Subject: Pain from Strength Training?

Hi,

Hope you can advise me.

My 8yo daughter is training level 2-3 gym and recent changes by her coach in increasing their leg strength training has resulted in my daughter having severe anterior leg pain and heel pain after each session resulting in tears and needing analgesia. The pain is often lasting 2 days and appears to be both in her calf muscle and shin bones. She does not have shin splints but I am concerned this could be the beginning.

I discussed my concerns with her coach who felt she needed to endure the pain to improve. I am concerned the pain will negate any strength gain in her muscles anyway. As a mother it is very difficult to allow your daughter to endure the pain.

Thanks for your response.

First of all, let’s make it perfectly clear that only a doctor on the scene can diagnose and prescribe treatment to any injury. Severe pain is always an indication that a doctor should be consulted and our rule of thumb is that any even mild injury that results in a gymnast being forced to alter their workout for more than two or three days indicates a doctor should be consulted.

This is a common question and concern at this time of year (off-season summer training). Many gym programs and coaches dramatically increase their conditioning programs at this time of year. While from an annual season planning point of view this is exactly what should be done, the questions and concerns come in the implementation of those programs.

Pain is the body’s alert system. Pain is an indication of the overuse of a body part or injury to that body part. Levels of pain tolerance vary considerably from individual to individual so evaluation of the seriousness of pain is difficult for coaches, parents and even the gymnast themselves.

Training pain could be grouped into three general levels – muscle soreness, mild injury and severe injury. Muscle soreness can be safely ignored. Mild injury requires healing treatment and rest. Severe injury requires a doctor’s care.

One of the first things to determine is where the injury is. Muscle soreness results from micro-tears and is a natural catalyst for muscle growth and strength increase. There is a range of the level of tearing that goes up to the level of injury.

Mild injury to ligaments and tendons and in rarer cases, muscles, means that the injury is severe enough that rest and recovery are needed just to get back to normal and no increase in strength will occur. In fact, strength decrease may occur if the injury recovery period extends long enough for muscle deterioration to occur. It is usually okay to continue to work out other parts of the body after swelling has gone down (and your physician has agreed), if care is taken to avoid any more use or injury to the body part in question.

When injury, mild or otherwise, has occurred, there is risk of further, more severe injury if rest and recuperation time is not taken. Injured body parts are much more prone to further and often even more serious injury. With an injury there is no percentage in continuing to workout on the injured body part as no strength increase is going to occur and further injury is a risk and even more down time is possible.

The training lessons that coaches, parents and gymnasts should know and understand is that any change in strength and conditioning work should be gradual and progressive in order to avoid injury. Many coaches are not aware of exactly how specific strength and conditioning training is. The assumption is that after the peak competition season, gymnasts are at the peak of their conditioning. And this is true when it relates to the specific type of workouts the gymnast has been doing, usually multiple routines and maintenance conditioning.

Changing to another form of workout and other types of strength and conditioning training means that the gymnast is not going to be able to perform at peak until they have adapted specifically to the new exercise. Often, coaches and gymnasts assume they can move directly from their high intensity competition workouts immediately to the high intensity level of a different strength and training regimen. This is not true. The strength and training regimen intensity must be dialed back until the gymnast can adapt to the new type of training. Failure to do so can result in injury. Training is very specific. Changes to training must back up and progressively build back up to the higher and highest intensity levels.

Without knowing what types of workout changes have taken place and the extent of the “injuries” to your daughter’s legs and heel, I cannot be of specific help. I can tell you that a heel injury from leg strength training is worrisome and repeat my admonition that if the pain and injury have caused two or three days of interference with her workouts, then you should check in with a doctor.

A gymnast’s perception of pain is not always a good indicator of the extent of a problem. We recently learned of the case of a gymnast, with an incredibly high drive and desire and super high tolerance to pain, who hid the seriousness of a knee injury throughout a whole season. She continually re-injured and re-injured her knee and wore away almost all of the ligaments on both sides of her knee. No one took sufficient notice until her kneecap began to dislocate over and over again, including three times during her arthroscopic exam. Even surgical reconstruction was not an option because there was nothing left to reconstruct. Young gymnasts cannot be counted on to have the knowledge and experience to understand how significant an injury they might or might not have.

Unless your coach is a Board-certified physician, they have no business diagnosing injuries or prescribing treatment and recovery programs or determining what an appropriate level of pain for your gymnast is. This is true for a host of legal and medical reasons and for the protection of both your gymnast and the coach.

Again, if your coach on the spot is not qualified to evaluate the extent of your daughter’s injury, there is no way we can do so from afar. You are right to be worried about her condition and to oversee the handling of this by the coach. While on the one hand, your daughter may just be pain sensitive to a couple of days of sore muscles and some mild ligament strain, there is also the possibility that there is an injury and that prudence justifies seeing a doctor and following professional advice.

Don’t get me wrong. We are all in favor of building tough gymnasts, both mentally and physically. In fact, many of the gymnasts I trained later became triathletes and marathon runners in order to find comparable workouts. But progress in gymnastics must be carefully evaluated, planned and managed and the effects of injury must first be carefully avoided and if they occur anyway, dealt with promptly to minimize training disruption.

The goal of everyone should be to protect your daughter’s health and well being and minimize any downtime from potential injuries, so that she can best and most quickly reach her gymnastics goals and dreams. Your coach should understand and be on board with this.

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