I recently posted on my facebook page a blog from strongerbyscience.com on the why & how of tapering & peaking for athletes. It’s a good summary article, and here I have added some key additional research detail on tapering which was not included in the summary or post..

At the end of the day training can be a numbers game (how often to run, how far, how fast) and tapering decision-making should be too. So to help inform your decisions regarding taper variables here’s some of the known outcomes of tapering according to the research studies. Remember, the aim of tapering is to achieve a ‘supercompensation’ to the pre-taper training stimulus and the best race day performance you can achieve in the circumstance. And when training has been disrupted due to pain, illness or injury you may need to adapt your decision making to be ready on race day.

How much does tapering improve race performance?

• Elite track athletes can experience  0.3-0.5% improvement in performance through tapering (Hopkins 2005).
• This gain can potentially be from 0.5% to 11% in non-elite athletes (Mujika & Padilla 2003).

How much can a moderately trained athlete decrease training frequency in a taper and not adversely affect race day performance?

• Moderately trained athletes maintain physiological adaptations even when there is a  decrease in training frequency of up to 50% during a taper (Bosquet et al. 2002, Mujika & Padilla 2003).

How much can an athlete reduce training intensity during a taper and not adversely affect race day performance?

• During a taper, a training intensity of less than 70% VO2 max has been shown to maintain or reduce performance (no supercompensation occurs) (West et al.2013, Kiecolt-Glaser et al. 1998).
• During a taper, maintaining a training intensity of more than 90% VO2 max is associated with improved performance (supercompensation occurs) (Cook et al. 2011).

Tapering protocols assume an athlete has reached a satisfactory training distance in the month preceding taper start date, and an undefined but decent number of miles in the legs over the preceding weeks & months. This is individual but typically considered to be a minimum longest distance run of 18-19 miles, and possibly up to 22 miles dependent on experience and the level of athlete (e.g. novice, intermediate, advanced, elite). If your longest distance is below 19 miles you should seriously consider withdrawing from the marathon – there are always more marathons. Be a smart athlete.

What should a runner do when pain, illness or injury has disrupted training and meant that less training than ideal has been completed during the training programme (reduced training volume)?

• Consider using  a short duration step taper or exponential fast decay progressive taper  if there is decreased overall training volume pre-taper (Kubukeli et al. 2002), the latter has been shown to still lead to 3.95 to 4.1% performance gains on pre-taper performance (Zaradas et al. 1995, Mujika & Padilla 2003, Banister et al. 1999). Step tapers are often considered not to be as effective but if it means you can settle down or inflamed tissue or pain before race day then you may be good to go on the day as a result of a week's rest beforehand.

There’s nothing like data to inform training (it should be science-based after all). However, even within science there is individual variability and some subjects form outliers falling outside the common responses. Having said that 95% of athletes will fall quite close to the research results (within two standard deviations in statistical terms). So use the science to make the right decision for you.

The more you have trialled different tapering approaches the more you will know how they affect you; the less you have the more you should start from a scientific start point. And when training volume has been reduced pre-taper you may need to think differently – very little, if any, tapering research has been done on rehabilitating athlete’s, but we’ve all seen a big race where an athlete has had less than ideal preparation but performed well on the day (the higher the mileage you’ve done in the past and the more you’ve maintained high levels of conditioning the more likely this is).

Enjoy running – train smart – successful athlete’s adapt to adversity.

Be realistic , confident & ambitious, but not over-ambitious. Race day will lift you but preparation is key.

In Part One I covered the 4 phases of healing process for soft tissue injuries. Now here’s how the athlete should manage a new soft tissue injury in the first few days with the POLICE regime. This is what all athletes should follow, from amateur to Olympic level.
 
Protection – try to protect the injured body part. For example, wearing  a good sports brace, don’t overuse the injured limb, even use a crutch for a few days if you are limping badly.
 
Optimal Loading  – many people think you have to completely rest a new injury; this is not the case. As soon as you are able to it is a good idea to load the injury gently within tolerance (so not wincing in pain, moving very abnormally, guarding it, or limping!). Gradual loading of soft tissue injuries has been show to promote a faster healing rate than complete rest, just don’t load it too much too soon. Let the pain levels and the quality of your movement guide you.
 
Ice – take a packet of frozen peas, wrap them in damp tea-towel, and apply to the injured body part. Use a pack of peas big enough to cover the painful, swollen part and a bit more. National Guidelines say you can ice an injury for up to 30 minutes at a time but no longer, commonly 10-15 minutes is recommended . This should be done in the first 24-72 hours. You can apply an ice-pack regularly but always have at least an hour’s gap between one ice pack ending and the next beginning.  Icing a soft tissue injury as soon as you can after injuring it reduces the amount of cells that die as a result of the trauma and therefore limits tissue damage. The ice pack reduces the bleeding and swelling and means that the injury is less extensive than it would be, so the sooner you ice it the better! After 48-72 hours you don’t need to ice it anymore unless you think you are causing new swelling by loading it too much too early!
 
Compression – applying a compression bandage to the injured body part reduces swelling and helps push swelling away from the injury site. If it is too tight you will get pins and needles or cold, numb peripheries (hands or feet) – remove the compression if this happens! Compression garments can also be used but need to be good quality purchases to provide enough compression to make a difference.
 
Elevation – rest the limb supported above the rest of your body (and above your heart preferably) for periods during the first 24-72hours. This helps to drain swelling away from the area and reduces bleeding in the early phases. This combined with compression and ice packs maximises your recovery rate from the injury.
 
72 hours after injury is a great time to see the physio for a specific diagnosis & to build a tailored rehab program for the injury, but it’s what you do in the first few days that helps change the prognosis for how it will take you to get back rehabbed to training and competition.
 
Pete Jowsey MSc MMACP MCSP HCPC                                                                                                    www.pjphysio.co.uk

Sooner or later in any sport worth its title ‘sport’ athletes pick up some kind of soft tissue injury. What you do in the immediate hours and days following dictates how quickly you get back to training and your best. The current scientific approach to managing early stage injuries is known as POLICE. This stands for:
  Protection - Optimal Loading – Ice – Compression - Elevation 
                                                  
In this blog (part one) I will explain the stages of soft tissue injury. When we injure soft tissues (muscles, ligaments, or tendons) we damage cells. New (acute) soft tissue injuries go through 4 phases in the healing process:

• the Bleeding phase – this typically lasts 0-2 hours; then as the internal bleeding reduces the body moves into,
•  the Inflammation phase – this typically lasts 24 to 48 hours for a milder injury but can be up a week plus for more extensive injuries. This is when the injured body part swells and that throbbing aching pain dominates.
• the Repair phase –  the body starts to lay down scar tissue to patch up the torn fibres (the damaged cells); this stage is typically lasts few days to a few weeks (depending how bad the initial injury was) as the body rebuilds the injured part. When the tensile strength is strong enough you as the athlete tend not to notice the injury anymore; however,
•  the Remodelling phase – goes on for many months as the new tissue becomes more and more well organised and gets biomechanically better and better structured.

In Part Two I’ll help you understand how the POLICE regime can be used in the first few days of new soft tissue injuries.
Pete Jowsey MSc MMACP MCSP HCPC                                                                                                   www.pjphysio.co.uk

There's been a lot misreported about Andy Murray's 'shoulder injury' & the magical effects of the physio. Based on what Andy said in the post-match interview & how the physio treated it here's a 'physio-eye view'.

Andy reported that the pain was near his scapula and his shoulder felt tight serving. He was not pictured gripping his shoulder joint  but over the back of the upper trapezius, into the right upper thoracic spine region. His physio manipulated his mid to upper thoracic spine joints, performed similar thrust techniques on the rib angles where they join the thoracic spine as well, and applied some brief trigger point pressure to his upper traps muscle (although this may just have been assessment) and his lats muscle under the armpit. We need every plane of movement available for the tennis serve action, and correct balance of muscle forces as we throw the racket head through the ball.

The manips increase the spinal joint glide (needed for the mechanics of serving); drop the tone in over-active muscles (especially in any guarded muscles running from the scapula to the thoracic spine). The 'few good cracks' Andy reported are 'cavitation'- nitrogen bubbles bursting within the spinal joints. The manips also stimulate the brain to release powerful non-opioid pain relieving chemicals into the bloodstream, using nor-adrenaline pathways - increasing muscle recruitment - part of our fight-or-flight system.  And a little trigger point pressure to be sure the upper traps & lats muscles have let go.

Not so mystical! Not quite 'healing' (as nothing was torn or damaged).

Nevertheless the effects were 'magic' - pain reduced or gone, moving well, great muscle control, focused & able to be on his game - the difference between losing 6 games in a row and winning 5 on the trot. Game-set-and match, Murray! 

Well reasoned & well applied physio makes the difference. That's what you pay your physio for! 

Now to prepare well for the last 16.

#it'snottheshoulderthistime      #knowyourmanips

Exercise stresses your body. You don’t have to be an Olympic medallist. You may just love taking part, do it for social participation, general health, fitness goals, or wellbeing benefits. Your body needs the right amount and types of stresses.

Here’s 6 simple steps you can take to protect your health when exercising:

1. Warm-up

 A 10 minute warm-up of gradually exposing our body to increased heart rate and increasing range and speed of joint movement prepares your body effectively. Warm-up makes a difference to how our tissues perform. You are less likely to injure tissue if you warm up in this way. 

2. Think of the intensity of your exercise

How many times do you perform your exercise? What speed? If using weights, how heavy? How many hills are there in your program? Downhills count too for runners! Change training variables gradually. 

3. Strengthen your thigh muscles

Do a few simple strengthening exercises for the quadriceps twice a week. For example, squats or lunges. This gives you stable, well supported knee joints.

4. Look after your back

Work on posture, flexibility, and having core muscle control. We live in a world of sitting – try to break it up regularly.  Simply standing up and sitting down again every 30minutes has a marked benefit in changing tension on tissues and improving circulation. Walk and stand more.

5. Schedule recovery time

Have 2 days a week where you don’t do strenuous exercise.  This allows your tissues to recover, adapt, and strengthen. Training is the stimulus. Recovery is where your body changes. 

6. Be structured & consistent

Approach sport and exercise in a structured and consistent way and you’ll really experience the benefits. Stress your body in a good way!

Call me to discuss anything in this article.