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OVERUSE INJURIES: What They are and How to Prevent Them


What causes overuse injuries?

Injury occurs when the tissue is subjected to repetitive submaximal loading. The repetitive activity fatigues the tissue. Without sufficient time for recovery, micro areas of structural damage build, leading to pain and injury. With adequate recovery, the tissue adapts to the demand, becomes stronger and can sustain higher loads. Therefore, the major cause of overuse injuries is training errors! With training errors, the phrase “Too much, too fast, too soon, too bad” applies. When one does too much or too fast training before the body is ready, i.e. too soon, then too bad an injury occurs.

Also, intrinsic and extrinsic factors lead to injury. Intrinsic factors are abnormalities in anatomy or other factors with the person. Examples include flat foot deformity or over pronation, supination, joint laxity, inflexibility, muscle weakness, and anatomic malalignment. Prior injury and menstrual dysfunction, or lack of periods, that leads to weak bones are also intrinsic factors. Extrinsic factors include training equipment or surface, footwear, technique, training errors, and peer pressure.

How does one prevent overuse injuries?

The first step is to correct training errors. Some general rules include, first, don’t increase by more than 10% per week either distance, time or intensity. Second, only increase distance, intensity, surface, or type of training one at a time. Third, have adequate recovery built into the training schedule such as cross training, days off, slow and light days or weeks mixed with harder days or weeks. Again, the key is to give the tissue adequate time to recover, build on the stresses that are place upon it and not break down. With keeping a training log, corrections in the training schedule can be made to avoid future injury, as the injury usually is from a change in training that occurred several weeks prior to the injury. Fourth, a good way to monitor the stress on the body is by monitory hear rate, weight and amount of sleep. If your heart rate increases by more than 10%, weight decreases by more than 10% or the amount of sleep decreases by more than 10%, then the body is stressed and needs recovery time. While correcting training errors, the next step is to correct the intrinsic and extrinsic factors that may be awry such as any abnormalities in biomechanics, muscle imbalance or weakness, flexibility, equipment fit, surface adjustments, etc. With the sport, it’s not just running, swimming or kicking a bull but also stretching, resistance exercise such as weight training (even if it’s body weight) and form.

Finally, how do you treat overuse injuries?

Generally treatment includes: A) Rest, meaning modifying activity including cross training or decreasing training time or mileage B) Ice C) Medications D) Physical therapy for rehab including stretching, strengthening, and return to work E) Avoiding re-injury. It’s important to not just treat pain from an overuse injury with NSAID’s. More is needed than just masking the pain to be able to play through it. Seek medical advice early whether it be team athletic trainer or physical therapist or physician to avoid time lost or further injury. Also, it is important to have a diagnosis so that specific treatment can be given. The earlier care is sought, generally the quicker the recovery as intrinsic, extrinsic, training factors and rehab can be modified early to start recovery.

In conclusion:

Avoid overuse injuries by:

  • Correcting training errors
  • Correcting intrinsic and extrinsic factors
  • Recovery days: cross-training or rest days
  • Keep a training log
  • Seek medical advice early for quicker recovery

by Stephen Scharmann, M.D. and
Jason Blackham, M.D.

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This entry was posted on Wednesday, March 3rd, 2010 at 12:58 pm and is filed under Expert Answers, Sports Medicine. You can follow any responses to this entry through the RSS 2.0 feed.

One Response to “OVERUSE INJURIES: What They are and How to Prevent Them”

  1. [...] splints are an “overuse injury”, so my first recommendation would be to read the article on overuse injuries written by Dr. Scharmann and Dr. Blackham. Okay, now that you’ve read that, let’s move on to [...]

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