Case Study: Rob’s Soft Tissue Injury Cascade
During lockdown this year, I, like many others, found more time in the day to exercise from home. My routine quickly changed from running once a week (10km) to running upto 4-5x and backyard HIIT training most days.
Suddenly upping my training load, I felt strong and it gave me a new focus through an uncertain time. But, that feeling didn’t last long as I started to experience niggles growing into injuries, forcing me to take a break. I had to ask myself “What would I tell my patients?”
Injury Timeline:
Mid April 2020: Strained right hip flexor muscle whilst sprinting at the end of a backyard HIIT session. I hadn’t sprinted in 6 months, oops!
2 weeks later: Started playing outdoor 5 a side soccer with friends. I felt strong running and changing direction but I could feel hip flexor discomfort when kicking the ball further than 10 metres with not much power. At the end of the game (when fatigued), I sustained a right adductor strain whilst chasing after the ball.
May 2020: Continued jogging and HIIT during the week and performed some adductor/groin rehabilitation.
Early May 2020: Played soccer for the next 2 weeks and both times, strained left adductor. On top of this, my right hip flexor was still sore from kicking the ball.
Mid May 2020: stopped soccer for 2 weeks and rehabilitated the groin and felt fully recovered.
Early June: Increased running, continued HIIT and started 5 a side soccer indoor (smaller size pitch but hard surface). In one week, I ran nearly 30km, played soccer and did x3 HIIT sessions. I felt strong and thought I had fully recovered...
Early - Mid June: Started to feel bilateral Achilles soreness/stiffness, worsening over 2 weeks. Running became more difficult as my cadence reduced from 187 to 174. I lost my spring and couldn’t hop without pain and generated poor power. I was completely frustrated with my body at this point!
Mid June: Ceased running for a period of 3-4 weeks and paused from soccer. Commenced calf/Achilles rehabilitation as well as rehabilitation for my original injury (right hip flexor).
August: Return to soccer at full capacity.
Why was this happening to me? I knew that I needed to think back to why all of these injuries kept cropping up.
My hypothesis was that the original hip flexor strain had never fully healed, leading to weakness and reduced muscle length. This placed more demand and compensation on both adductor muscles with sprinting and soccer. I never allowed it to heal as the kicking kept aggravating it.
I overloaded my entire system by completing too much exercise involving jumping, landing and running and didn’t allow the injuries to completely recover in strength, power and mobility/flexibility.
The key to fixing the underlying soft tissue injuries was to restore flexibility, strength and power in the original injury which set everything off.
Once I was doing a run every second day within 80% of the previous intensity & distance, I re-commenced five-a-side soccer in August. I knew I had overcome the root cause of the issue when I could kick the ball hard with power and not feel the original quad injury at all!
My lesson to myself through this whole injury experience?
Do as I say and not as I do! Even physios need to be told to slow down sometimes!
Learn more about Recurrent Injuries.
