Managing Injuries

AUTHOR: Alan Milway

Sep 03, 2013 AUTHOR: Alan Milway
Managing Injuries

A word that fills me with dread. Hugely frustrating for athletes, they can make or break a season- if not a career.

In downhill racing the mechanisms of injury can be wide and varied. Unlike many sports, most stem from outside of the gym and are sustained during crashes. Broken bones and soft tissue damage are very common. Training injuries can still occur obviously – strain injuries received during strength training are very possible, and issues of discomfort and soreness may also stem from an underlying issue that needs addressing, such as a postural problem.

Shoulders and wrists are very common injury sites – falling forward on to an outstretched hand or head/shoulder first in to a tree or the soil. Just recently my entire week was focused on working with injured athletes: Motocross rider Tommy Alba -sidelined and awaiting an operation on a scaphoid injury, mountain bike racer Phil Atwill recovering from a broken thumb, and Taylor Vernon starting a long road of rehab following a broken back.


What is interesting are the differences and similarities between each rider I see: the differing support structure around each of them, the way in which they hear different advice when given to them, but the clear intention and drive to return to full competition as soon as possible. The hunger is there to return and injury is seen only as an inconvenience. As my Jeremy McGrath poster used to say ‘Pain is only temporary…’

As a coach working within these sports, trying to limit the incidence of injury is obviously an important part of my job. It could take up the vast proportion of my training, and striking the balance here is important. If prehab or injury prevention exercises fully take over or are the sole focus of your training plan you may lose the focus on performance and improving the key determinates that are needed to make the athlete successful – are they still getting stronger, more powerful and able to go longer before fatiguing?

In a sport where you are against the clock and your physical capabilities play a key role in performance I have to keep these points in mind for these racers.

This article isn’t to discuss the reasons behind why athletes may become injured, but to comment on the importance of managing injuries when they occur.

 2013-07-05 11.14.11

In Olympic sports there is often a pretty established support framework. If you reach a certain level of performance or achievement you become surrounded by this framework, which will offer a lot of support when needed. However, in the sports in which I work there is no such framework. It is sometimes difficult to hear that an NHS appointment is booked for 8 weeks time, or that an athlete has been given a sheet of exercises to do by a physio and booked back in for 6 weeks time.

Careers can be ruined, the love for their sport can be ruined, and a lot of money may need to be spent to put you back to a place where the very next run it may all happen again…

Having seen another season with its fair share of injuries there are some really key things for athletes to take away if you do suffer an injury:


  • Get a clear, professional evaluation as soon as possible. If you are abroad you may have to pay extra for scans. If you are in the UK don’t just take the word of the first aider in a field. Seek a specialist who works within sport and deals with sportsmen who want to return – not a factory worker who wants to watch Jeremy Kyle for 8 weeks.
  • Listen to what you are told. If an experienced and trusted consultant tells you to immobilize for 4 weeks, he means 4 weeks. He has seen dozens of people like you and knows the injury far better than you can imagine.
  • Find a good sports physio. I have seen good physios and I have seen bad physios. Do you want to travel 10mins to see a bad one and get nowhere for weeks, or travel 3 hours to see a good one and get it addressed?
  • Build a clear plan of action for rehabilitation with a physio or consultant. Have a focus for what you are doing; the exercises, movements, time scale and routine to follow.
  • Be prepared to pay for this advice and service. The NHS is a great institution but it is not designed for athletes returning to competition. You could wait months to see a consultant or physio, or you could sell that old pair of forks in your workshop that are gathering dust and get the best advice and treatment possible within the same week. You choose, but expect to invest in your body and pay more for better expertise and a quicker return from injury.
  • Did I say listen to the advice you are given?

 milway shoulder

I have seen athletes suffer injuries and almost bury their head in the sand in denial, carrying on and just making things worse. On the other hand I have seen athletes buy a flight home that day, consultancy the next day and surgery that week. Which one will return sooner and be healthier in the long term?

I was at a conference recently and was discussing the role of Redbull with someone. This individual made a flippant remark about their nutrition strategy, but I had to stop them there and explain that I have never seen a sponsor give such support to their athletes. I have the privilege to work with Redbull athletes and be involved in the support network afforded to them. It is quite incredible to see the level of support offered to their athletes and far beyond the marketing return they might require or demand.


Darren Roberts is their injury and rehab specialist and heads up the UK support network. He has worked with athletes across all disciplines and has knowledge brought from experience, seeing it all before and interacting with surgeons, physios and other specialists daily. He is also probably the most well connected man you will ever meet in this area. You want to learn about shoulder surgery? He will be the man in the operating theatre being talked through the procedure by the surgeon. Treatment for that ankle pain you have? He will be there with the physio and then delivering the specific exercises required as the athlete moves forward.

 Back injury

If you are a Redbull athlete and have an injury, Darren will have you booked in with the right specialist and will know your options straight away. All probably whilst you are in the departure lounge on your way back from the event.


The scary thing is the number of athletes who don’t have access to this framework; the Juniors who hurt themselves and rely on parental funding to get them the treatment they need, the lack of good advice and information out there for parents or athletes to source and use as reference, and the finances required to get the treatment needed.


There are a select few GB riders who are on a BUPA plan with British Cycling, but this does not go very deep, and I do not think it extends to Juniors? Wouldn’t it be great if every UCI registered downhill team had access to a UCI/Governing body support network ‘just in case’…

 taylor scar

You may not have a support network around you, or have anything in place for injury. However that doesn’t mean you can’t get the best advice or treatment – you will just need to be proactive, treat it as part of being an athlete and expect to invest in your body.


Before long you will back on your bike.


 leaned over




Comments (0)