Overuse Injury

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 wellbeing, 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.

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 is critical in avoiding overuse injuries, as slight changes in 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.

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.

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 crosstraining 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
• Using ice after an activity for minor aches and pain
• Using anti-inflammatory medications as necessary

If symptoms persist, a sports medicine specialist will be able to create a more detailed treatment plan for your specific condition. This may include a thorough review of your training program and an evaluation for any predisposing factors. Physical therapy and athletic training services may also be helpful.