Collected answers from Dr. Pierre Hofer

Should I cool or warm a pulled muscle?

Pulled muscles can affect any muscle group. In runners, they mainly involve the calf and thigh muscles. External influences such as blows and kicks do not cause pulled muscles. Rather, excessive and rapid stretching leads to a reflex hardening of the muscle. This causes cramp-like pain, which can be very intense. A pulled muscle does not damage the muscle fibre. If the athlete continues training despite the discomfort, there is a risk that the initial pull will develop into a torn muscle fibre.

As a treatment, the affected muscle should first be cooled for 20 to 30 minutes. Afterwards, the pulled muscle should be stretched gently, but only within the pain-free range. The goal is to release the increased muscle tension. After initial treatment, a light compression bandage can be applied. If significant pain persists for more than three days, a medical assessment of the injury is recommended.

Is a morning workout more effective?
A Finnish study examined men who trained either in the morning (between 7:00 and 9:00 a.m.) or in the afternoon (between 5:00 and 7:00 p.m.). At the start, the strength values of the afternoon group were clearly better. However, the differences fully evened out over time. In general, many studies show that endurance and strength development are greatest between 4:00 and 7:00 p.m. This is probably related to muscle temperature, which is highest at that time. Still, it can be said that everyone has their own preferences. Our body adapts very quickly to the training time. A morning workout may need to be started a little more gently until the «operating temperature» is reached, but it is just as efficient as an evening workout. So whether you train in the morning, at midday or in the evening is more a decision based on personal preference.

Is strength training once a week worthwhile?
Even one strength training session per week is absolutely worthwhile. When done correctly, it is a reliable way to increase strength, raise bone density and prevent injuries. It can also help prevent conditions such as arteriosclerosis, high blood pressure and overweight. From the age of 30, muscle mass begins to decline. Targeted muscle training can counteract this biological decline in muscle. It is never too late to start strength training. Muscles remain adaptable throughout life. Muscles do not grow during training; they grow during the recovery phase. Training provides the essential growth stimulus. As a rule of thumb: take at least one day of rest between training sessions. As with other sports, the key in strength training is that training frequency should be increased before training duration, and duration before training intensity. Consistent strength training is a guaranteed path to success.

Dr. Pierre Hofer
Specialist in Orthopaedic Surgery, Sports Medicine SGSM, Klinik im Zentrum. Through his sporting successes as an athlete and as a coach (he was, among others, the coach of the Gier brothers, Olympic champions in rowing, Atlanta, 1996), he quickly built a considerable reputation in the city and region of St.Gallen. He completed his comprehensive training in orthopaedics and traumatology of the musculoskeletal system in Neuchâtel, Lausanne and St.Gallen. Since 1999 he has held the additional qualification in sports medicine. Many sports associations and clubs now entrust him with the medical care of their athletes. At Orthopädie St.Gallen, Dr. Hofer has specialised mainly in the treatment of shoulder and knee injuries.

Why do I get muscle soreness?
Muscle soreness occurs mainly in people who are poorly or rarely trained, caused by so-called dynamic-negative, eccentric loads. This means unfamiliar braking movements, as mainly occur in activities such as downhill walking, squash, tennis, football, strength sports and others. Endurance disciplines (running, cycling) rarely cause muscle soreness. A well-trained athlete will only experience it with very intense or completely unfamiliar loads.

• Discomfort lasting up to a maximum of one week

Until the early 1980s, it was assumed that the cause of muscle soreness was a high build-up of lactate (lactic acid). Today we know that muscle soreness is due to damage to contractile elements within the muscle cell. The above-mentioned loads cause damage to these elements. The damage is intracellular, meaning the muscle cell is not destroyed. Within hours, the damage triggers an inflammatory reaction, and the cell absorbs water and swells. This swelling is what we perceive as pain. This is also the reason why
muscle soreness does not appear immediately, but at the earliest a few hours after the load. Typically, the muscles then feel stiff, weak, hard, and sensitive to movement and pressure. The symptoms peak after 1 to 3 days and usually subside on their own after 1 week.

• Light training at low intensity

To treat muscle soreness and reduce pain, mild circulation-promoting measures are recommended, in the form of light training (gentle cycling or running, movement exercises in water, etc.), as well as careful passive stretching and gentle heat treatments. For very severe muscle soreness, anti-inflammatory medicines (Voltaren, Ponstan and others) can be taken, but you should watch out for intolerances to these medications (ask your doctor or pharmacist …).

• Risk: pulled muscles and muscle tears

Strength and explosive loads should be strongly avoided when you have muscle soreness, because in this state the risk of a pulled muscle or a muscle tear is greatly increased. As mentioned earlier, muscle soreness subsides on its own within just 1 week and leaves no lasting damage. For the same load, the athlete is then protected from new muscle soreness for several weeks.

How can I prevent injuries and overuse problems in running?
That running has a positive effect on physical health and performance, is a good preventive measure against cardiovascular disease, and can favourably influence many other health problems, is undisputed. In addition, running has a strong positive effect on
mental well-being. Those who regularly include moderate running as a fixed part of their life gain lasting feelings of achievement as well as good self-control over body and mind. Running has boomed in recent years. The participant numbers in city marathons clearly show this.

How do I train in winter?

• Training in the cold

Training can be done easily and effectively even at sub-zero temperatures. Because the lungs are additionally challenged in severe cold, it is worth preparing well before going out to train, unlike in summer. In winter, the dry, cold air is the problem. It cools and dries out the mucous membranes of the airways, which can lead to typical burning and irritating cough. This irritating cough has nothing to do with a cold cough, but it is still unpleasant and can become painful over time. As long as there are no breathing problems, outdoor temperatures down to minus 10 degrees Celsius are harmless. However, if you suffer from easily irritated airways (asthma) or pre-existing conditions, you should avoid outdoor training in severe cold where possible.
At the latest from minus 15 degrees Celsius, you should move your training indoors, because the body is no longer able to sufficiently warm the air you breathe. The cold air irritates the mucous membranes, which can ultimately make it harder to take in oxygen.

• Protecting yourself from the cold

Exercising outdoors is healthy, strengthens the immune system and helps prevent colds, provided you are dressed correctly. In warm weather, a cotton T-shirt is not especially comfortable but still acceptable; in winter, however, cotton should be avoided as the first layer.
Instead, the so-called onion layer principle comes into play. Wearing several layers on top of each other helps regulate body temperature simply and quickly, especially in winter. If it gets too warm, a layer can be removed quickly. The first layer should be a close-fitting functional underlayer. This wicks sweat away from the skin and ensures you do not feel damp and cold. A sports bra should be a matter of course for women in winter as well. For the second layer, functional material should also be preferred. Depending on the outside temperature, the third layer can be either a vest or a jacket made of breathable and at the same time windproof material.

• Proper training structure

Whether professional or amateur athlete, in winter too every workout begins with a proper warm-up. Warming up improves muscle elasticity, which increases the muscles' readiness to perform. For endurance sports (unlike skiing, sledding, etc.), the sport itself is usually the warm-up.
Here it is important to increase performance gradually by monitoring your heart rate. The target training zone should be reached after five to ten minutes at the earliest. The respective muscle groups can additionally be activated effectively through stretching. Many athletes breathe through their nose in cold weather to warm the air. This is not absolutely necessary. Healthy athletes who are not sensitive can also breathe through their mouth in the cold. Breathing through the nose usually does not provide enough air to train at an appropriate pace. Tip: place your tongue against the roof of your mouth, which further warms the air. Intense training sessions can also be carried out in severe cold. Such sessions usually lead to heavy sweating. Sweaty clothing increases the risk of catching a cold! After such training, it is important to quickly move into warm rooms, shower and put on dry clothes. This way, you do not run the risk of catching a cold even in severe cold.

Sources: Coach Magazin, various issues