Adequate preparation as well as appropriate rest and recovery from sport and activity can help prevent overuse injuries from occurring. However with every good intention an overuse injury is easily sustain and is a common type of injury we see here in our Physiotherapy practice.
To fully understand the nature of the overuse injury, how to treat it and prevent it from happening again we must take a look at some background information about this common condition.
As a result of our sport or activity we can sustain one of two types of injuries - acute or overuse types.
This type of injury can be characterised by the sudden onset of a ‘sharp’ pain with the potential for the sudden loss of function, usually as a result of a traumatic event. Some examples of acute injuries would be sprains of the ankle, dislocation of the shoulder, bone fractures, etc.
This type of injury is quite different from the acute injury in that the presence of pain and in some cases inflammation too can be totally absent. Instead of the sudden onset of pain and dysfunction there are numerous and repetitive micro traumas that occur to the muscles, tendons, joints and bones. These micro traumas are subtle and if frequent enough they will eventually lead to pain and dysfunction due to the eventual breakdown of the affected body part.
Overuse injuries are believed to be the most common type of injury for the sports person and are more challenging to diagnose and treat as they are usually not caused by a a single traumatic event. Examples of overuse injuries are runner’s knee, tennis elbow, shin splints and achilles tendinopathy.
Related article: Pre & Post Injury Preparations
As the name suggests this type of injury is caused by vulnerable body parts usually not getting enough rest. The consistent levels of strain through exercise or activity then cause a body part to further weaken and eventually become injured.
Progressive training in any sport, both in professional and amateur level, requires some degree of over-loading of two main body systems, the cardiovascular and musculoskeletal systems, in order to improve strength and performance. However when the amount of over-loading exceeds the bodies ability to regenerate, heal, repair and strengthen what results is a particular part of the body becoming over stressed and damaged.
As noted above the symptoms of an overuse injury are not sudden and can be subtle at first. Such an injury is typically noticed with the onset of some degree of pain, possibly with the affected area becoming red and warm to touch as well as some signs of inflammation being present, but not always.
A recent article we published about Patellar Tendinosis offers a specific explanation about what differing types and behaviours of pain mean in relation to the stages of tendon degradation and treatment options.
Article: What is Patellar Tendonosis
Understanding the different types of pain which can be experienced from sporting activity is an important requirement in accurately identifying stress limits.
Some expected levels of pain are usually experienced as a result of strain placed on the body from strenuous exercise. This type of pain is typically experienced after exercise as the familiar aches also referred to as ‘delayed onset muscle soreness’ (DOMS) and is quite normal. This type of pain should subside within a couple of days and can often be relieved by an appropriate pre-exercise warm-up.
Related Article: Understanding muscle pain
Pain can start to indicate an increased risk for injury when the pain begins to be felt during exercise. This type of pain does not usually diminish physical performance but your training programme should be adjusted to reduce overloading until the pain has gone completely. It is seldom a good idea to push through pain.
The next level of pain is one that causes an immediate drop in performance and the pain does not subside when you stop exercising. At this point complete rest is a necessity as is seeking professional medical attention.
Treatment options will vary according to the specific diagnosis but generally the PRICE protocol is applied in all cases - Protect, Rest, Ice, Compression and Elevate.
Related article: Heat & Cold Therapy
Anti-inflammatories can also be taken when prescribed to help reduce early stage inflammation.
Most overuse injuries will also require specific rehabilitation exercises to gradually recondition the affected part to fully strength once more. Advice and instruction is best sought from a Chartered Physiotherapist who will also be able to assist with pain relief techniques.
The most important factors that must be included in your training programme are adequate rest and recovery periods.
Top tips to prevent an overuse injury:
In addition, if taking up a sport or activity for the first time, or returning after a prolonged period, a physical screening assessment can be performed by a Chartered Physiotherapist. This would identify risk factors which may put you at risk for developing an overuse injury and once identified a preventative treatment and a pre-habilitation plan can be put in place.
Related article: Back To Sport Screening
It is important to remember that your body makes its strength and stamina gains during its rest and recovery time. Without rest you will actually go backwards in your training.
Posted by Simon.
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