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Injury Prevention for Triathletes: A Physical Therapist’s Perspective




I completed my one and only full triathlon back in 2009—so, no, I’m not a triathlon expert. But over the years, I’ve biked and run legs for several triathlon teams (never swam—for good reason!) and competed in plenty of biking and running races, from 5Ks to a full marathon.

If you're here looking for an intense, high-level training breakdown, this probably isn’t the blog for you.

BUT, if you want injury prevention advice from a sports physical therapist—and some practical training insights to keep you healthy before and after race day—you’re in the right place. Let’s get started.



Triathlon Training Comes with Injury Risks

Triathlon is a demanding sport. In fact, one prospective study following 174 triathletes during a 26-week training cycle found that 87% suffered from an overuse injury. Ouch!


Before we dive into how to prevent those injuries, here’s a quick breakdown of the sport’s structure.

---

NAME                SWIM                             BIKE                    RUN

Sprint                .75K / 750 meters  20K / 12.4mi      5K / 3.1mi

Olympic            1.5K / .9mi            40K / 24.8mi        10K / 6.2mi

Half-Iron/70.3 1.9K / 1.2mi        90K / 56mi            21.1K / 13mi

Ironman.            3.8K / 2.4mi      180K / 112mi        42.2K / 26.2mi


Generally, the event time breakdown follows a consistent formula:

* Swim: ~20%

* Bike: ~50%

* Run: ~30%

This is key when planning your training. For example, if you’re dedicating 10 hours per week, you’d aim for:

* 2 hours swimming

* 5 hours biking

* 3 hours running

Distribute those hours throughout your week however works best for you, and you’re already on the right path.

> 💡 Getting Started: Before jumping into a plan, make sure you’re healthy, injury-free and have a baseline level of fitness. Can you swim 100 yards freestyle without stopping, bike 20 minutes continuously, and run for 10? Great! Feel free to use this training guide attached: [8-week Sprint Triathlon Training Plan]


Common Triathlon Injuries

Unfortunately, injuries can get in the way of training fast. Here’s a breakdown:

🚫 Training-Stopping Injuries:

* Navicular bone stress injury

*Osteitis pubis

  • Possibly Plantar Fasciitis

⚠️ Treat-and-Train Injuries:

* IT band syndrome

* Neck strain

* Low back pain

* Shoulder impingement (especially swimmers)

* Hamstring tendinopathy

* Patellar or Achilles tendinopathy

* Hip flexor strains

* Patellofemoral (kneecap) pain

Expert Tip:

Brad Beer (APAM Physio) offers these great risk-reducing strategies:

* Monitor your total running time the week before tapering (linked to injuries)

* Limit speed work—especially for Ironman distances

* Minimize hilly runs (linked to Achilles issues)

Long runs may *protect** against Achilles problems

* Be cautious with high-speed cycling (linked to back pain)


 Injury Risks by Discipline

🏊‍♂️ Swimming Injuries

* Shoulder impingement

* Neck and upper back tightness

🔧 Prevention Tips:

* Address muscle imbalances (tight front, weak back)

* Strengthen the rotator cuff and scapular stabilizers

* Mobilize thoracic spine

✅ Try These:





-Chest stretch in door and foam roller 


The purpose is to stretch out the anterior muscles- or the muscles in front of the shoulder and chest.  Make sure this is not painful in either shoulder or elsewhere, just a gentle stretch














-Foam roller thoracic 

This is great to work on extension of our upper back - especially needed with cycling, but also very important with swimming.






-Sidelying thoracic opener


This is a great exercise for upper back mobility, but especially for those swimmers!






The following are all strengthening.  Check them out on my youtube channel:


-Blackburn exercises: https://youtu.be/EWdu3jK2gus

-scaption with bilateral ER: https://youtube.com/shorts/MoHOWUL2mFQ

-ER progressions:


🚴‍♀️ Cycling Injuries

* Hip impingement

* Neck/upper back strain

* Tendonopathies (hamstring, glute)

🔧 Prevention Tips:

*Get a professional bike fit**—seriously, it’s worth it. 

* Mobilize tight hip flexors and strengthen the posterior chain.

✅ Try These:

-Hip mobilization 



















This helps to create more space for the joint to move, and works well for people who feel a “pinch” in the front of the hip



We all need this!  But especially after the mobilization to then stretch the soft tissue with it


-Donkey kick: 

A great strengthening for the glues, hamstrings and posterior chain

Both of these are excellent for creating more power, but also working on the posterior chain so you don’t start to get compensation and overuse patterns in a flexed posture. 


-Prone swimmers

Starting on your stomach, squeeze the shoulder blades together, lifting the arms off the floor.  Maintain the shoulder blades pulled in as you bring the arms out to the side and up like making an upside down snow angel.  Then pull the arms down into a goal post position, and then repeat. 




🏃‍♂️ Running Injuries

* Stress fractures

* Plantar fasciitis

* Patellar/Achilles tendonitis

* IT Band pain

🔧 Prevention Tips:

* Evaluate and optimize running form

* Shorten stride length and reduce vertical bounce

* Train with proper cadence


✅ Cadence Drill:

1. Count your right foot strikes in 15 seconds.

2. Multiply by 4 → this is your cadence (steps per minute).

3. Aim to increase by 5–10% using a metronome app.

4. Sync your steps to the beat!

🔄 Kinetic Chain Awareness:

Remember: motion on one side of your body affects the opposite side. Holding your phone in one hand? That could alter the opposite ankle’s movement. It all connects!


Exercises for Injury Prevention

A dynamic warm-up is critical before every session. Static stretching has its place, but pre-training should be movement-focused.

✅ Sample Warm-Up:

* Leg swings → Step jacks → Squats → Single leg RDLs

* Lunge twists → Arm circles → Arm openers

* Quad pulls → A skips → B skips → Light jog

Running-Specific Strengthening:


-Eccentric calf raises

Raise up on both feet, take one foot away, and slowly lower down on the affected side.  Repeat.  Make this harder by performing off a step or stair. 














-Eccentric step downs: 

This works the quad muscle, and just like the eccentric calf raises, does so in a lengthening manner, which can be helpful in preventing both tendon and muscle injuries. Start standing on a stair. Step down with one foot, just tapping the heel, then return to the starting position. Don't let your hips shift, and try not to set you weight down, just tap the heel.



-Wall knee drives

Great warm up as well as hip flexor and core strengthening exercise























This works even better if you figure out your cadence, and try and perform the exercise to the cadence you run at!

-Side plank with leg lift: https://youtu.be/iIyl6MuCJio

Important in strengthening both the glute med and lateral hip stabilizers, but also working it with the core which is needed when running.

💡 Why eccentric training? It strengthens muscles as they lengthen—exactly how many running injuries occur. It’s a smart way to build resilience and deceleration strength. Final Thoughts

Whether you're training for your first sprint or eyeing an Ironman, your best performance starts with staying injury-free. Balance your training, listen to your body, and don’t overlook strength, mobility, and form.


Train smart. Recover smarter. And most importantly—have fun out there. You’ve got this!

If you are running the Julie Hughes Triathlon here in Sitka, look for my table for recovery care and injury screens!  Good luck, everyone!


More info, or to schedule: www.medicinebymovementwellness.com or 907-623-8708

 
 
 

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