in foot mechanics. However, both tibialis posterior and flexor digitorum longus travel near the subtalar joint where pain is often noted.
These small muscles are significant in their function not as plantarflexors of the talocrural joint, but as actors in subtalar inversion. This distinction means they can become hypertonic when attempting to preventing excessive mobility at the subtalar, resulting in inflammation and pain.
Treatment for all is very similar: rest, adjusting training volume, footwear, and possibly orthotics. Some success has been noted anecdotally utilizing dry needling and electric stimulation in the area, but the author did not find any quality studies on the matter at the time of this writing.
New methods and coaching styles, such as those introduced in ‘The Hybrid Athlete’, are facilitating changes in the landscape of strength sports. With change, some early adopters risk jumping in too fast without understanding the underlying training principles, and thus risk additional inflammation and injury with new stimuli. The author has outlined a few of the primary symptoms to both avoid and manage, but his opinion is to first and foremost seek professional help if the athlete can not manage symptoms alone. A reputable coach and rehab specialist will pay for themselves practically over the course of an athlete’s career, but a prudent athlete should be able to self manage the basics when beginning the hybrid athlete journey.
Until next time: stay strong, run hard, and be awesome to each other.
1 Viada, Alex. The Hybrid Athlete. Ch 4: 50-51.
2 A.A. Zadpoor, A.A. Nikooyan. The relationship between lower extremity stress fractures and ground reaction force: a systematic review. Clinical Biomechanics: 26 (2011) 23-28
3 Falvey EC, Clark RA, Franklyn-Miller A, Bryant AL, Briggs C, McCrory PR. Iliotibial band syndrome: an examination of the evidence behind a number of treatment options. Scand J Med Sci Sports. 2010 Aug;20(4):580–7. PubMed #19706004.