Injury Prevention - Defeating the Unseen Fencing Opponent
by Jason Rogers
"MY NUMBER ONE ISSUE IS TO PREVENT INJURY”
These sage words belong to Jeremy Summers, former four-time national team member in sabre and now Director of Sports Medicine for USA Fencing. In addition to his role with the USFA, he has just returned to fencing after more than a 15-year hiatus. He has found that his body isn’t cooperating like it used to, but, luckily, he has a few tricks up his sleeve.
I know Jeremy from attending summer camps in Kansas City with six-time Olympic Medalist, Vladimir Nazlymov. I was 13 at the time and completely in awe of Jeremy, his brother, Tim Summers, and Terrence Lasker. The trio seemed to me to have it all figured out. I remember marvelling at Jeremy’s technique and spending hours in front of the target trying to imitate it.
Now, when I asked him what he would have done differently as he looks back at his early training, he says:
“There's so many things that I wish I could have done better. My knowledge set now, compared to when I was an athlete, is vastly different. I've been kicking myself for 16 years!”
Thankfully, Jeremy’s on a mission to ensure that coaches and fencers are better equipped to design complete training programs to help ward off common fencing injuries. He understands that the more intelligently we train and take care of ourselves, the better we can perform and the longer our careers can be.
Think of Hungarian epee fencer, Géza Imre, who won his first Olympic Bronze in 1996, only to follow that up in 2016 with an Olympic Silver at age 41. His gold medal winning opponent from South Korea, Park Sang-Young, was still in diapers when Imre won his first Olympic medal!
There are an increasing number of examples like Imre, which can be partly attributed to improvements to approaches to injury prevention, says Jeremy. Strap in as we explore this critical topic in depth.
TABLE OF CONTENTS
WHY IS INJURY PREVENTION IMPORTANT?
Let’s start with a car analogy. You can’t drive the car with a flat tire, and while having a fast car is important, your first priority should be keeping it on the road. In other words, it doesn’t matter how good of a fencer you are; if you are sidelined or hampered by an injury, you simply cannot perform. Injuries don’t just affect you physically by taking you out of action for some period of time, they can also have a lingering mental effect by eroding your confidence in your own body. You can be fully ‘healed,’ yet still hesitate to push yourself to your full capacity, fearing a flare up or re-injury of a tender area. Injuries are a complex issue which we must look at from several angles.
WHY ARE YOU INJURED?
Before we get into the details, Jeremy helps us understand a key question that must be asked before you even begin to think about implementing any sort of training plan.
“Are you injured now, and if so, why are you injured?”
Jeremy explains why this is important:
“There are two types of injuries. The first type is a chronic injury that occurs as a result of accumulation over time. These are much easier to prevent. The second is an acute injury, where some type of trauma occurs. These are harder to foresee, but some are preventable”.
An example of common chronic fencing injury is achilles tendonitis. In this case, inflammation has increased over time and use causing regular pain. Compare this to a muscle tear that is an acute injury that occurs suddenly due to a specific movement during an event or accident.
CHRONIC INJURIES* – AVOIDING OVERTRAINING
Often chronic injuries result from overtraining and failing to give your body enough time to recover. Our minds have a natural tendency to think that more practice equals faster improvement, however this isn’t exactly true. You must train often to improve. However, beyond a certain threshold, you have diminishing returns and excess training can actually be harmful to your body. A better approach is to make your practices shorter but very focused and to ensure your body has sufficient time each week to rest (more on this later). It’s important to weigh the benefit of that extra bout or practice session against the risk of injury and the possibility of missing out on weeks or months of practice. At a certain point, it stops being worth it.
USA Fencing is blessed to have many talented coaches from all over the world, but this translates, unfortunately, into a wide range of opinions on the baseline number of hours for training each week.
The key thing is to listen to your own body. There are general guidelines as to what works for most people, but like in most things in life, everyone and every body is different. It can be difficult to recognize the fine line between properly challenging yourself and overtraining. The typical symptoms of overtraining, according to a paper published in the British Journal of Sports Medicine, are
- Extreme fatigue
- Heavy muscles
- Sleep disturbance (e.g. nightmares)
- Appetite and weight loss
- Loss of competitive drive
- Loss of libido
- Increased irritability and anxiety
- Higher resting pulse
- Excessive sweating
- Recurrence of minor infections
Additionally, the bodies of many adolescent athletes are still developing and should not be put under the same strain as adult athletes. Another contributing factor to overtraining, which tends to affect younger athletes, is pressure from parents and/or coaches. An excerpt from a paper written by Joel Brenner, a pediatric specialist at Johns Hopkins, suggests some guidance for young athletes.
“The American Academy of Pediatrics Council on Sports Medicine and Fitness recommends limiting 1 sporting activity to a maximum of 5 days per week with at least 1 day off from any organized physical activity. In addition, athletes should have at least 2 to 3 months off per year from their particular sport during which they can let injuries heal, refresh the mind, and work on strength, conditioning, and proprioception in hopes of reducing injury risk.”
I personally struggled a great deal with the issue of overtraining. As an adolescent athlete, my training schedule was not extensive. I trained with my first coach, Daniel Costin, for about two hours, typically four times per week. However, when I went to college at The Ohio State University, I entered into a very different training mentality. My practice schedule, in effect, doubled to two hours, twice a day, five times per week in addition to an aggressive schedule of NCAA, junior and senior competitions (domestic and international).
Looking back, I now understand how important it was for me to work full-time with Vladimir Nazlymov and how deeply I wanted to live up to his expectations and confidence in me. As a result, I didn’t always listen to my body and often found myself battling many of the symptoms mentioned above. I was an adult, and the fault was completely my own for pushing myself too hard and not acknowledging the little voice in my head that was telling me to slow down. If you ever feel this is an issue for you, the first step must always be to share your concern with your coach to see what can be done to limit excess training.
ACUTE INJURIES * – STAYING OCCUPIED
Unlike chronic injuries, acute injuries are a result of something out of the ordinary happening to you. When I was 17, I was training in Kiev, Ukraine and crashed guards with another fencer. My wrist just happened to be in an awkward position and the collision severely damaged the ligament in my wrist. Subsequently, I spent 2 months in a cast and brace, and then had restricted use for another 3 months (more on that later). I was devastated and very worried about my fencing future.
When you are injured, it is very important that you don’t come back too soon (easy to say, hard to do!). There is a lot of internal and external pressure to get back in the game as soon as possible because your coach wants you to or you hate sitting on the sidelines watching your teammates improve. Jeremy understands this as much as any athlete but strongly recommends that you resist and give yourself the full opportunity to heal.
There is, however, work that you can do during recovery. The first thing to evaluate is whether you can make simple modifications to your training to avoid aggravating your injury, so that you can remain physically and mentally active, even if it’s limited. For example, athletes with injuries to the wrist or elbow, can generally still do cardiovascular exercise. If that’s not possible because the injury is more serious, you can work on your tactical game by watching videos. The key is to stay involved and to keep the feeling of progression. Without that, it’s very natural to become impatient and then make a poor decision to come back too early, which can cost you additional time on the sidelines by making the injury worse.
When I injured my wrist I spent the last three months of the injury fencing with my other hand (I’m left handed so I fenced with my right). Surprisingly, I fenced reasonably well, and I was able to maintain my feeling of the distance with my opponent. Most importantly I felt less pressure to return before my injured wrist was ready because I was busy training myself in other ways. I look back on this period as being a overall benefit to my fencing as it provided the unexpected opportunity to train another part of my brain and to balance out some of the muscle differences that occur as a result of doing an asymmetrical sport. To this date I am still fairly ambidextrous, which I partially attribute to this time period.
ACUTE INJURY PREVENTION
Of course, these incidents are unpredictable. But fear not! Jeremy breaks down what we can do in several simple areas.
ACUTE INJURY PREVENTION – MAINTAINING MOBILITY
One of my major regrets is that I only became serious about stretching towards the middle of my career. By then it felt like, no matter how much I stretched, I was always operating from a low baseline of flexibility. Fortunately, later in my career I was able to make major improvements in my flexibility when I really focused on it and worked with both a Pilates instructor and Scott Weiss of Bodhizone NYC. I will be eternally grateful to Scott, who helped open my body up through mindful and intense stretches in the years following 2008 Olympic Games. Scott recommends some great hamstring (a bete noir for many fencers) stretches below.
Another technique that Jeremy recommends to improve stretches is called the “contract-relax” method. The feeling of discomfort when you stretch is a natural reaction your body produces when it thinks the muscle can go no further without injury. However, a healthy muscle is able to stretch a little further than your body expects, and this technique confuses the natural reaction, allowing you to surpass what your body normally allows. By stretching the muscle to the point of resistance, then contracting the muscle for at least 6 seconds, you lessen this response. Then after you release and stretch again, you will find that you can go a little bit further than before. You can repeat this several times, but be very careful with this technique. Start slowly, giving your body time to adjust, as it can be quite intense at first. Also, it’s important to note that this type of stretching should be avoided prior to practice/competition as well as when the muscles are very tired or injured--the extra stress can be too much.
As we get older we start to lose the natural mobility that our bodies possess when we were younger. There are additional ways to slow this process, but it requires discipline. Yoga and/or pilates, in addition to regular stretching are all good techniques, but they must be done regularly to be effective, Summers says. If you are trying to make real progress on your flexibility, Jeremy recommends at least 15-20 minutes, twice a day.
ACUTE INJURY PREVENTION – WARM UP & COOL DOWN
For most athletes and coaches these concepts are a no brainer. However sadly, common knowledge does not equal common practice. Most athletes do take the 15-20 minutes to warm up, but often that warm up includes static stretching (like a basic hamstring or quad stretch). Jeremy doesn’t recommend this because “you're effectively turning the muscle off and not preparing it to fire." In addition, very few athletes take the additional time after practice or competitions to a proper cool down, which helps the body regulate itself after hard work. Zipping up your gear and jumping into the car for 30 minutes isn’t going to do wonders for your hammies! Just 10-15 minutes of light exercises and light stretching will help your body move lactic acid out of the muscle, aid recovery and ultimately help prevent future injuries.
My post-competition cool down routine was fairly simple and involved light jogging, basic stretches and a foam roller routine (see below). Yes, it was really difficult to implement, especially after a tough loss, but it was some of the best time I invested. I was lucky to enjoy a 17-year competitive career without an injury that required surgery; part of which I attribute to my disciplined warm up and cool down habits.
ACUTE INJURY PREVENTION – STRENGTH TRAINING
Many recognize the importance of a strength and conditioning program to improve performance. But fewer people understand that it’s equally about preventing injuries. When you target exercises to certain areas, they become more stable and resilient, and when unexpected movements or collisions occur you are more likely to escape the situation unscathed.
Designing a strength training program for yourself can be a daunting challenge, because the possibilities are endless. It’s great if you can work with an experienced trainer who can build a custom program for your needs. If that’s not possible, Jeremy has suggests a easy strength program everyone can implement.
It consists of 8 simple exercises and does not require sophisticated gym equipment or weights (although they can be done with weights), so it’s perfect for fencing practice environments.
This exercise can be done with a 5 foot pipe (PVC pipe works well), which you hold directly above your head, arms out wide. Keep your toes pointed slightly outwards. Holding the bar in position will force you to keep your back upright and your hips open as you lower and return to standing. Because fencers tend to round their shoulders to cover their target, an overhead squat helps to create mobility in the chest, shoulders and hips. Click here for alternate view.
SINGLE LEG DEAD LIFT
Start on one leg, keeping the knee slightly bent. Your other leg is relatively straight and should extend behind you. Reach down towards the floor using the strength in your hamstring to lower and return to the starting position. This helps with both strength and balance. Once you master the movement, you can slowly start adding weight to the exercise by holding 2 equal dumbbells, one in each hand.
Holding your hands in front of you, step out to the side (with your feet still pointed forwards). As your foot lands, bend the stepping leg while keeping your back/spine straight. The other leg should remain straight. This exercise works both the bending leg and the extended leg and is excellent for strengthening muscles in the inner thigh where fencers are prone to injury.
Start with the arms in front of you and your knees a little more than hip distance apart. Keeping your knees bent in an athletic stance, step with one foot out to the side, shortly followed by the other foot stepping back under you. Your knees should remain bent the whole time. This exercise can be made more difficult by adding a Theraband tied around your knees to create additional resistance as you take each step. Click here for view with Theraband.
Lying on your slide with legs straight, use the arm underneath you to stabilize your head and neck. Lift the top leg up, keeping it straight, and then return to original position. The bottom leg can be bent to stabilize your body.
There are a number of exercises to target the hamstrings. Begin by lying on your back with both feet flat on the floor. Push up with your legs and buttocks to create a bridge. The longer you hold this position at the top, the more difficult the exercise. Return back to the original position. To make the exercise more difficult, progress to using only one leg. Another variation is to place your feet on an elevated platform (like a bench) to increase the intensity. Also, the further you move your feet away from your butt, the more challenging the exercise will be. And lastly, for the hotshots, you can use an exercise physio ball: place your calves on the ball while lying on your back, lift your butt up while keeping legs straight, and then pull the ball towards you so your feet come flat on the ball and you are in a bridge. Extend and repeat. Click here for view of one leg progression.
A weak core predisposes you to injury so strengthening your abdominal muscles and core endurance are a vital part of your training. Get into a pushup position, then lower yourself into a plank by placing your elbows and forearms on the floor. Your knees should be off the ground and your tailbone tucked under. That’s it! This exercise will get more difficult the longer you hold it.
Turn on your side with one elbow and forearm on the floor. Push up into a plank with your body in a straight line, balancing your weight between your elbow and forearm and the side of your foot. The other arm can rest on your side or be straight up in the air. Like the exercise above, it will be easier when you start, but get more challenging the longer you hold the position.
ACUTE INJURY PREVENTION – STRENGTH TRAINING – REPS & SETS
Jeremy recommends you do this routine every other day or 3 times per week.
The actual number of sets and repetitions depends on your current fitness level. If you haven’t done any strength training, start slow and use the first month to build your base strength. Once you feel stronger, you can progress at your own pace.
How many? Ideally, you are performing each exercise until the final rep is very difficult. This is the state when the muscle gets the maximum benefit. Depending on the number of reps you are doing, you are actually working on different aspects of muscle development. When you are struggling to finish 12-15 of an exercise, you are building strength. When doing 20-25 reps, you are building muscle endurance. The term “power” is often used to describe the ability to execute explosive, athletically-related movements. One increases their “power” by using heavier weights and fewer reps. When it’s hard to finish 4-6 reps with the appropriate weights, you are building your “power." Training power is not something that’s important to do all year long and should be avoided in developing bodies. However, as you progress, consider incorporating this into your routine, first under the supervision of a trained professional**.
A good goal for the lower body exercises is 2-3 sets of 12-15 reps for each exercise. If you are finding that easy, then first increase your number of reps to 20-25. When that becomes easy, begin adding additional sets to each exercise. If you can do 4-5 sets of 20-25 repetitions, you are really kicking butt!
With the abdominal exercises (planks), Jeremy suggests that you build up to 45 seconds for each lateral (side) plank and up to 2 mins per anterior plank. Aim for a couple of sets. These goals are the same for both preventative and rehab programs***. Athletes with current low back pain should avoid these exercises until evaluated by their doctor.
RECOVERY – DAYS OFF & SLEEP
This one is pretty simple: you must give yourself days off. Your body is not a machine and it needs time to recover. When you do prolonged exercise you are actually creating small injuries to the muscles (i.e. little tears) which cause the body to react and make them stronger. However, your body can’t do its work effectively unless you give it the chance to do so. Jeremy recommends 1-2 days off per week depending on your training intensity. This is, however, slightly open to reasonable interpretation and preference. For some, a day off may include an activity where you break a small sweat. For example going for a light 15-20 minute jog during which your heart rate remains between 130-150 beats per minute (which helps improve your heart’s ability to pump blood and your muscles’ ability to utilize oxygen).
Getting enough sleep is a key factor in recovery. Most of us lead busy lives that cut into our precious, restorative slumber. You will never get the most out of practice or competition unless you break out of zombiehood and get enough sleep!
There is much debate about how many hours one should sleep. The rule of thumb is to get eight hours. In addition to the number of hours you sleep, you need to consider the quality of your sleep. Eight hours of tossing and turning won’t do much, and you will be right back to zombiehood.
Gatorade Sports Science Institute looked at a variety of research about sleep and summarizes some ways you can improve the quality of your sleep:
- The bedroom should be cool, dark and quiet. Eye masks and earplugs can be useful, especially during travel.
- Create a good sleep routine by going to bed at the same time and waking up at the same time.
- Avoid watching television in bed, using the computer in bed and avoid watching the clock.
- Avoid caffeine approximately 4-5 h prior to sleep (this may vary among individuals).
- Do not go to bed after consuming too much fluid as it may result in waking up to use the bathroom.
- Napping can be useful; however, generally naps should be kept to less than one hour and not too close to bedtime as it may interfere with sleep.
RECOVERY – MASSAGE
One of the best recovery tools is getting a good old massage. It’s easy to mistake massages as an unnecessary luxury, but they are an important part of an athlete’s overall program. Jeremy has written an article titled "The lowdown on soft tissue therapies for athletic injuries" for an upcoming issue of American Fencing Magazine. We will share that article when it comes out, but in the meantime, he talks us through some of the benefits of massage.
Having someone work on your body helps to alleviate the impact of over-training which causes repetitive damage to the tissue. The tighter and more ‘wound up’ your muscles are, the more likely you are to injure them. Massage helps work out any adhesions (caused by the tissues sticking together), while also telling your central nervous system to relax the muscles. Lastly, massage helps flush out the waste products your body produces (for example in the lymphatic system) and bring new blood (and therefore oxygen) to the muscles.
When going through periods of intense training, getting a regular massage is something you should consider. When my training was at its peak, I went as often as twice a week for a short massage to improve recovery. The best shortcut for massage, especially when you are travelling, is to use a foam roller. It’s a cylindrical piece of foam in variations of approximately one foot to three feet in length. I brought one to all of my competitions (his name was ‘Frank’). Frank was my ‘go to’ cool-down partner and I was the butt of many jokes as I was happily rolling around on the floor in a random spot in the venue. Despite the snickering, I managed to escape my competitive career with very few major injuries!
RECOVERY – NUTRITION & INJURY
Nutrition is an area that is an inherently confusing topic because there is so much conflicting information out there. As Dr. Douglas Andersen, chiropractic and general nutrition whiz, puts it:
“There's more than one path to the top of the mountain...Every body is different, and there's no one right answer.”
Nevertheless, he lays out some simple advice that can help guide nutrition choices while you are injured or coming back from an injury. What many people don’t understand is that when you are injured, your body requires extra resources above and beyond what it normally needs to repair, regenerate and recover.
The importance of protein even when injured
There are a number of studies that suggest athletes need more protein throughout the day than the average person to prevent the body from having to metabolize and break down muscle for energy. When you are injured, your metabolic rate actually increases because you're using extra energy and nutrients to repair that injury. This is the reason that when athletes are not practicing due to injury, they often don’t gain weight. Continuing to keep a healthy high-protein diet can enhance recovery because it helps maintain a positive nitrogen balance (the best state for muscle growth). Dr. Anderson suggests one gram of protein per pound of bodyweight (however if you want to be fancy just Google “Protein Calculator”).
Vitamin C, not just good for when you are sick
Most of us know Vitamin C is important when we are sick (I think I am personally responsible for 10% of Airborne’s sales alone). However, few of us know that vitamin C is critical for healing. When it comes to Vitamin C, we should think about it not just for immunity (as above), but also to help control inflammation. The body's initial reaction to injury is inflammation, which is in a defensive attempt to protect and restore the body to normal. Medically, one of the first steps in injury treatment is to reduce the inflammation, which vitamin C can help with. So, don't just take Vitamin C when you have a cold. Make sure that you're getting enough when you have an injury, too. As an added bonus, it also helps our bodies make the stuff we need to make to heal ourselves: collagen. Doug suggests ten milligrams per pound of bodyweight (in divided doses). So If you weigh a hundred fifty pounds, you should take five hundred milligrams three times a day, when you're injured.****
Jeremy summarizes all of this quite nicely for us:
“The first thing is to recognize is that most injuries are chronic. If you are dealing with a chronic injury, you must determine if it's from overtraining or if it's from weakness and lack of preparation. In most cases, it’s the former, and the athlete is not resting enough to allow for recovery.
You must also think about what you are doing to address mobility. Hip mobility is often the biggest issue for fencers followed by lower extremity flexibility*****.
The third thing to think about is developing a proper strength conditioning program. You must make sure that you have enough strength and endurance in these key areas to withstand the extra load you are putting on your body.
That last consideration is giving yourself enough recovery time. Add to this, of course, nutrition because it goes hand in hand with recovery for your tissues. Always make sure you get enough protein to allow your body to recover from the work load that you just gave it.”
And that, folks, is injury prevention for fencing in a nutshell.
* If you have an injury you should always first seek the advice of a medical professional. *
** Always speak to a Doctor or trained professional before you make any changes to injury treatment, weight training program or nutrition plan **
***When evaluated by a medical professional, trunk strength testing is often performed to identify each athlete's trunk endurance and stability with plank, side plank stability and a shoulder tap movement evaluation. Optimal performance on these tests are greater than 45 seconds on side plank testing with less than a 5% asymmetry, greater than 2 minute endurance time for anterior plank, and the ability to maintain a stable trunk during the shoulder tap movement screen.***
****(if you already get a lot of Vitamin C in your diet through vegetables and fruits such as oranges, then you might need less.)****
*****Lower Extremity Flexibility – Ankle, Knee, Hip - See Below*****
Musculature that is typically short and tight on fencers:
- Hip flexors
- Gluteal group
- TFL (hip abductor),
- Gastrocnemius (part of the Calf muscle)
Musculature that is typically weak on fencers -
- Anterior core endurance
- Lateral core endurance
- Gluteal group
******Header Image Photo courtesy of Serge Timacheff / FIE******