Ironman Injury Prevention

Triathlon Photo

The 37th Ironman World Championship is taking place in Kona, Hawaii on Saturday, October 10, 2015.  2,300 athletes from 62 countries will swim 2.4 miles in open water, cycle 112 miles and run 26.2 miles.  The Hawaii Ironman is always one of the most inspiring sporting events of the year. Coverage of this event focuses not only on the professional triathletes but also on many amateur athletes who embody the mantra of this event: “ANYTHING IS POSSIBLE”.   Watching ordinary people achieve an extraordinary goal is truly inspiring and many viewers will decide to take on the Ironman challenge themselves.

Completing an Ironman is unquestionably a tremendous achievement but equally challenging is getting to the starting line healthy, trained and strong.  A recent study of triathletes with over 26 weeks of training leading up to an Ironman revealed an injury rate of 56%; more than half of these athletes sustained some form of overuse injury!  Here are a few tips to keep in mind in order to avoid injury when training for long course triathlon:

  1. Avoid the terrible too’s; too much, too often, too soon.

Preparing for an Ironman requires at least 10 hours of training per week.  Increasing your training load too rapidly is one of the surest ways to sustain an overuse injury.  Exposing bones, joints, tendons and muscles to loads far greater than they are accustomed to will likely lead to a breakdown somewhere.

If you are a novice triathlete, consider making an Ironman your long term goal. Spend a few years in the sport and work your way up to the IM distance.  Start with a relay, then some short course triathlons and move up to the Olympic and 70.3 distances over a period of several triathlon seasons.  You’ll hone your triathlon skills, learn from your mistakes and allow your body to develop the fatigue resistance and resilience to tolerate months of 10-20+ hours a week of training.

  1. Build a solid base of strength and stability.

After many hours of repeating the same movements (swimming, biking, running), any weaknesses, imbalances and asymmetries will be amplified.  For example, if your hip drops every time you land on your right leg causing your right side to drop out of alignment, sooner or later something down that chain will break down and you’ll get a one way ticket to the House of Pain.

Strength training is as important a part of your training program as swimming, biking and running.  You don’t have to spend hours in the weight room but a comprehensive progressive strength training program focusing on single leg stability and core strength should not only help avoid injury but also lead to better performance.

  1. Follow a periodized training program.

Preparing for an Ironman takes months and a well-designed training plan can take the guesswork out of training.  Ideally, you work with a USAT certified coach who can design a plan that takes into account your individual strengths and weaknesses, your competitive goals, your level of experience, and your lifestyle (how many hours you can reasonably train).   You can find an appropriate coach through USAT ( or through online training platforms such as Training Peaks (  If an individual coach is out of your price range, consider joining a triathlon club or check out some of the generic training plans available through the sources mentioned above.

  1. Plan recovery.

Do not equate rest with being lazy or slacking off.  Planning your recovery is as important as planning your training sessions.  The stress you apply to your body during your training sessions is the stimulus for the positive adaptations that take place during recovery.  If you never allow time for recovery, the fitness gains cannot take place and injury and poor performance are likely outcomes.  Adequate sleep, a solid nutrition plan, foam rolling, stretching, massage, spending time with loved ones; these are all important components of your training and are easy to skip when you are juggling a demanding job and a 15-20 hour training week.  When planning your week, schedule your recovery time just as you do your training sessions and your work obligations.

There’s a reason so many triathletes get the IM tattoo after completing an Ironman; it represents the commitment, sacrifice, hard work, and determination it takes to achieve this daunting goal.  Completing an Ironman is often a life-altering experience; it changes how people view themselves and opens possibilities for accomplishments in other areas of their lives.  If you’re considering an Ironman, it is certainly true that “ANYTHING IS POSSIBLE” with commitment, determination and smart training!



Polly de Mille is the coordinator of performance services at the Tisch Performance Center at Hospital for Special Surgery. In addition to being a registered nurse, she holds a master’s degree in exercise physiology and is certified by the American College of Sports Medicine as a registered clinical exercise physiologist, exercise specialist and exercise test technologist. She is also a certified USAT Level 1 triathlon coach.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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