Dr. Brian Damhoff Blog Speaks: Injury Progressions

The Damhoff crew advance to sectionals for the first time since 2010 (Andy Derks photo)
 
Before the regional race at Lockport where we advanced to sectionals for the first time since 2010 began, I had the pleasure of speaking with Neuqua Valley head XC coach Paul Vandersteen. Now outside of interacting on Twitter (On a side note, Twitter is a great way to not only communicate but learn, if you want to follow me on twitter my handle is @DrBrianDamhoff) this was my first time meeting a coach who I look up to very much for much success his program at Neuqua Valley has had over the years. Last week I spoke of creating a culture, Neuqua Valley certainly has a great culture. In my conversation with Coach Vandersteen we began to talk about dealing with injuries and progressions on bringing back athletes from injuries. As we were talking, I knew this would be a great topic to spend a little time on in the blog!
 
There are two general assumptions you can make about injuries in cross country. One, they suck and two, they are going to happen no matter what you do. Now, how you manage these injuries can play a big part on a quick return with minimal loss of aerobic fitness or a slow return with a maximal loss of aerobic fitness. As coaches, we dictate a lot when it comes to athletes managing injuries. I go by some general guidelines when it comes to an athlete coming up to me and saying coach this hurts. However, it should be noted that every athlete is different and very individual so what works for 99 athletes may not work for the 1 athlete of yours that is injured.
 
If an athlete has pain with running, I don’t let them continue to run hard and cause more pain. I don’t mind sending an athlete in to bike for a day or two if that means that they stay healthy. I also don’t mind pulling an athlete from a workout early or perhaps not even letting them run the workout and instead just going for an easy run. I do mind pushing athletes through obvious pain. I rely largely on feedback from the athlete about their aches and pains. If an athlete can’t get healthy by taking a day or two of biking, then they need to strongly think about getting some treatment for their injury. Whether that’s the athletic training staff, a physical therapist, a chiropractor like myself, etc. find someone good that you have good success with and stick with them. I think it is important to note that whoever treats the athlete regardless of profession, if they only treat the site of pain, they are doing the athlete an injustice. 
 
Once an athlete is cleared to return from a health professional, you have to be careful not to bring them back too quickly or you risk them becoming injured once more. I like to start with a week of one day on, two days off with cross training with a slow progression into running. The second week we go one day on, one day off of cross training. If they’re 100% pain free, then in week three, we can go back to almost full strength. I still will be guarded during workouts and get direct feedback from the athlete to ensure that we’re on track. If at any point in the process, the athlete feels pain, you need to take a step back or you risk going back down the road that got them injured in the first place. Time wise, the first day they’ll only run for 5 minutes, if they feel good, the second day we run on it’ll be 10 minutes. We follow this progression of building up in time for the first 2 weeks. I won’t let that athlete run more than 20 minutes unless I’m really convinced that they’re healthy. 
 
If you are diligent in your approach and have a good health professional to work with your team, it will pay large dividends. As many of you cross country coaches know, keeping your team healthy is a very important aspect of the sport. Our team this year had 1 stress fracture, 2 severe cases of shin splints, 1 severe case of knee pain, 1 case of Peroneal tendonitis and 1 severe case of heel pain related to a growth plate issue. That’s a total of 5 injuries that required more than a day or two of biking out of 43 athletes throughout summer running and the cross country season. Outside of the stress fracture, all were able to return to full strength by the end of the season and 2 of these 5 previously injured athletes were featured on our top 7 at regionals.
 
Speaking again of regionals, we were ecstatic to advance to sectionals for the first time since 2010. We came in ranked 4th and we finished 4th behind 1st place Neuqua Valley, 2nd place Plainfield South and 3rd place Oswego. We faced some adversity during the race as our #2 had a side cramp that forced him to become a non-factor for us and after the race, we as coaches had some doubts as to what place we had finished. However, we were led by a strong 2nd place individual finish by Jack Sebok who finished behind Oswego’s Peter Johnsrud. Next week is sectionals and we will be focused on trying to finish higher than what we are ranked. It has been awhile since we’ve put together a total team effort and we’d like to do that on the course of Chicago Marist. Our sectional is absolutely loaded with Sandburg, Hinsdale Central, Neuqua Valley and Lyons Township who across the board are the top 4 3A teams in the state of Illinois. The race will be fast and will have some large implications for what will happen in Peoria the following weekend!