Common triathlon related injuries

 By Jane Rothe – Physiotherapist and Triathlete


When it comes to triathletes there are three common biomechanical problem areas that lead to  both social and serious athletes paying their Vital Core physiotherapist a visit…

1) Upper back stiffness
2) Hip flexor tightness
3) Poor rotational control of lower limbs

Upper back/thoracic stiffness

This is a big problem for most of our sedentary society, and results from sustained slumped positions such as driving or computer use.

Our bodies love to move and unfortunately the upper back often doesn’t get a chance to do all the twisting and bending it was designed to do.

It follows that long hours spent training on the bike whether in a road or time-trial position can be problematic for triathletes.

If the spine becomes inflexible, other areas of the body, namely the neck and the shoulders have to compensate and are put under more strain and can result in:
• Shoulder tendinopathy/ impingement
• Cervical (neck) pain/ headaches
• Inefficient swim and run technique
• Suboptimal performance

Tight/ Shortened hip flexors

Jane in action

The hip flexors are the muscles located at the front of the hip and these can become tight when they are kept in a shortened position.

For example, these muscles can become short in those who spend a lot of time sitting during the day.

You can imagine then when a recreational triathlete who sits 8 hours a day for work and then spends an extra few hours per week (or 10!) in the saddle may be setting themselves up for trouble.


The type of problems that can result from tight hip flexors are listed beneath:

• Low back pain
• Hip pain (bursitis, tendinopathy)
• Knee/ patella pain
• Inefficient and sub-optimal performance

Poor rotational control of the legs

Jane in actionThis really refers to inefficient movement caused by rolling in or out of the arches, shins or upper legs due to weakness, tightness, poor technique or all of the above. A really nice analogy is to think of our legs on the bike or during a run like pistons within the engine of a machine moving up and down efficiently. Any rolling in or out or side-to-side movements would lead to abnormal friction and breakdown of the machine over time. Similarly if there is any extra rotation of the limbs, over time this can lead to pain and dysfunction. The most common injuries seen in the clinic due to this problem are:

• Heel, arch or achilles pain
• Knee/patella pain
• Shin splints
• ITB problems

What can I do about it?

Visit a qualified and experienced health professional who can competently assess your biomechanics and provide you with individualized exercises or advice to rectify the issues before they become a problem. Here at Vital Core Physiotherapy Jane a recreational triathlete herself has
been assessing and managing triathletes of all levels and ages for several years.

Most often management will involve:
• Flexibility exercises (stretching, foam roller, other mobilising or self massage techniques )
• Technique exercises (strength and specific technique training, core strength (deep controlling muscles of the trunk, pelvis and hips)
• Manual therapy (dry needling, massage, spinal mobilisation)

Other thoughts…
Although it is not discussed in this article, load (timing, under or overloading- post to follow) and burnout (sleep, diet, psychosocial stressors), as well as other not often considered factors such as hormones are just as important in the prevention and understanding of sports related injuries and therefore their management.

In addition the above information relates to skeletally mature athletes only. For kids and teens, muscles, bones and tendons respond differently and can result in different kinds of injuries. Stay tuned for more blogs on this….


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