2010년 5월 5일 수요일

운동 중 부상 방지를 위한 10가지 지킬 사항: THE 10 LAWS OF INJURY PREVENTION

1. Know Your Limits
." Various studies have identified injury-thresholds at 11, 25, and 40 miles per week. Your threshold is waiting for you to discover it. Runner and sports podiatrist Stephen Pribut, D.P.M., warns runners to beware the "terrible toos"—doing too much, too soon, too fast. Every research paper and every expert agrees that this—"training errors"—is the number one cause of self-inflicted running injuries. The body needs time to adapt from training changes and jumps in mileage or intensity. Muscles and joints need recovery time so they can recover and handle more training demands. If you rush that process, you could break down rather than build up.
Running experts have recognized this problem, and long ago devised an easy-to-use 10-percent rule: Build your weekly training mileage by no more than 10 percent per week. If you run 10 miles the first week, do just 11 miles the second week, 12 miles the third week, and so on.
Experts point out that an overly aggressive approach to hill running, intervals, trail running—indeed, any change in your training habits—can produce problems.
2. Listen to your body
Most running injuries don't erupt from nowhere and blindside you. They produce signals—aches, soreness, persistent pain—but it's up to you to not dismiss them and take appropriate (in)action. "Runners can be crazy the way they'll run through pain," Ferber says. "They need to pay more attention to pain and get to the root of what's causing it."
At the first sign of an atypical pain (discomfort that worsens during a run or causes you to alter your gait), take three days off. Substitute light walking, water training, or bicycling if you want. On the fourth day, run half your normal easy-day amount at a much slower pace than usual. If you typically run four miles at nine minutes per mile, do just two miles at 11-minute pace. Excellent. Reward yourself with another day off, and then run three miles at 10-minute pace. If you're pain-free, continue easing back into your normal routine. If not, take another three days off, then repeat the process to see if it works the second time around. If not, you've got two obvious options: Take more time off, and/or schedule an appointment with a sports-medicine specialist
3. Consider Shortening Your Stride
a December 2009 study reports that runners who shorten their stride by 10 percent could reduce risk of tibial stress fracture by three to six percent. The basic idea: Overstriding is a common mistake that can lead to decreased efficiency and increased injury risk. If you shorten your stride, you'll land "softer" with each footfall, incurring lower impact forces. "A shorter stride will usually lower the impact force, which should reduce injuries,"
If you've had frequent running injuries, you might want to experiment running with your normal stride, just slightly shorter—about 10 percent. "This will help reduce your stride so you have more turnover,"
4. Use Strength Training To Balance Your Body
You need something—and what better than muscle?—to keep your body properly aligned. It's particularly important to strengthen the hip muscles. He claims his clinic has cured 92 percent of knee injuries with a hip regimen. "Strengthening the hips is optimal for effective rehabilitation, as opposed to treating the area where the pain is located (e.g., your knee)," he says. "When you strengthen the hips—the abductors, adductors, and gluteus maximus—you increase your leg stability all the way down to the ankle."
You need just enough core, hip, and lower-leg strength training to keep your pelvis and lower-extremity joints properly positioned. "Healthy running should be as symmetrical and fluid as possible," "If you don't have muscle balance, then you lose the symmetry, and that's when you start having problems."
5. Rice work
When you've got muscle aches or joint pains, there's nothing better than rest, ice, compression, and elevation for immediate treatment. These measures can relieve pain, reduce swelling, and protect damaged tissues, all of which speed healing. The only problem with RICE is that too many runners focus on the "I" while ignoring the "RCE." Ice reduces inflammation, but to ice-and-run, ice-and-run, without giving the tissues enough time to heal, is a little like dieting every day until 6 p.m. and then pigging out.
RICE is most effective when done immediately following an injury. If you twist your ankle or strain your hamstring, plan to take a few days off from running (see Law II). Apply ice—for 10 to 15 minutes at a time, several times a day. A homemade ice pack—a baggie filled with ice cubes and water—is best. A bag of frozen vegetables is also effective. If you can, elevate the area (easy for foot and ankle injuries, not so much for hip or hamstring issues) to limit swelling. Compression can also further reduce inflammation and can provide pain relief, especially when you first return to running. An ACE bandage is the simplest way to wrap a swollen area, but Amol Saxena, a sports podiatrist in Palo Alto, California, uses a compression dressing with 3M Coban, a self-adherent over-the-counter product. He then uses Kinesio Tex Tape or a Darco Body Armor Walker for when the swelling goes down. "The tape pulls up the skin slightly, allowing more blood to flow to the injured area," he says
6. Run on a level surface
No doubt you always run on the left side of the road facing traffic. That's good for safety reasons. But it also gives you a functional leg-length discrepancy, since your left foot hits the road lower on the slope than your right foot. You're also placing your left foot on a slant that tends to limit healthy pronation, and your right foot in a position that encourages overpronation. And you're doing this—running in an unbalanced way—160 to 180 strides a minute for mile after mile, day after day, week after week. Clint Verran, a physical therapist in Lake Orion, Michigan, sees the results of this cambered running in his clinic, where he treats a higher incidence of left-hip injuries in runners than right-hip injuries.
The local track also provides a firm, essentially flat surface that's great for slow-paced running. (When you do faster interval training on a track, you put unequal torque on your feet and legs due to the need to keep turning left, so be careful if you are injury prone.) Also consider the treadmill.
7. Don't Race Or Do Speedwork Too Often
Researchers have found a correlation between injuries and frequent race efforts. This connection might extend to speedwork since intervals also require a near-maximal effort. So if you train fast once or twice a week and then race on the weekend, that's a lot of hard efforts without sufficient rest, particularly if you follow this pattern week after week. Some experts are cautious about recommending regular speed training for certain runners, especially those who get hurt easily. "You might get five percent faster, but your injury risk could climb by 25 percent," Verran says. "That's a bad risk-benefit ratio. I think most runners can hit their goals without going harder than tempo pace
Recognize that races take a heavy toll, so give yourself plenty of recovery time (one day for each mile raced). If you are trying to quicken your pace for a specific goal, add a weekly speedwork session to your training plan, but be judicious about it. Even Olympic gold medalists only do five to 10 percent of their training at 5-K race pace and faster
8. Stretch the Back Of Your Legs
Runners are tight in predictable areas, they get injured in and around these areas, and therefore they should increase flexibility in these areas. The muscle groups at the back of the legs—the hamstrings and calf muscles—stand atop most lists of "best muscles for runners to stretch." Hamstring and hip-flexor flexibility seems to improve knee function (several reports link poor hamstring and hip-flexor flexibility with "larger knee joint loads"), and calf flexibility may keep the Achilles tendon and plantar fascia healthy.
knee and Achilles problems are among runners' most frequent complaints, and so experts recommend increasing the range of motion of muscles that can strain these areas if there is underlying tightness. Just don't do static stretches (holding an elongated muscle in a fixed position for 30 seconds or longer) before running. However, dynamic stretching can be done as a safe, effective prerun warmup.
9. Cross-Training Provides Active Rest and Recovery
Running is hard on the body, although claims that it creates impact forces up to seven to eight times body weight are exaggerated, according to the experts I consulted. But they acknowledge the forces can reach two to three times body weight with each stride, and even more on downhills. It's no surprise that our muscles, joints, and connective tissues get weary from all this shock-absorbing. So experts agree that most runners benefit from at least one nonrunning day a week, and that injury-prone runners should avoid consecutive days of running. Cross-training offers a great alternative.
Use cross-training activities to supplement your running, improve your muscle balance, and keep you injury-free. Swimming, cycling, elliptical training, and rowing will burn a lot of calories and improve your aerobic fitness, but be careful not to aggravate injury-prone areas (see below).
The Laws of Perpetual Motion: Keep it Safe
Cross-training can help you stay fit when you can't run. But pick wisely, says podiatrist Stephen Pribut. Some activities may exacerbate an injury.

Runner's Knee
Yes, usually okay: Swimming
Sometimes okay; let pain guide you: Stationary Bike, Elliptical
No, usually not okay: Rowing Machine

Iliotibial-Band Syndrome
Yes, usually okay: Swimming
Sometimes okay; let pain guide you: Stationary Bike, Elliptical, Rowing Machine

Calf Strain, Achilles Pain
Yes, usually okay: Swimming, Stationary Bike, Elliptical, Rowing Machine

Plantar Fasciitis
Yes, usually okay: Swimming, Stationary Bike, Elliptical, Rowing Machine

Shin splints
Yes, usually okay: Swimming
Sometimes okay; let pain guide you: Stationary Bike
No, usually not okay: Elliptical, Rowing Machine

Stress Fracture
Yes, usually okay: Swimming
Sometimes okay; let pain guide you: Stationary Bike
No, usually not okay: Elliptical, Rowing Machine
10. Get Shoes That Fit
"There's no single best shoe for every runner," says J. D. Denton, who has owned a Fleet Feet running store in Davis, California, for 14 years. Not only that, but it's impossible to say that shoe ABC will eliminate injury XYZ. Denton and his staff are careful to draw a line between giving medical advice and suggesting a top-notch shoe. "We're careful not to say, 'This shoe will cure your plantar fasciitis,'" Denton says. "Shoes aren't designed to cure injuries. Our goal is to make sure you get the shoe that fits and functions best on your feet."
Don't expect shoes to correct an injury resulting from training error or muscular imbalance. However, when you need new shoes (replace them every 300 to 500 miles), go to a specialty store to get expert advice. As a general rule, buy less shoe rather than more shoe (unless you weigh 220 pounds or know you need the Monster Mash model). Studies show that shoes perform best when they fit best. Ask your shoe salesperson: "Why is this the best shoe for me?" If he or she can't provide a sound answer, find another store.

an excerpt from runnersworld.com

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