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June 4, 2014

The niggle

The Niggle

What is the niggle?

Recognise it and prevent re-injury.

You may be feeling the gains of training and hitting your stride. Some of you, however, will be starting to feel the accumulation of the breaking down and rebuilding process that occurs as part of training, as something more like breaking down and not-quite rebuilding.

This is the infamous ‘niggle’. This is when you are most susceptible to re-injury or more severe injury.

To consider the niggle, we must consider inflammation.

Inflammation is the body’s response to injury and invasion, and has three recognised phases:

  • Acute (2-5 days)
  • Sub-acute (5 days – 3 weeks)
  • Chronic, when the actual remodelling and repair of tissues takes place (3 weeks – 3 months +)

One feature of injury is a reduced range of movement (ROM). This can briefly be described as follows, according to the three phases the repair process will move through:

  • Phase 1 (acute) – you don’t manage to get to the normal range at which you would start to feel a stretch, and it will be achy or painful.
  • Phase 2 (sub-acute) – you will get to your normal ROM, but the ache will still be present at or just before that range. (Integrating proprioceptive skills is particularly important here. More on this later.)
  • Phase 3 (chronic) – Normal ROM and some ability to extend this without discomfort. (Functional or dynamic movement is important here.)

The swelling typically associated with inflammation is only evident in the acute phase. So when this phase has passed and you are at about day 4 or 5, when in the sub-acute phase is the time you are most likely to think, “well, I’ve rested for a few days, I can stretch to my normal range, okay it aches a bit, but it’s just a niggle – it’ll be okay.”  No.

This is the point at which your muscle tissue is at its weakest! It hasn’t started to remodel yet, and it doesn’t have the protective restraint of acute inflammation.

This is when you are most susceptible to re-injury or more severe injury.

RISKS– of not observing a program of relative rest:

  • Incomplete remodelling of the tissues
  • Altered proprioception (sense of balance and the self in space, including the ability to react to changes in terrain)
  • Re-injury

GAINS– of observing a program of relative rest:

  • Appropriate remodelling
  • Lack of scar tissue
  • Maintained/improved proprioception

REMEMBER: you can use a time of injury to redefine the canvas on which you build your skills – to become better than you were before!

Injury doesn’t necessarily mean no training, it means altered training.

So, here is a guide to managing ‘THE NIGGLE’ and to prevent re-injury:

TRAIN AND STRAIN

OR

TRAIN AND REGAIN ?

 

1)   If you can’t get a normal range of movement when you try to stretch, and this is accompanied by an ache/pain, the area of muscle ache feels ‘boggy’ to the touch – you are likely to be in Phase 1.

DO: RICE

DON’T: compress it for too long; e.g sitting on a pulled hamstring while studying, at the computer, watching telly, etc.

2)   If you can get to the normal ROM, but as you feel the bind of muscle resistance, this is accompanied by an ache (sometimes this will present as a drawing sensation along the muscle or tendon, which may indicate tension around an adjacent nerve) – you are likely to be in Phase 2.

DO: functional ROM exercises that don’t push past the allowable range or require explosive movement. These may be done loaded – e.g short range lunges, or unloaded – e.g bicycling on your back.

DON’T: RUSH IT!

With this one week of easy training, you buy yourself an entire season!

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