Overuse Injuries

An overuse injury is a term used to describe damage and pain caused by repetitive movement and overuse. This repetitive movement causes trauma to tissues such as muscles, tendons ligaments, or bones creating tendonitis or stress fractures. Overuse injuries are unique because they are not a result of an acute injury such as a fall or crash, but are the result of training errors, improper technique, or taking on too much activity too quickly without enough recovery. A few examples are: carpal tunnel syndrome, jumper’s knee, little league elbow, shin splints, runner’s knee, swimmer’s shoulder, tennis elbow, golfer’s elbow.

Overuse injuries can affect people of all ages but can be extremely problematic for children because of their growing bones that are less resilient to extra stress.

  • Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students. Safe Kids USA Campaign Web site 2009
  • Twenty percent of children ages 8 to 12 and 45 percent of those ages 13 to 14 will have arm pain during a single youth baseball season. American Academy of Orthopedic Surgebaseballons 2009
  • Since 2000 there has been a fivefold increase in the number of serious shoulder and elbow injuries among youth baseball and softball players. Preserving the Future of Sport: From Prevention to Treatment of Youth Overuse Sports Injuries. AOSSM 2009 Annual Meeting Pre-Conference Program. Keystone, Colorado
  • Every year, more than 3.5 million children aged 14 years and younger are treated for sports injuries.

Symptoms of overuse can include impaired function, swelling, warmth, redness as well as aches and pain. Not every overuse injury is identical but many of the same principles apply. Here are a few ways to prevent overuse:

  • Warm up before workouts
  • Don’t push through the pain
  • Increase workouts gradually (adding miles as a runner)
  • Include an active cool down at the end of each workout
  • Cross-train
  • Use proper equipment

Many people believe that stretching before a workout will reduce their risk of overuse injuries. While stretching may be beneficial to increase the range of motion, there is little evidence to prove that it is useful in preventing these types of injuries. Strengthening activities are far more effective than stretching activities. A few examples of strengthening exercises for common overuse injuries are:

Sore Shoulder – Swimmers, tennis players, weight lifters, and anyone else who repeatedly raises their arms above their head is at risk for a shoulder overuse injury. To prevent this, work on strengthening the muscles in the rotator cuff. Some exercises to do this are shrugs, side lying external rotation, high to low row pulls, lawn mower pulls, and reverse flyes.

Lateral Knee Pain – lateral knee pain is very common among runners and can be prevented by doing wall sits, one leg squats, as well as side lunges.

Elbow Pain – There are two main types of elbow pain: on the inner side of the elbow and the outer. The pain on the inner or medial side of the elbow is often called golfer’s elbow. Pain on the outer or lateral side of the elbow is often called tennis elbow. Both types of elbow pain can be atleast partially avoided by strengthening exercises such as wrist flexes, reverse wrist flexes and ball squeezes.

Hamstring Pull – To help prevent hamstring injuries, try the following exercises: romanian deadlifts, squats, lunges, and hip bridges.

Remember, the reasons we train include competition, living functionally, or having fun. Overuse injuries impede all of these reasons and can be easily prevented.

Physical therapy can often be crucial in prevention and the healing process. Physical therapists can supervise use of the injured part, educate the patient, develop a home exercise program, and use modalities such as transcutaneous electrical nerve stimulation units, similar electrical treatments, ultrasound/phonophoresis, iontophoresis, and heat/cold.

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