Overuse Injuries

• There are basically 2 types of injuries: acute injuries and overuse injuries. Acute injuries are usually the result of a single traumatic event (macrotrauma). Common examples include wrist fractures, ankle sprains, shoulder dislocations, and hamstring muscle strains.
• Overuse injuries are more subtle and usually occur over time. They result from repetitive microtrauma to the tendons, bones and joints. Common examples include tennis elbow, swimmers shoulder (rotator cuff tendonitis and impingement), Little League elbow, runners knee, jumper’s knee, Achilles tendonitis and shin splints.
• In most sports and activities, overuse injuries are the most common and the most challenging to diagnose and treat.

Why Do Overuse Injuries Occur?

• The human body has a tremendous capacity to adapt to physical stresses. In fact, many positive changes occur as a result of this. With exercise and activity, bones, muscles, tendons, and ligaments get stronger and more functional. This happens because of an internal process called remodeling. The remodeling process involves both the break down and build up of tissue. There is a fine balance between the two. If break down occurs more rapidly than build up, injury occurs.
• This can happen when you begin a sport or activity and try to do too much too soon. If you begin playing tennis and play for several hours in an attempt to improve rapidly, you are setting yourself up for an overuse injury. Don’t try to do too much. Allow your body adequate time to recover. As a beginner, you may also have poor technique, which may predispose you to tennis elbow. With overuse injuries, it often takes detective like work to understand why the injury occurred.

What Factors Are Usually Responsible for Overuse Injuries?

• Training errors are the most common cause of overuse injuries. These errors involve too rapid acceleration of the intensity, duration or frequency of your activity. A typical example is a runner who has run several miles three times a week without any problem. That runner then begins advanced training in a marathon, running a longer distance every day at a faster pace. Injury or break down is inevitable. Overuse injuries also happen to people who are returning to a sport or activity after injury and try to make up for lost time.
• There are also technical, biomechanical and individual factors. Proper technique is critical to avoid overuse injuries. Slight changes in form may be the culprit. For this reason, coaches, athletic trainers, and teachers play a role in preventing overuse injuries.
• Some people are more prone to overuse injuries and this is usually related to anatomic or biomechanical factors. Imbalances between strength and flexibility around certain joints predispose them to injury. Body alignment, like knock-knees, bow legs, unequal leg lengths and flat or high arched feet, is also important. Many people also have weak links due to old injuries, incompletely rehabilitated injuries or other anatomic factors.
• Other factors include equipment, like the type of running shoe or ballet shoe, and terrain, hard versus soft surface, in aerobic dance or running.

How Are Overuse Injuries Usually Diagnosed?

• The diagnosis can usually be made after a thorough history and physical examination. This is best done by a sports medicine specialist with a specific interest and knowledge of your sport or activity like those at Saint Vincent Sports Medicine. In some instances, X-rays are needed and occasionally additional tests like a bone scan or MRI.

How Are Overuse Injuries Treated?

• Treatment depends on the specific diagnosis. For minor symptoms, cutting the intensity, duration or frequency of the offending activity brings relief. Adopt a hard/easy workout schedule and cross train with other activities that allow you to maintain overall fitness levels while your injury recovers. This is very important for treating the early symptoms of overuse injuries.
• Working with a coach or teacher or taking lessons can assure proper technique. Paying particular attention to proper warm up before activity and using ice after activity may also help. Aspirin or other over-the-counter anti-inflammatory medications can be taken to relieve symptoms. Be sure to follow the necessary precautions when taking over-the-counter medications.
• If symptoms persist, a Saint Vincent Sports Medicine specialist will be able to create a more detailed treatment plan for your specific condition. This may include a thorough review of your training program and an evaluation for any predisposing anatomic or biomechanical factors. Physical therapy and athletic training services may also be helpful.

Can Overuse Injuries Be Prevented?

• Most overuse injuries can be prevented with proper training and common sense. Learn to listen to your body. Remember that “no pain, no gain” does not apply here.
• The 10 percent rule is very helpful. In general, you should not increase your training program or activity by more than 10 percent per week. This allows your body adequate time for recovery and response. The 10 percent rule also applies to increasing pace or mileage for walkers and runners, as well as to the amount of weight added in strength training programs.
• Seek the advice of a Saint Vincent Sports Medicine specialist when beginning an exercise program or sport to prevent chronic or recurrent problems. Your program can also be modified to maintain overall fitness levels in a safe manner while you recover from your injury.

For information about the prevention and treatment of overuse injuries, call Saint Vincent Sports Medicine at 814-866-3466.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.