Identifying the ‘root cause’ of injury – part II

May 20, 2019

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In the last blog post, I delved into the subject of injury in triathletes and had some really positive feedback. Thanks to everyone for their comments, and if you haven’t read my last post I’d highly recommend going back to that one (click here) before proceeding with this one as it provides some insight into what I’ll elaborate on here…

So last time I pointed out that when an athlete experiences a ‘sudden’ overuse injury (like something going ‘ping’ during a training session), the fact of the matter is that there was absolutely nothing ‘sudden’ about it. Rather it was whatever you were doing in that moment that was simply the bodies last straw. There would have been an accumulation of other factors building beneath the surface (which you were probably even aware of, but chose to ignore) that lead to that moment. In the last blog I discussed training overload as a big contender to the causes of injury risk amongst triathletes. This time I’m going to look at sleep.

Now, most athletes have heard along the way that sleep helps you recover – and this is something I go on about with my athletes quite a lot. In fact, I have a lot of my athletes record their sleep quality and duration in their training calendars to help me (and the athlete) monitor this big player in the injury game. A bad night’s sleep may influence a training session as a one off (typically 24 – 45hrs later), but what I’m really looking for is poor sleeping habits on a whole, which really raise the alarm.

Sleep and injury prevention for triathletes

So let’s take a look into why is sleep so important to aid in injury prevention…

I’ve mentioned before that when you are training, your body is producing cortisol – which is also known as the ‘stress hormone’. In isolation, this is fine, in fact we actually need that ‘stress’ as it is the stimulus for progress, BUT that progress will only take place when we bring that stress back down to the bodies equilibrium state. In addition to the cortisol produced in training, sleep deprivation is another trigger that causes the body to produce elevated levels of cortisol. So by continuing to train as per normal AND depriving your body of a sufficient amount of sleep, you are further elevating the amount of cortisol in your body. It’s at this point that the good ‘stress’ that the body needs to leverage off to progress produced in training, moves into ‘strain’ – which is where the injury risk starts to increase exponentially.

To avoid shifting from ‘stress’ (good) to ‘strain’ (bad), the body needs the opportunity to lower cortisol levels after training – which is precisely what your body does when you’re asleep. In fact, not only does cortisol production reduce when you’re sleeping, when you go into a deep sleep your body actually starts releasing a growth hormone. This hormone stimulates muscle growth and repair, bone building and even fat burning. So the more time you spend asleep, the better chance your body has of ‘wiping the slate clean’ from the day before by bringing back down cortisol levels AND stimulating growth hormones to repair the microscopic tears you’ve made in your muscle fibres while training.

How much sleep is enough?

Commonly, researchers recommend adults get 7 – 8 hours of sleep per night. But this does not take into consideration an adult who has done 1, 2, 3 + hours of vigorous exercise that day. In order for your body to repair the additional damage training does to your body (this is on top of life stress, sitting at a desk, manual labour etc), it needs to be offset with additional sleep hours. Those embarking on IM training should be looking at 9 – 10 hours sleep per night to give your body sufficient time to repair from the day before and get ready for the next. Now I can already hear so many high achieving corporate executives and parents scoffing at the thought of fitting 9 – 10 hours of sleep per night in. If, after taking a genuine look at your daily routine and simply cannot wipe out 9 hours of time, then try getting 10 – 11 hours at least once a week. Getting to be really early on a weekend night, or even getting in an afternoon nap on the weekend will all add to the bodies repairing opportunities. Or even just commit to regularly getting to bed an extra 30 min earlier each night. This will equate to an extra 168 hours of sleep per year, which is the equivalent of sleeping for an entire week – straight! That’s the kind of recovery time that money just cannot buy. No amount of post workout protein, compression garments, massage or foam rollering will even come close to the effect that kind of sleep will have on your mitigating your risk of injury (and it’s FREE!).

With this information, perhaps you can take a new perspective on your last injury and consider the amount and quality of sleep you were getting in the lead up to the incident. Were you consistently getting at least 8 hours sleep? Was it quality sleep – remembering that the body needs deep sleep to start releasing growth hormones? Try to be logical and objective in this process as it will give you the best chance of piecing together a multitude of factors that lead to the injury rather than any one thing in isolation, which will give you the best chance of making sure it doesn’t happen again.