There are basically two types of injuries: acute injuries and overuse injuries. Acute
injuries are usually the result of a single, traumatic event. Common examples include wrist
fractures, ankle sprains, shoulder dislocations, and hamstring muscle strain. While overuse
injuries are more common in sports than acute injuries, they are subtle and usually occur
over time, making them challenging to diagnose and treat. They are the result of repetitive
micro-trauma to the tendons, bones, and joints. Common examples include tennis elbow,
swimmers’ shoulder, Youth Pitching elbow, runners knee, jumping knee, Achilles tendinitis,
and shin splints.
Why do overuse injuries occur?
The human body has a tremendous capacity to adapt to physical stress. We need to think of
”stress” in the context of its negative effect on our emotional well-being, 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 remodelling. The remodelling process involves both the breakdown and
build-up of tissue. There is a fine balance between the two, and if the breakdown occurs
more rapidly than build up, an overuse injury occurs.
What factors cause overuse injuries?
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, incomplete 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.
How are overuse injuries usually diagnosed?
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.
What is the treatment for overuse injuries?
Some tips for treating an overuse injury include:
Cutting back intensity, duration, and frequency of an activity.
Adopting a hard/easy workout schedule and cross-training 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.
Can overuse injuries be prevented?
Most overuse injuries can be prevented with proper training and common sense. Learn to
listen to your body. Remember that, “no pain, no gain” does not apply here. The 10 percent
per week. This allows your body adequate time for recovery and response. This rule also
applies to increasing pace or mileage for walkers and runners, as well as to the amount of
weight added in strength training programs.
Always remember to warm up and cool down properly before and after activity. Incorporating
strength training, increasing flexibility, and improving core stability will also help
minimize overuse injuries.
Seek the advice of a sports medicine specialist or athletic trainer when beginning an
exercise program or sport to prevent chronic or recurrent problems. Your program can also be
modified to maintain overall fitness levels in a safe manner while you recover from your
injury. You should return to play only when clearance is granted by a health care
professional.
PHYSIOTHERAPY INTERVENTION :
We as Physiotherapists are skilled at diagnosing the specific injury , and then through
multiple modalities , we are able to treat the various common conditions discussed above and
accelerate injury repair.
Deep soft tissue release
Manual therapy and joint mobilisation
Electrotherapy
Shockwave therapy
Acupuncture
Exercise rehabilitation
To prevent the injury recurring , a personalised strength and flexibility programme should
be prescribed .
For the end of season and pre-season , players should seek our professional advice to do a
screening and biomechanical assessment , as this will detect any abnormalities early on and
then a structured programme can be designed for them as a preventative measure. This will
hopefully allow the players to have less injury time during the season .
Clinton Grobbelaar
( Physiotherapist )