What Are Overuse Injuries?
There are two general categories of injuries: acute and overuse. Acute injuries are usually the result of a single, traumatic event. Common examples include wrist fractures, ankle sprains, shoulder dislocations, and hamstring muscle strains. While overuse injuries are more common in sports than acute injuries, they are subtle and usually occur over time, making them challenging to diagnose and treat. They are the result of repetitive micro-trauma to the tendons, bones, and joints. Common examples include tennis elbow, swimmer’s shoulder, runner’s knee, jumper’s knee, Achilles tendinitis, and shin splints.
Why Do Overuse Injuries Occur?
The human body has a tremendous capacity to adapt to physical stress. We tend to think of “stress” in the context of its negative effect on our emotional well-being, but physical stress, which is simply exercise and activity, is beneficial for our bones, muscles, tendons, and ligaments, making them stronger and more functional. This happens because of an internal process called remodeling. The remodeling process involves both the breakdown and buildup of tissue. There is a fine balance between the two, and if breakdown occurs more rapidly than buildup, an overuse injury occurs.
What Factors Cause Overuse Injuries?
Training errors are the most common cause of overuse injuries. These errors involve rapid acceleration of the intensity, duration, or frequency of activity. Overuse injuries also happen in people who are returning to a sport or activity after injury and try to make up for lost time by pushing themselves to achieve the level of participation they were at before injury. Proper technique form may be the culprit. For this reason, coaches, athletic trainers, and teachers can play a role in preventing recurrent overuse injuries.
Some people are more prone than others to overuse injuries. Imbalances between strength and flexibility around certain joints predispose individuals to injury. Body alignment, such as knock-knees, bowlegs, unequal leg lengths, and flat or high arched feet, also impact overuse injuries. Many people also have weak links due to old injuries, incompletely rehabilitated injuries, or other anatomic factors.
Other factors include equipment, such as 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 specific interest and knowledge of your sport or activity. In some cases, X-rays are needed and occasionally additional tests like a bone scan or MRI are required as well.
What Is the Treatment for Overuse Injuries?
Some tips for treating an overuse injury include:
- Cutting back the intensity, duration, and frequency of an activity
- Adopting a hard/easy workout schedule and cross-training with other activities to maintain fitness levels
- Learning about proper training and technique from a coach or athletic trainer
- Performing proper warm-up activities before and after activity
- Using ice after an activity for minor aches and pain
- Using anti-inflammatory medications as necessary
Can Overuse Injuries Be Prevented?
Most overuse injuries can be prevented with proper training, good technique, and paying attention to your body’s warning signs. One helpful guideline is the 10 percent rule, which recommends increasing training intensity, duration, distance, or workload by no more than 10 percent per week. Gradually progressing your activity level allows your muscles, tendons, bones, and joints time to adapt and can help reduce the risk of injury.
Warming up before activity and cooling down afterward are also important. Incorporating strength training, flexibility exercises, and core conditioning into your routine can improve overall performance while helping to prevent overuse injuries.
Athletes of all ages can benefit from guidance when starting a new sport, training program, or returning to activity after an injury. The fellowship-trained sports medicine specialists at Center for Sports Medicine & Orthopaedics have advanced expertise in diagnosing, treating, and preventing overuse injuries. They understand the unique demands of sports and physical activity and can help identify risk factors before they lead to more serious problems.
If an overuse injury does occur, early evaluation and treatment can help prevent it from becoming chronic. A sports medicine specialist can develop a personalized treatment plan that may include activity modification, rehabilitation exercises, physical therapy, athletic training services, and recommendations to safely maintain fitness during recovery. Once symptoms have resolved, a gradual return to activity under the guidance of a healthcare professional can help reduce the risk of reinjury.