When Angela asked me to write about something related to the Open and Open training, the first thing that came to my mind was, “Can we change the system for Masters in the Online Qualifier ?” But you guys have already surgically dissected that better than any first-year anatomy lab. The second thing that came to my mind in the orthopedic world in which I live in was “overuse”. Overuse, or repetitive stress injury, is definitely the number one diagnosis that I see in my Sports Medicine practice.
It is part of the sports culture nowadays for adults and children. If playing baseball four months in a year is good then 12 months must be better right? Not so fast. It’s the same thing with CrossFit, but also it’s the beauty of CrossFit. One has to guard against overtraining one movement and one exercise. If you have overdone pulling, then you can focus on pushing if something is not right. Just like a chaperone at a dance or a lifeguard at the pool, I’m the one who to tries to keep everybody safe and take away the fun stuff.
Don’t get me wrong, I live for the fun stuff, but training properly is more important in the long run.
So what’s the purpose of the Open? To make it to the Games, right? Well for the large majority of us mortals, it is not to make it to the Games but to have fun, compete, or just do the Wod that 300,000 others are doing and see where they fit in in this game we call CrossFit. As we know all too well, the intensity of the workouts can be quite mind altering (insert any Open workout ending in .5) People can get swept up in their position on the leaderboard and those filters!! Raise your hand if you are positive you are the fittest law enforcement officer in Rhode Island aged 52 to 52 and 3 months who has a peanut allergy who Rx’ed 17.2. We all do it. Admit it. My point is when you are in the heat of this battle sometimes driven by ego and competition and placement, I have heard of people doing some of these Wods three to four times. Now if you are fighting for an endorsement contract from Pro Po Nutri Ex Get Yer Yayas powder, then you may have to put in several efforts. But… for most of us, one or two times should be enough.
At the Games, I have seen people show up in pain from overtraining and subsequently have poor performances. There is a certain time one has to say, “Ok, I’ve been doing this for however many years and I have to rely on my level of fitness going into the Games.” This should hold true for the Open also. As Del Lafountain pointed out in his article about prepping for the Open, it is time to train things that you are bad at. But when you decide you are going to start putting in two hours a day of bar muscle up practice for four days in a row, your body may not like the idea as much as your brain does.
(There actually is some benefit to decreasing volume and allowing the body to be in its best possible shape.)
So what I am talking about is tendinopathy or micro tears that occur in a tendon from stressing that tendon too much.
It can strike any body part at any time, and there is a high chance of getting it if you run 26 miles or do 2600 bar muscle ups. Training plays a huge role in tendonitis.
From what I have seen tendonitis starts as a result of something different in one’s workout routine, including:
– New exercise
– New weight
– New distance
– Higher intensity
– Faster speed
– Change in course
– Change in repetitions
For the CrossFit world, you can see where things can go wrong fast. The coaches at CrossFit New England where I workout do a good job at scaling recommendations for people, as should other gyms.
The tendon has to accommodate the stress. If the tendon is overstressed it will develop small microtears in its substance or collagen fibers. When enough of these microtears occur, inflammation kicks in. The body actually sends the same cells it uses to kill infections at your tendon (monocytes and macrophages) and they try to repair and remodel the tendon. These cells release substances that are noxious and painful, causing swelling and tenderness. Then the body sends the scar formers (fibroblasts) to try to strengthen the weakened area and decrease the inflammatory phase. You can see tendinopathy on the left and normal tendon on the right. I love these slides because it drives the point home to athletes who don’t know what tendinopathy is and they see why they are having issues. So what does this mean for you?
Say you have a biceps tendonitis or Achilles tendonitis. You need to modify. Working out and avoiding injuries comes down to what I call “The Rule of Threes”. You should not have pain:
1) While you are working out
2) Right after the workout
3) Pain the next day
Call it what you will…tightness, achiness, soreness, tweaked, spent, grittiness, junk, evil humors. There is a difference between muscle fatigue and tendon pain that I hope most of you have never felt, but when you get the latter you will know it. The muscles are the squishy part in the middle of the limb whereas the tendons are located typically near the joints themselves. The most common tendinopathies I see are:
1. Biceps at insertion in front of elbow or at origin in front of shoulder
2. Patellar tendon at end of kneecap closest to the foot
3. Achilles (for location refer to mythology) usually an inch away from the heel
The locations don’t matter but the treatment is all the same. ACTIVITY MODIFICATION. The important take home point is: Let the tendon heal. If you catch it early and feel something is wrong, taking it easy for 2 to 3 weeks may be all that you need. Don’t push through pain or soreness. Enjoy your Open and don’t overdo it. Adult Swim is over, now get back in the pool and have fun!
Admin photo legend:
#1 How you hope to never see Dr. Rockett
#2 what microtears look like compared to a non microtears tendon
#3 Patrick Vellner the 3rd Fittest Man on Earth getting his torn biceps checked out from the Road to the Games Crossfit Media
#4 Who to look for in Madison-say hi to the Doc