Overuse Injuries and Training

For some of us, exercising and working out is a “religion”.  We look forward to our workouts because of how exercising makes us look and feel, what it does for our self-esteem, and how it provides an emotional “break” from everyday life. Although the American College of Sports Medicine (ACSM) recommends some moderate-intensity physical activity most days of the week (if not all) but some fitness enthusiasts take it a bit too far. For example, some may spend an hour every day, while other may come two or three times each day for different workouts or classes.  Regardless, these individuals show up to they gym because they LOVE it.  Unfortunately, too much training can result in overuse injuries that can get in between you and your workouts.

What are Overuse Injuries?

Injuries can be a major setback to any workout program.  There are generally two types:

1. Acute injuries – usually the result of a single, traumatic event (i.e., bone fractures, joint sprains and dislocations, and muscle strains)
2. Overuse (or chronic) injuries – are the result of repeated micro-tearing of soft tissues (i.e., tendons, bones, and joints)

Overuse injuries typically occur over time and aren’t detectable until it’s too late.  Common examples of overuse injuries include:

• Tennis elbow (outer part of the elbow becomes sore and tender)
• Swimmer’s shoulder (pain located in the shoulder capsule due to the inflammation of the tendons of the rotator cuff muscles; typically caused by repeated overhead movements)
• Runner’s knee (pain behind or around the kneecap, especially where the thighbone and the kneecap meet)
• Jumper’s knee (pain at the point where the kneecap tendon attaches to the bone of the lower leg)
• Achilles tendinitis (tightness and pain in the thick tendon behind the ankle)
• Shin splints (pain along the inner edge of the shinbone)
• Plantar fasciitis (pain felt on the underside of the heel)

Why Do Overuse Injuries Occur?

The human body is an amazing in how it adapts to its environment.  It can also take on a significant amount of physical stress without causing long term damage.  Exercise and physical activity are beneficial for strengthening bones, muscles, tendons, and ligaments. This occurs as a result of the remodeling process. This process involves the synchronized breakdown and buildup of tissue.  If the balance between the two processes is “off”, and the breakdown occurs more rapidly than buildup, an overuse injury occurs.

What Causes Overuse Injuries?

The most common cause of overuse injuries are errors in training intensity, duration, or frequency. For example, someone who weight trains three times a week suddenly decides to increase their frequency to five days a week and increases the volume of sets and repetitions for each exercise. Another example is a recreational runner who decides to run their first marathon (26.2 miles). The requirement to increase the number of miles per week can be overwhelming for someone who has only run a maximum of five miles at any given time.

It is possible to increase training volume without experiencing overuse injuries, but the right periodized program and proper technique is critical as slight changes in form may be the culprit. For this reason, coaches, athletic trainers, and personal trainers can play a role in preventing recurring overuse injuries.

Regardless of the training program or exercise technique, some people are just more prone to overuse injuries than others. Imbalances between strength and flexibility around certain joints, differences in limb length from one side to another, or poor posture can predispose individuals to injury. Weaknesses due to old injuries and or existing injuries may also be a contributing factor.

Other factors contributing to overuse injuries may include:

• Training surface (i.e., hard surface, uneven terrain, etc.)
• Equipment (i.e., appropriate type, size, weight, etc.)

How Are Overuse Injuries Diagnosed?

A “nagging”, painful injury should be diagnosed by a medical professional.  It is usually done using a thorough medical history and physical examination.  A medical specialist with experience in soft tissue injuries (i.e., physician, physical therapist, physiotherapist) and/or your sport of physical activity is recommended. Depending on the degree of the injury you may also require x-rays or an MRI exam.

Tips for Treating Overuse Injuries

If you have not taken the necessary precautions to avoid an overuse injury, here are recommendations to get back on your feet and in the gym as soon as possible:

1. Cut back on the intensity, duration, and frequency of an activity
2. Utilize a workout schedule that includes both “hard” and “easy” workouts to give your body a chance to heal (i.e., sport-specific workouts mixed in with dry-land training to maintain your fitness levels)
3. Work with a personal trainer or sport-specific coach to learn proper training techniques
4. Use ice after any type of physical activity to alleviate minor aches and pains
5. Use anti-inflammatory medications (if necessary) at recommended dosages

If symptoms persist, see your doctor or sports medicine specialist.  They will be able to create a more detailed treatment plan for your specific condition. Physical therapy or other treatment interventions may also be helpful.

How Can I Prevent Overuse Injuries?

Because overuse injuries are hard to detect until it’s too late, prevention is extremely important. Luckily, preventing an overuse injury only requires basic “common sense”:

1. Use proper technique when you exercise
2. Use the appropriate intensity, duration, and frequency of exercise in your training program
3. When you take your training to an elevated level, use the “10 Percent Rule” (increase your training no more than 10 percent per week)
4. Include a proper warm up and cool down to your workouts
5. Listen to your body and let pain be your guide
6. Use common sense when it comes to your overall health and wellness

Whether you are a fitness “newbie”, a seasoned fitness professional, or an athlete pursuing their sport, overuse injuries can get in the way of your success.  To avoid chronic injuries along the way, it is recommended that you seek the advice of a sports medicine specialist or athletic trainer when beginning an exercise program. If you are currently faced with an overuse injury, your current program can be modified to help you maintain your fitness, while you recover from your injury.

Written by TodaysFitnessTrainer (trainer@todaysfitnesstrainer.com).