Health and vitality are positive results of exercise performed properly. When tissues like tendons, muscles and bones are repetitively loaded they adapt to this loading pattern and become stronger. However, if a person pushes too hard too soon, then those tissues may not have time to fully adapt and risk of injury increases. Overuse injuries are sustained from repeated action, unlike acute injuries that occur suddenly, such as broken bones or sprained ankles. Even elite athletes can suffer from overuse injury if they don’t follow the right routine for their chosen activity – a scenario that is often only realised after injury has occurred.
Some typical overuse injuries include:
- Tendinopathy: Injury to the fibres connecting muscle and bone
- Bursitis: Painful movement of muscles or tendons over bones due to aggravated bursae
- Shin Splints: Overstrained muscles that attach to the shin
- Stress Fractures: a weakened area of bone caused by repetitive application of force
- Compartment Syndrome: Caused by increased pressure in muscle compartments, typically in the lower legs, during exercise
Initial symptoms of overuse
Soreness or stiffness can be a sign that damage by overuse is taking place. These symptoms are often noticed the morning after physical activity and usually dissipate during warm-up. Continued aggravation can result in more damage and pain that persists through warm-up and during physical activity. In more extreme cases there will be a degree of ongoing pain or discomfort at all times, regardless of physical activity.
Overuse injury usually includes inflammation, with symptoms that include swelling, redness, warmth and functional impairment. Building muscle and strength requires a process called remodelling that involves tissue breakdown and build-up. When breakdown becomes too prominent an overuse injury can result.
Who is prone to overuse injury?
It is usually a sudden change in loading that is often the primary culprit for overuse type injuries. This makes sense as by suddenly increasing a particular type of activity, the body is not being given enough time to adapt to the increasing load. Other factors that need to be considered include biomechanical pre-disposition or medical conditions, such as low bone mineral density, which may increase risk of certain types of injury.
Improper equipment and sports gear can also be to blame for some overuse injuries. This is commonly noticed in the appearance of injuries such as achilles tendonitis, where improper footwear may be worn or sporting events take place on the wrong playing surface.
Treating overuse injury
The first step in treating overuse injury involves a physical examination to determine both an accurate diagnosis and the degree of injury. A Sports and Exercise Medicine Physician will thoroughly investigate the cause and extent of injury, while also examining for predisposing factors such as biomechanical alignment. If the injury is known to be caused by a particular activity or sport, a specialist with a good working knowledge of that activity is best suited to determine a recovery plan. Treatments your specialist prescribe may include:
- Education about training techniques to avoid aggravation and injury
- Adjusting schedules to minimise the frequency, intensity or duration of exercise
- Cross-training for all-round strength and maintenance of fitness during recovery
- Suggesting appropriate warm-up and cool-down activities
- Using ice and anti-inflammatory medications
- Physical therapy to promote healing and aid movement
- More serious overuse injuries such as certain stress fractures may require more strict periods of rest
How to prevent overuse injury
Many people who suffer from an overuse injury lament that they ‘should have listened to their body’. Common sense should always prevail, even when accustomed to the old adage of ‘no pain, no gain’. Some Sports and Exercise Medicine Physicians apply what is known as the 10% rule, where training or activity increases are kept below 10% from one week to the next. This modest increase won’t shock your bodily responses and will also provide adequate recovery time before the next session.
Proper warm-up and cool-down is essential. A moment of impatience to get going without warm-up, could possibly result in years of injury frustration. Stretching exercises such as yoga or Pilates may appear unrelated to sport or other physical activity, but can greatly increase flexibility and core stability. People suffering from chronic and recurrent problems should always seek the advice of a medical specialist or professional trainer prior to commencing a new exercise program.
Overuse injuries can be debilitating and even downright depressing for an active person, however, if managed properly a return to full movement and peak fitness is often entirely possible.