Don’t slip up on your winter training programme

With many people having a well-earned break from their exercise routines over the festive period, January is time to kick start fitness plans with a vengeance! And, with this Spring seeing a return to the traditional April slot for the London Marathon, entrants will need to start clocking up the miles in training from now on. Whether you’ve got a race planned, a sporting event in sight or you’re on a general fitness drive, winter training needs to be well thought out to make sure you stay safe, keep warm and avoid injury. 

Here, Dr James Thing, Consultant in Sport, Exercise and Musculoskeletal Medicine and Founder of The Joint Injection Clinic, in Golders Green and Chelsea, London, gives his top tips on exercising through the colder, darker months.

1. Build up gradually

While it can be beneficial to take a break from exercise, it’s particularly important to reintroduce training load gradually in order to prevent injury such as bone stress and stress fractures. So, if normal training load is 40 miles per week pre-Christmas and then you take 2 weeks off completely, it would be sensible to reintroduce lighter training of 20 miles per week and gradually build back to your previous mileage over a couple of weeks. There is good evidence to show that if you ramp up your load/running intensity too quickly after a rest period you are more likely to run the risk of developing a significant injury, as your body needs to re-acclimatise to the load again. This is true of weights/resistance programmes in the gym, as well as endurance and cardio training. In winter, a good warm up is likely to help with preconditioning of the larger muscle groups and potentially reduce the risk of injury although the evidence for this is still unconvincing. A cool down with stretching can be beneficial and help to wind down after an intense training session.

2. Kitted up!

If you’re training outside (whether that’s jogging, playing hockey or hiking), protecting your body from the cold is a must. Wearing underlayers and specialist kit like compression ‘skins’ which help to keep the muscles warm, can help to reduce the risk of muscle injury. Also consider wearing a hat or ear warmers as a large percentage of body heat can be lost from the head while training in cold weather. It’s also important to ensure that trainers have good grip for icy roads as a heavy fall is a sure-fire way to interrupt optimal marathon training! It is worth running with a phone in a small bag or running belt so that if you do pull up with an injury, you have a means to contact help, particularly if running in isolated areas and make sure you wear reflective gear if running on roads at night. If the roads are particularly icy or in snowy conditions, you could head to the gym for a treadmill session rather than risking the slippery outdoor conditions.

3. Injury zone

The most common problems that we see in Clinic in the winter are muscle injuries, most likely as a result of an inadequate warm up and going from a cold environment to full activity before preconditioning the larger muscle groups, i.e. hamstrings, calves, quadriceps. We also see an increase in bone stress injuries such as stress fractures, as some people will start their marathon training too aggressively and go from a low-level baseline fitness to running regularly without building up gradually. This rapid increase in training can precipitate bone injuries, as well as issues such as medial tibial stress syndrome (shin splints). Osteoarthritis affects 8.5 million people in the UK¹ and can cause pain and problems with normal knee function, which has a detrimental affect on quality of life. If you’re suffering, it’s worth considering speaking to a physiotherapist or doctor about your pain. They will usually recommend a combination of exercise treatment and caution with aggravating activity but may also discuss injection options, including steroid and hyaluronic acid (lubricant) injections. For patients with established knee arthritis it is also worth looking into some of the new innovative and minimally invasive treatment options like Arthrosamid® – a single hydrogel injection that works to cushion the knee joint, reduce the patient’s pain, decrease stiffness and help movement. It has been shown to the safe and can give long-acting relief, improving quality of life². There are no serious side effects related to the hydrogel, and following the guidance from your doctor, successful treatment will show within 4-12 weeks².

4. Get ski-fit before you go!

If you’re planning to hit the slopes this winter, it is important to work on your cardiovascular fitness with activity such as running, cycling, cross-trainer and swimming. Travel restrictions in recent years will mean that many of us haven’t skied or snow boarded for a couple of years – so preparation will be more vital than ever. It is also important to work on specific muscle groups before skiing. Skiing and snowboarding requires us to maintain a semi-squatted position for long periods. This requires us to be strong in the quadriceps and the glutes. Exercises such as squats can be particularly useful, as can squat holds, i.e. sitting against a wall with the knees at 90 degrees and maintaining the position. If this is too tricky then simply trying to go from sitting to standing without using your arms is a less intense option. Knee braces can offer some support and some advanced and costly braces claim to reduce the risk of cruciate ligament rupture, but it is also important to have correct binding settings, so that if you do fall, the skis come off rather than locking your feet in place and causing damage higher up in the knees.

5. A marathon task

For people training for the London Marathon on April 23^rd, January marks the start of a 4-month countdown to race day! My advice is to start slowly, take regular rest days and follow a training programme that includes strength and conditioning and cross-training, as well as running. As enthusiastic as you might be about your New Year fitness intentions, don’t be tempted to ramp up the intensity or mileage by more that 10-20% week on week. Finally and most crucially - seek early medical advice if you develop any niggles, don’t just ignore it!

^References:

^{1. https://www.nice.org.uk/guidance/cg177/documents/osteoarthritis-update-final-scope2}

^{2. Bliddal, H., et al. (2021). Polyacrylamide Hydrogel Injection for Knee Osteoarthritis: A 6 Months Prospective Study. J Orthop Res Ther. 6(2). 1188. ISSN 2575-8241.}

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