What is an Overuse Injury?
In today's spiel, we're going to talk about overuse injuries and clearly define it, so that we can address approaches to treatment later.
An overuse injury is typically defined by tissue damage that is sustained by a repetitive movement or stress unlike an acute onset injury like a femoral fracture or the ever-so-common ankle sprain.
Typical structures involved with pathological examples:
Muscle-tendon junction (MTJ)
Nerve entrapment, impingement or occlusion, Carpal or Tarsal tunnel syndromes
Stress reactions and some forms of shin splints, exostosis (spurring)
Growth plate (physis) in youth and adolescent athletes
Osgood Schlatter, Saltar-Harris fractures, Apophositis
We see these typically appear in scenarios where an excessive or improper training load is applied to a person/athlete that either has poor tissue tolerance that's ill-equip to handle the demands of training/rehab or someone who's skeleton is not in an optimal position to perform efficiently. To put it simply, affected tissues were unable to handle the increase in weight, the amount of reps, the duration of sustained exercise, or adequately distribute forces and not having adequate time or nutritional intake required to recover (which is determined on an individualized basis). Ramping training regimes logically and appropriately while allowing enough time for the body to adapt can make a HUGE difference.
Most common overuse injuries we see typically fall under the soft tissue, muscle, tendon, and bursa category. When too much force is applied (from jumping or too much weight being used) and the natural break down and repair cycle of collagen can't keep up with the extent or rate of breakdown, you get thickened, hot, inflamed tendons that sometimes creak like an old floor board when you move. That process repeated over and over again creates an ongoing cycle of inflammatory responses that cause pain and discomfort, resulting in decreased performance.
Now, a silent player in this whole equation that absolutely needs to be addressed is individual daily habits and occupational requirements. I have two types of athletes that come to me all the time with overuse injury symptoms and patterns. Athlete 1, for example, can have the same training/playing times and intensities as well as the same sleep and nutritional habits as Athlete 2, BUT---
Athlete 1 has an extremely physical warehouse or serving/waitressing job while Athlete 2 has a desk job. On one hand, Athlete 1 has to worry about adequate recovery, mobility, and optimizing training time and load while Athlete 2 will need to take a more specific approach in movement preparation to ensure they're in an optimal skeletal position to perform. Both are susceptible to overuse injuries, but for completely different reasons, each requiring a different approach to injury prevention and management.
It's a part of managing patients/athletes that really has to improve in my opinion across the board. Completeness in total athlete management can be the difference between a prescribed rehab and exercise program success or failure.
Taking the total athlete, patient-first, approach should be the only way to manage athletic injuries and is what is going to help get players back faster and better than before.
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Thryve Healing and Performance