End of Season: Time for "Time Out"!
By Donald M. Christie Jr., MD

With the successful Spring Series at the Nordic Heritage Center in Presque Isle bringing a snowy New England competition season to a close, many skiers were of one mind: time for a rest! The exhilaration of putting on the bib and skiing up to the "Start" line was tempered by the feeling that the poor 'ol body really needed some rest and restoration.

Indeed, this "body wisdom" has sound roots in physiology and in the proper care of musculoskeletal injuries. The principle of overload, which states that one must, on purpose, stress the function of a physical system by an appropriate amount of effort at an appropriate interval to see an improvement in function, implies that, lest we drive ourselves to wrack and ruin, intervals of adequate rest must follow any overload, to allow desired repair, restoration, and growth.

Skiers, now is that time! During the season, the competition calendar waits for no one. As a consequence, it is possible to accumulate chronic overload and fatigue, perhaps signaled by annoying aches here and there, or an unexpected drop-off in performance. We may fall prey to "whatever is going around." Occasionally, we begin a race, only to drop out and prepare for another day. We may even decide to sit out a race altogether. Sometimes during the season, minor injuries or illness force us to take time out. (I think of these events as "blessings of Nature in disguise," allowing us to get a rest otherwise not taken.) For most, however, now is the time to "mellow out."

Don't forget nutrition. Decreased daily energy need means cutting down on portions of starches (carbohydrates, sweets) and fats -- most certainly cutting down on "junk" food -- but it doesn't mean shorting "quality" nutrition. Retain your intake of high quality protein (lean meat, low fat dairy products, beans, nuts, soy products) and vitamins and minerals (from fresh fruit, whole cereal grain foods, vegetables, lean meat, and low fat dairy products).

Many elite skiers take several weeks off at this time of year, doing relatively nothing (that is, "nothing" compared to their usual training routines). High school skiers may begin a spring sport, such as track or cycling, but still they must take care to let the body rest and heal from the long winter season. Otherwise, continued overuse may exacerbate "old" injuries, or worsen latent fatigue. Those at the college level and beyond especially need this "spring break" to restore and rebuild, as they plan their dry land training. "Periodization" is a concept well accepted in the strength-training world, but its principles, including a periodic change in training routine and spells of relative rest from high-stress workouts, equally apply to serious endurance sport athletes.

Finally, this is a good time to take stock of nagging injuries and properly rehabilitate the whole body, to be ready for the dry land season that will follow. Apart from the condition of exercise-induced brochospasm (reviewed in the Newsletter earlier this season), the most common sports-specific medical problems are overuse injuries of the shoulder girdle (especially the rotator cuff muscles and shoulder blade elevator) and the hip girdle (deep gluteals -- the "rotator cuff " of the hip girdle).

The former may result from overzealous poling training, or a fall on the snow, while the latter comes from punishing freestyle training, in which one tends to skate more off the handed side -- pushing out and back, out and back -- triggering the overuse injury of the deep gluteal muscles that, like their rotator cuff shoulder counterparts, may be overlooked or misdiagnosed.
Shoulder pains may be misleadingly felt in the anterior and outer arm, even spreading down the arm, while the true fault lies in a muscle around the shoulder blade. Likewise, deep gluteal overuse may masquerade as low back and sacroiliac pains, or sciatica-like pains down the thigh and leg, even to the outer ankle. These chronically injured muscles are invariably too tight and need careful flexibility training. If problems persist, an athlete should consult a sports physician, or a physician attuned to musculoskeletal problems and aware of the specific demands of Nordic training and competition.

So, take some well-deserved time off, to rest, recuperate, and take stock of any injuries. Then begin a well-planned dry land program.
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Dr. Christie, chair of the NENSA Sports Medicine Committee, is a sports physician and internal medicine consultant in Lewiston, ME, and welcomes comments and questions at dchristie@adelphia.net.