Now that the long season is over and the aches and pain of endurance training are behind us; there is no better time for healing and recovery of nagging injuries. For some the morning darkness and cold weather settle in and we find comfort in turning over in bed and missing a work out. For most of us, though, there is relief that the pressure of hard hours of training are behind us. Our bodies tend to crave this time and desperately need it to heal some of the ravages of training.

Our bodies are like machines; they work well but need constant care. As we get older, and our warranty starts to expire the process of care and maintenance requires more attention. Unfortunately there are no extended warranties available. Rest and recovery through proper training and rehabilitation is how we get better.

70 % percent of our bodies' dry weight is made up of the protein collagen. This is the major constituent of muscles, tendons, and ligaments, all of which are used and abused during endurance training. Just like a piece of rope, if you pull hard enough some of the fibers will tear; maybe not completely but enough to cause pain and inflammation. This mechanism of overuse injury is so common in endurance sports. You wake up sore and stiff, long runs seem to be harder to do, you bend over to pick up your kids toy and your back hurts. Sounds familiar? Well you are not alone. Sure we can tear a meniscus cartilage or tear a ligament in the knee but more than likely what we all suffer from is some nagging ache or pain that occurs with our training. As we push the limits of our bodies with training, tissues become strained and painful.

Injury recognition is the first line of defense in the prevention of further trouble. How often have we run through pain? Probably too often! Pain is your body's way of telling you something is wrong. Pains that persist throughout activity are the ones that we most often have to pay attention too. It is very common to be stiff or have an ache that goes away when we warm up. These are sometimes very normal with endurance training but also can be early warning signs of impending injury. Take heed with these signals and begin the process of healing treatments. A general rule of thumb can be, if pain and discomfort go away within the first few moments of your warm-up you can probably continue with that activity. On the other hand, if pain persists, raise the white surrender flag and acknowledge that there is something wrong and go home and start to take care of it.

R.I.C.E is an acronym for rest, ice, compression, and elevation. These are the basic tenets for initial injury treatment. I like to revise the concept of rest into relative rest. How many times do you hear someone say if it hurts don't do it? Not what you want to hear. The concept of relative rest allows you to engage in activities that are less stressful and hopefully will be pain free. Some of the examples include using an elliptical trainer versus running, using less resistance in the spin class or spin in a higher gear on the bike, using a pull buoy while swimming to decrease shoulder strain. There are many ways to modify training or change the activity that will allow you to stay physically active while helping you recover and keep you out of the psychiatrists' office with post injury depression.

Ice is essential to injury recovery. The most crucial time to ice an injury is within the first 36 -48 hours of injury recognition. Ice should be applied to the area for 10-15 minutes with a protective layer or cloth between the ice and skin. Ice can burn if left in one place to long. This can be repeated every 1-2 hours in the initial period. This helps decrease swelling and pain. After this time ice is still helpful especially if there is persistent swelling. Heat should only be applied to the area after this initial injury period. There is no evidence that alternating between the two is better.

Compression and elevation are very useful to ward off the effects of swelling, which is ultimately the enemy of injury recovery. It slows all progress down. Ace bandages should be applied if there is swelling. Elevation of the injured part above the level of the heart is important.

Regaining muscle strength and flexibility are core principles to any rehabilitation program. Gentle stretching of tight muscles and tendons helps return the normal elasticity that allows for full range of joint motion. Strengthening the muscles around the injured area helps the tissues heal and protect it from further injury. The old workout concept of "No Pain No Gain" is just not helpful in these injury states.

During this first part of the off-season take some time to allow your body to heal.

You can still go to the gym or pool but alter your activities and lessen the stress on your body. If there is an injury that won't seem to go away, it is always a good idea to seek out professional help. For most of the nagging injuries using the principles of R.I.C.E and a good program of flexibility and easy painless strengthening exercises can be the best remedy.

Dr. Mark Klion is a board certified orthopedic Surgeon and Ironman Triathlon Finisher. BodyworksMD is a series of DVDs' that were developed to allow anybody, anywhere to follow a rehabilitation program to help heal sports injuries. It is a physician guided and physical therapy approved program. Click HERE for more information.