CAUSES AND PRIVENT

What Causes Overuse Injuries?

• Lack of appropriate muscle strength or endurance
• Poor core stability
• Muscle imbalance (strong tight muscles versus weak stretched muscles)
• Inflexibility
• Malalignment or Biomechanical issues (e.g. flat foot, squinting patellae)
• Training errors
• Faulty technique
• Incorrect equipment.

By far the most common cause of overuse injury is training errors.  Moreover, the most common error is "too much, too soon".

How to Prevent an Overuse Injury

We can prevent overuse syndromes.  Some of the ways to prevent this injury include:

• Warm-up (including stretching) and warm-down (including stretching) before and after all exercise.
• Use proper equipment (e.g. jogging shoes for jogging, a racquet that is the right size with the proper grip size and strings strung to your level of play).
• Increase at a rate no faster than 10% increase per week (distance, speed, weight, etc).
• Practice and concentrate on correct technique.
• Condition for 2-3 weeks before starting - strength and flexibility.
• Listen to your body - pain is a warning that something is wrong.  Early identification and treatment will allow you to continue your activity.
• Identify and correct the cause of pain or discomfort.
• Ensure full injury rehabilitation, e.g. a sore right leg can cause an overuse injury in the left through compensation.

CAUSES

Signs of Overuse or Inflammation include:

• Swelling (which may be unnoticeable)
• Warmth to the touch
• Redness
• Impaired function of the part.

All of these signs may be present but not noticeable in the beginning stages.  Often the first sign may be stiffness or soreness (especially in the morning) which may disappear with warm-up. Continued use may cause continued damage and the pain will last through and past warm-up and may be even worse after activity is finished.

The Four Stages of an Overuse Injury:

1. Discomfort that disappears during warm-up.
2. Discomfort that may disappear during warm-up but reappears at the end of activity.
3. Discomfort that gets worse during the activity
4. Pain or discomfort all the time.

Injury identification and treatment in stage 1, allows continuing activity as long as the injury does not worsen.

A stage 2, activity may continue at a modified pain-free level while being treated.  Treatment must continue until completely healed.

If the injury progresses to stage 3, activity must immediately cease. The supervising physiotherapist will allow a return to activity after identifying the cause and you are completely symptom-free. Competitive athletes, depending on the individual circumstances, may return to activity.

If the injury progresses to stage 3, activity must immediately cease. The supervising physiotherapist will allow a return to activity after identifying the cause and you are completely symptom-free. Competitive athletes, depending on the individual circumstances, may return to activity with stage 1 symptoms.

overuse

What is an Overuse Injury?

Overuse injuries refer to injuries sustained from repeated action (such as repetitive strain injury) as opposed to acute injuries, which occur in an instant (such as a sprained ankle).

Overuse Injuries Can Occur to the Following Structures:

• Tendons: tendinopathies
• Muscle-tendon structures (e.g. tennis elbow)
• Soft tissue compartments (e.g. compartment syndrome)
• Periosteum cartilage, which is the covering of the bone (e.g. shin splints)
• Bursa (e.g. bursitis)
• Nerve tissue (e.g. neural mechanosensitivity)
• Bone (e.g. stress fractures).

Exercise applies stress to the body. Your body adapts by thickening and strengthening the various tissues involved.  Hence, muscles get stronger, firmer and sometimes larger, tendons get stronger and bone density increases.

However, if exercise is applied in such a way that adaptation cannot occur, the excessive overload can cause microscopic injuries, leading to inflammation, which is the body's response to injury. 

spinal injury

Children's Back Pain

Adolescents can be particularly vulnerable to spine injuries mainly due to a combination of high flexibility and low muscle strength and control.

The competitive athlete and most individuals who exercise regularly or maintain a level of fitness and core stability control are less prone to spine injury and problems due to the strength and flexibility of supporting structures. Your physiotherapist can assist the resolution of any deficits in this area. Luckily, problems involving the lower lumbar spine are rare in athletes and account for less than 10% of sports-related injuries. Injuries do occur in contact sports and with repetitive strain sports.

Sports such as gymnastics, cricket fast bowlers, and tennis have a higher incidence of associated lumbar spine problems related to repetitive twisting and hyper-bending motions. 

Spondylolisthesis is a major concern and need to be appropriately treated by a physiotherapist with a special interest in these type of injuries. Luckily, most injuries are minor, self-limited, and respond quickly to physiotherapy treatment.