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Tissue capacity and training load

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, Aug 26, 2015.

  1. Craig Payne

    Craig Payne Moderator


    Members do not see these Ads. Sign Up.
    Worth a read:
    Balancing training load and tissue capacity
    ..been talking about this a lot lately in my Clinical Biomechanics Boot Camps
  2. Griff

    Griff Moderator

  3. The concept of trying to optimize "tissue load" at least in running is not a new idea. We talked about this concept back in the late 1970s on our college cross-country and track teams in regards to training intensity management, hard-easy programs, etc...except we didn't use the term "tissue load". Runner's World magazine had articles on it also around that time. Nothing new under the sun.
  4. Griff

    Griff Moderator

    No suggestions that it is new that I can see. It is poorly taught and subsequently understood at undergraduate level here in the UK in 2015 however.
  5. Agreed. We were never taught this concept in Podiatry School. I learned it my exercise physiology classes in undergraduate, in reading Runner's World and through discussions with my cross-country coach, who just so happened to be a PhD in Exercise Physiology. The idea of "hard-easy" training though seemed to be fairly new in the mid 1970's and I thought was an excellent idea, which is based on tissue load concepts. It certainly helped me and my running. Another idea we practiced in the late 1970's was to rotate multiple running shoes into your training runs, and not run in the same shoe every run. This idea was also based on the idea of avoiding the same specific loads on the exact same tissues on every run. I found this to be helpful for my training and injury-prevention also.
  6. Ian Linane

    Ian Linane Well-Known Member

    Nice article

    Leaving aside running, there is much of value in managing load for everyday patients managing low leg, foot and ankle injuries.

    Often suggest to my general patients that part of the key to their treatment and recovery is to "re-educate tissue to tolerate full loading again" ....aiming to "minimise a re-injury risk". Something they seem to switch into quite quickly. Another phrase I use is we need to "take you from a point of injury, back into usual function and then on into performance level" to minimise re-injury risk (which may be a work related performance issue rather than a sports one).
  7. Craig Payne

    Craig Payne Moderator

    What causes an overuse injury in runners: when the cumulative load in the tissues exceed what the tissue can take.
    What cases diabetic foot ulcers: when the cumulative load in the tissues exceed what the tissue can take.

    What we get into at the Boot Camps now is the increasing emphasis on increases the ability of the tissues to take load rather than putting all the effort into reducing load (ie orthotics, off loading)
  8. I believe that, overall, discussing the effects of immobilization, rest, different types of training methods, different types of strengthening/stretching programs, diet, shoes and foot orthoses on tissue load/deformation characteristics has been the way forward now for at least the past ten years. Thankfully we have gotten away from only looking at the amount of rearfoot varus, forefoot valgus/varus and ankle joint dorsiflexion as the way to treat our patients with mechanical therapies.

    In my own practice, I continually am giving training advice to my injured patients, discussing shoe types, discussing orthoses vs no orthoses, discussing stretching and strengthening programs and also now focus on discussing "running form". In addition, I try to spend some of time trying to explain what is happening at the microscopic level in their tissues when they get injured, when they have a specific x-ray/MRI finding and when they are trying to heal their injury. I think discussing the tissue characteristics at the microscopic level helps the athlete-patient better understand what is going on in their body and why I am doing what I am doing with my treatment for them.

    Welcome to the 21st century!!
  9. It was a good overview article, but one point, which I feel is important, that was not mentioned in the article must be made. We can theorize all we want that injuries are due to too fast, too much, too soon. However, in the final analysis, we won't know, until the injury occurs, that the training was too fast, too much or too soon.

    For example, let's look at a hypothetical Runner A and Runner B:

    Runner A will ramp up his weekly training mileage by 20% per week over a one month period and suffer no injuries, will have a significant increase in fitness level at the end of that month, and he will be a better, faster runner because of his relatively rapid increase in training duration. However, Runner B will try to ramp up his weekly training mileage by 20% per week and after two weeks, suffer a running injury, which not only prevents him from progressing, but also ultimately results in a loss of fitness level by the end of that month's period.

    Runner B visits his sports podiatrist and the podiatrist tells the patient that he was increasing his training mileage "too fast, too much, and too soon". However, this same sports podiatrist never sees the other runner, Runner A, who did just fine and gained a significant increase in fitness by increasing his training by 20% per week.

    The moral of the story is that we can theorize all we want about how each runner, or other athlete, should increase their training safely over a given time period with the goal to reduce injury. However, if the goal of the athlete is to not avoid injury but rather to reach peak performance, sometimes the athlete must train harder, faster and longer than what would be recommended for another individual who just wants have "any increase in fitness".

    In addition, until a researcher, sports clinician or coach can somehow effectively predict location and type of injury in an athlete with good success, we are all at the mercy of the unknowns that cause one individual to become injured often and another individual to become rarely injured, even though they are doing the exact same training.

    In other words, don't think that because you proclaim to your injured sports patient that the reason for their injury that they "ran too fast, too much or too soon" that you have really solved the true etiology of their injury.

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