Plan D Training Part II
Swimmers get injured. Whether these injuries occur because of bad luck or bad training, they happen. It's at this point, good coaches are separated from the rest.
Good coaches have options. They’re able to help swimmers continue to improve, even if they can’t perform ‘normal’ training.
In part I, we examined some strategies from maintaining swimming skills. In part II, we’re going to examine the equally important task of maintaining fitness.
With thought and creativity, it can be done and done well.
The biggest challenge in Plan D Training is maintaining fitness. Maintaining fitness requires work, and work is exactly what is contraindicated in many injury scenarios, particularly to the afflicted area. This is where creativity is required, as we must find a way to work as many areas of the body as possible, all without compromising the healing process.
Maintain general cardiovascular fitness. One of the primary challenges is to maintain general cardiovascular and aerobic fitness. Without this supportive fitness, everything tends to fall apart. The nature of the injury will dictate what is possible from a cardiovascular standpoint. Typically, running will not be an option as the impact created upon ground contact will tend to jar most injured areas, regardless of the location of the injury. The upper body is actually pretty heavily involved in running.
For upper body injuries, your standard cardiovascular machines (bikes, ellipticals, etc) can be effective, as can kicking in the pool. The key consideration here is rotating the type of cardiovascular equipment used, as well as the volume of kicking. Too much of the same type of work, too soon, is simply going to cause more injuries to tissues unaccustomed to the new loading.
For lower body injuries, swimmers are often able to continue to swim in the water, which allows for the maintenance of general fitness, often at a fairly high workloads. As with lower body injuries, be careful with too much, too soon. Be judicious with the use of pulling and the types of paddles that are used, lest the shoulders become injured as well.
Back injuries are harder because they can vary greatly in terms of what is tolerated. Find some activity that they can do for extended periods of time, and have them do it. If that’s walking, it’s walking. Do what’s possible and increase workloads and exercise types as permitted. Anything is better than nothing. In some cases, swimming VERY slowly is tolerated. If so, do that.
The key point is that there needs to be some type of training that allows for elevated heart rates and respiratory rates. HOW that is achieved is secondary to achieving it.
Maintain muscular metabolic fitness. While it’s important to maintain general aerobic fitness, we also need to address local muscular fitness. This is a lot harder to do. When maintaining general aerobic fitness, it doesn’t necessarily matter HOW you move to get the heart rate and respiratory rates up. The specific muscles used don’t really matter. In contrast, when looking to maintain fitness in specific muscles, those specific muscles need to be trained.
For upper and lower body injuries, targeting the healthy muscle groups is pretty simple. Simply following the instructions for maintaining general aerobic fitness will suffice. Manage volumes and intensities to target the specific adaptations you would like to achieve.
For injured muscles, or muscles that cross injured joints, maintaining fitness becomes a challenge. If the injured area can be moved at all, doing so will have a positive impact. This is true even if the volume and intensity of movement is extremely low. Anything helps.
For all injuries, weight training machines may be of use. This a grossly underappreciated option for maintaining metabolic fitness. These machines are typically not weight bearing and allow for isolation of certain joints. Swimmers can alter their position on the machine to potentially allow them to move without pain.
For instance, someone with an ankle injury, could still potential use a leg extension machine or a leg curl machine. This can allow them to exercise the legs when they would otherwise be unable to do. On two occasions, I’ve coached swimmers with broken bones in their feet that were able to use these machines to great effect. The same workarounds can be used with upper body injuries.
For those with back injuries, the stability provided by the machines may allow them to perform any number of movements that would be impossible while swimming or using cardiovascular machines. Back injuries are very unique as to what is tolerated, and experimentation is required. In general, activities that minimize the movement of the spine, as well as the stabilization requirements of the spine, are going to be better tolerated.
As most injuries are to a single limb, strength training machines allow for training the healthy limb, which would be impossible on an exercise bike for instance. As mentioned above, exercising the healthy limb can have a positive impact on the injured limb. Everything is worth doing.
I understand it may be confusing as to why I am discussing strength training machines in the context of improving metabolic fitness. As opposed to exercising using traditional strength training repetition schemes, swimmers can perform 100s(!) of repetitions. Surely, this will have an impact on fitness levels of those specific muscle groups. Simply keep the loads low and the volumes high. It is a way to get the job done. You can also use interval training as well. For instance, a swimmer could perform 15 sets of 30 seconds of work alternated with 30 seconds of rest.
For those familiar, KAATSU training is an effective alternative. If the injury is mild, using KAATSU in conjunction with movement can greatly lower the intensity required to create a training effect. For instance, if the injury allows for some low load movement, KAATSU can make that movement much more strenuous without aggravating the injury. This can help to maintain fitness of the injured limb.
In the event of a more severe injury, KAATSU can be used passively. This promotes blood flow and a level of metabolic stress to the injured area. While it won’t prevent the loss of fitness in the absence of any movement, it can certainly be useful in reducing the amount of fitness that is lost. Any effect can potentially result in better performance down the road.
For those who feel competent to do so, KAATSU can also be performed in the pool. Some swimmers may only experience pain when approaching certain intensities and volumes. As KAATSU can lower the intensities and volumes required to simulate physical changes, using KAATSU can be an effective strategy for maintaining fitness while staying below the threshold for pain. This approach can be particularly useful when swimmers have manageable injuries that still allow for some swimming to be performed. It will make the swimming that is done much more impactful.
Electrical Muscle Stimulation (EMS)
Similar to KAATSU, electronic muscle stimulation (EMS) can also be used. EMS can facilitate passive muscular contractions at any intensity level. Sustained contractions through EMS can produce an endurance training effect in muscles that are unable to be exercised due to injury. This may or may not be tolerated depending on the injury. As with the passive use of KAATSU, EMS is not going to completely prevent fitness losses. However, it can make a difference.
Maintain muscular strength. While maintaining aerobic and metabolic fitness is critical to sustaining performance possibilities, so too is muscular strength. All the fitness in the world isn’t going to matter if swimmers lose all of their strength. Any commonly included strength movement that can be performed normally, should be done so. For all those movements that cannot performed normally, we’re going to need to take alternative approaches to maintain or increase muscle strength.
Depending on the injury, alternative exercises can be used. For instance, a mild shoulder injury may be aggravated when doing a bench presses with a barbell, yet cause no problems when doing the same exercise with dumbbells, or when doing push-ups. Loaded squatting exercises may aggravate an injured back, while loaded lunges do not. In both cases, the preferred exercise is replaced with a second exercise that accomplishes the same outcome.
When working to maintain strength during times of injury, this should be our first strategy. Simply replace problematic training exercises with similar exercises that are equally effective and pain-free. If the injury is severe enough that using an equally effective exercise is not possible, we’d then move to exercises that are still effective, but less so. Using the squatting example above, we might move to some version of a leg extension and leg curl combination. While this may be less than ideal, these exercises would still allow for a swimmer to effectively train the muscles of the legs.
The same principles should be used for all exercises. It’s only when an injury does not allow for any movement across the required joints and muscles that we need to look for even more divergent ways of maintaining strength.
Most of the injuries that swimmers face are related to overuse. These issues tend to preferentially affect tendons and ligaments rather than the muscles. Depending on the specific injury, it is often movement of the tendons that causes problems, and those problems are often limited to certain range of motions.
We can bypass this issue by simplify performing static holds in positions that do not cause pain. An isometric strength exercise is a simply a strength exercise with no movement. A plank is a common example. However, any exercise can be performed isometrically, and it can be performed in any position, with or without added resistance.
Isometrics tend effectively build strength at joint angles that are close to the angles at which the hold is executed. This limitation can be overcome by performing holds in multiple positions. There is some evidence that isometrics performed in lengthened positions have positive transfer over a larger range of motion. As much as possible, it makes sense to give preference to these positions. In both cases, something is better than nothing, so do what you can.
Longer holds with less resistance will likely have a greater impact on maintaining muscle mass, while shorter holds with more resistance will be more effective at maintaining muscle strength. Isometrics can be performed for the injured area, as well as for any area that cannot be trained due to the injury. For instance, a back injury may prohibit the use of many lower body exercises such as squats, even though the legs themselves are not injured. Isometric holds cans stress the legs without aggravating the back.
As discussed in the skill maintenance section of part I, exercising one limb can have positive effects on the opposite, unexercised limb. These effects can be significant, particularly for strength adaptations. In the event that one limb cannot be trained, train the other arm as much as possible.
This will not only maintain the strength of the uninjured limb, it will maintain some of the strength for the injured limb as well. Any maintained strength that would otherwise be lost is strength that does not need to be re-gained once normal training can resume, it will keep the swimmer that much closer to the starting line.
In situations where isometric training is possible on the injured side, the benefits of isometric training in conjunction with cross education can maintain the vast majority of muscle strength. It’s a very powerful tool, particularly when some training can be performed on the injured limb. The same can be said when using EMS or KAATSU as described below. Cross education will make both more effective.
Electrical Muscle Stimulation (EMS)
Electrical muscle stimulation can be used to create very intense involuntary contractions of any muscle group in the body. These contractions can be STRONGER than contractions a swimmer is able to create on their own. For this reason, EMS can be of value for HEALTHY swimmers, which is a different conversation.
In the injury context, EMS is particularly useful of training healthy muscles and joints that cannot be loaded due to other injuries. Staying with our example of a back injury, let’s assume that the injury prevents the implementation of any dynamic strength activity that would train the legs.
Because EMS is isometric in nature, it has many of the same effects as the isometric work described above. The disadvantage is that swimmers are not initiating the contractions, the device is. However, the advantages are that much more intense contractions can be created, and these contractions can occur in a much more isolated manner, further protecting the injured area.
EMS could be applied to the major muscles of the lower body (quadriceps, hamstrings, and gluteal muscles) to allow for a strengthening effect. This would minimize losses of strength and muscle that would occur due to inactivity. When the back is healed, it will allow for a much smoother transition back into traditional strength training.
The same thought process can be applied to any injured area.
There are also situations in which swimmers that do not prevent swimmers from swimming, yet limit their ability to effectively strength train. In these situations, EMS is extremely effective at positively impacting strength levels without aggravating the injury. While EMS is not magic, it will maintain a large portion of the prior strength level and is effective in maintaining muscle mass.
For those individuals that can perform some movements, but only at very low loads, KAATSU is very effective for maintaining muscle strength. While a relatively high percentage of maximal load is required to maintain strength using traditional resistance training, very low loads are effective in maintaining and developing strength using KAATSU. For those individuals who can only tolerate very low loads, this is perfect solution.
KAATSU can be used for just about any movement, and while one would think that the placement of the bands on the arms and legs would limit the effects to those areas, this does not seem to be the case. The muscles of the chest and back seem to benefit as well.
KAATSU can be performed with relatively high frequency, and recovery is rapid. For those individuals with a limited capacity to train due to their injury, KAATSU does not seem to rob them of much of their capacity. It is a high reward, low cost activity. Fortunately, many of the effects for developing metabolic fitness can be achieved using the same protocols to develop muscle strength. It is an efficient tool.
Maintain ‘output capacities’. Creating high levels of force and speed is both a general and specific ability. While the specific ability is swimming really fast, the general ability is moving with high levels of force. If swimming fast is not an option, we need to find options for maintaining high speed and high force movements in different contexts. Some options include-
Maximal effort kicking
Maximal effort pulling
Maximal effort biking
Maximal effort strength training with multi-joint movements, performed with speed
Maximal effort strength training with single-joint movements, performed with speed
The goal here is to continue to be able to exert a lot of effort in a short period of time. The shorter the events the swimmer swims, the more important this is. The ability to create large force outputs at high speed is both a general ability and a specific ability. People that can exert a lot of force and speed can tend to do so in multiple activities. Any activity that is performed with very high levels of effort is going to contribute to developing this ‘general ability’. However, if you want to improve a specific skill, that skill needs to be practiced.
When the ability to train the specific ability is taken away (i.e. full stroke swimming), we need to find other options that can be performed safely without jeopardizing the injured area. This way we can retain the general ability to create high outputs, even if we can’t retain the specific ability. Any of the options listed above could suffice, it’s about finding a tool that works. The volume of this type of work is not as important as finding a way to maintain the intensity.
Swimmers performances are built upon fitness and building fitness requires training. When swimmers get injured, their physical training is compromised. However, options do exist to keep the training process moving.
There are multiple fitness traits that need to be maintained, and as with maintaining skills, these fitness traits can be maintained with some knowledge and ingenuity.
Hopefully, the options laid out here stimulate thought as to how one might go about helping swimmers maintain their fitness when the inevitable injury strikes.
In part III, we’ll talk about the biggest challenge of all, maintaining confidence.