Self-Assessment

The most important aspect of an injury is that it should teach you something about your training, competition, equipment, and lifestyle. Once you’ve learned this important lesson, you’ll become more sensitive to your body’s needs, especially with injury prevention and enhanced training and racing. This self-assessment process is one of the features I’ve regularly seen in better athletes.

Self-assessment is not the same as diagnosis. A diagnosis pertains to disease or serious conditions such as a bone fracture. Since most injuries are functional in nature, a proper assessment requires the gathering of important information about your body and its function.

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An assessment can come in the form of questions you ask yourself, such as your workout and race history or various signs and symptoms. For example, the questions below about a new injury are not unlike the ones I used when treating an athlete.

1. Did the problem begin soon after a new activity?

Some athletes develop an injury soon after modifying their training, typically increasing volume and/or adding anaerobic work. If a change in activity is associated with the onset of a problem, it may be that the activity is too much for your body to handle, that some previously silent muscle imbalance exists, or that you created one. The remedy: Return to your previous schedule to allow the body to heal.

2. Did the injury begin soon after new or different equipment or technique was used?

A new bike position, pair of running shoes, or change in swim stroke can be physically stressful. Once again, the cure is simple: Go back to your previous gear or technique until you feel better. Easing into these types of changes may be most important.

3. Does the problem get better or worse with movement or rest?

If your problem feels better with movement, it’s generally a good indication that it’s a less serious problem. As you move about, the muscles warm up and are able to function better. A proper warm-up can help balance muscles. Sometimes an adequate warm-up takes more than fifteen minutes, and some problems may feel better only after this period of time. But if you feel worse with any type of workout, stop. Don’t push yourself if the pain persists. If a problem worsens during activity, especially after you’ve had time to warm up, it usually means you should be resting to give the body a chance to heal. It may mean there’s a more serious problem, but it could simply be that the body needs more recovery time because of muscle inhibition. Pushing yourself in this situation often makes the problem worse and could lead to a chronic, recurring type of problem. The remedy: Reassess your training schedule, take three days off, use cold if indicated, try walking as a therapy, or use combinations of these methods to help the body self-remedy the problem.

4. Does your injury feel better or worse at the end of the day?

Generally, if your problem feels worse at the end of the day, physical activity, or even just weight bearing, such as prolonged standing, is an aggravating factor. In some cases, you may have accumulated fluid in your foot, ankle, and lower leg by the end of the day. The solution is to reduce training or take three days off and reassess these factors. Spend more time without shoes through the day. Use cold as indicated. If problems that are worse at the end of the day are not easily remedied, they may need further input from a health-care professional.

5. Is the problem better or worse in the morning?

After being off your feet all night, most physical problems feel better in the morning because your body has had time to recover without the added stress of standing, moving, or training. This may not happen if the aerobic system is poor or there is significant muscle imbalance. If these problems are not better in the morning, it may point to other complications.

Certain types of joint pain in those with arthritis may not feel bad in the morning until they get out of bed to stand and start walking, but gradually feel better after movement for an hour or so. This pattern of pain may indicate metabolic problems associated with diet or nutrition, in particular due to the regulation of calcium. In this case, too much calcium may deposit in the painful areas during the night, making movement initially more painful in the morning. The remedy varies with the individual.

6. Does the area of injury feel different or the same on the other side of the body?

If you have a problem, say, in your knee, feel all around the area. Then feel the same area on the other knee. Both areas should normally feel about the same. While the body is not perfectly symmetrical, both sides should be very similar. Many people become overly concerned—even obsessed—about how a specific joint, muscle, or other body area looks or feels.