How To Avoid Overuse Injuries

  • Injury Prevention   •   February 24, 2023

By Dan Mollins, PT

5 Minute Read

Overuse injuries are one of the most common injuries treated in my physiotherapy practice. An overuse injury is defined as a muscle or joint injury caused by repetitive trauma; while the word trauma sounds like a painful mechanism, repetitive trauma can be as simple as our normal daily activities. When we use our muscles, naturally there is some breakdown and building that occurs. This process is what helps us develop new muscle, or help build more muscle mass. However, when we do allow for adequate rest and recovery, our muscles may not have enough time for proper re-building, this can lead to injuries. The same process can happen with our bones and joints. Overuse injury at a bone level can be seen as a stress fracture in the foot of a runner, or at the joint level of an office worker being in the same posture day in and day out, creating the same force on the same joints each day. Throughout this article I will provide you with tips and tricks to avoid overuse in each of these anatomical structures.

Our first, and most commonly seen overuse injury, is strain of muscle tissue. Many of us know someone in our lives that feels like they need to move and be active every single day, without rest; But, is this really the best thing for our bodies? The age old saying “we build muscle in our sleep” has been coined for a reason. While the work we put in while being active helps set the stage for our muscle development, we truly build upon our current muscle mass while we rest. Increasing rest periods, i.e.Taking more days off from exercise, seems like one of the easier ways to prevent overuse injuries, it alone is not enough all the time. Two things I assure all my patients understand while they are training/exercising is; the importance of activation exercises, and the importance of mobility. Activation exercises are focal exercises to target specific muscles that are required for a given task. A prime example of this is activation of our glute medius muscles (muscles that stabilize our hips during activity) before running. If runners do not assure their glute muscles are primed and ready to go, they often overuse their quadricep and hip flexor muscles causing an added load through the knee. Mobility exercises are something that we all know we should be doing, but often forget if we are in a time crunch. Having proper mobility for a given task is one of the most important factors to preventing injuries. If you force a muscle into a position it is not comfortable in, then expect it to create force or work, this disadvantaged position will cause the muscle to overwork and become strained and/or injured. 

For a boney overuse injury, the primary cause is overloading a particular area without adequate support. This type of injury is most commonly seen with runners or walkers, who do not wear appropriate footwear or replace their footwear. Running shoes should be replaced once the user sees signs of noticeable wear through the shoe. Places to check on your shoes are the heel, and the lateral border; if these areas are noticeably worn down or damaged, it may be time to replace the shoes. Depending on the material of the shoe, instead of a worn down area, the user might instead see compression lines through the sides of the shoe (mostly seen in shoes with foam layers such as the Nike Pegasus, or Lululemon Runners). Many patients who are frequent walkers dont think to check their footwear after months of usage. It is important to consider new footwear after 400-500 kms, these numbers can come up quicker than you may think, especially if you are on your feet for work. Speaking with your physiotherapist, chiropractor or orthotists about your natural arch and footwear, can help provide tools such as orthotics, exercises, etc., to help mitigate the additional risk of stress fractures or bony contusions. 

Our third and final form of overuse injury can be seen in the form of joint pain caused by chronic posture. Heightened by Covid’s work from home experiences, chronic poor posture is on the rise. Head forward, chin down, and  rounded shoulders has become normal for most of us, whether it is working at our desk, or texting our friends on our phones. Our joints work best when they are allowed the freedom to move throughout their entire range of motion, allowing for proper nutrition; sadly, this is not the case for many of us during the 9-5 hours. Being sedentary in the same posture each day causes joint irritation as the joints can be seen resting in their closed positions, (especially the neck and lower back), which is the position of most joint compression. Not only does sedentary posture cause increased intra articular pressure, it can also lead to creep (the lengthening of our ligamentous support systems over time), making us fall more and more into these aberrant postures. Before we go into fixes, a great way to determine if you have poor posture is to set up your phone looking at your desk from the side. Once set up, most phones have a time lapse setting, if they do not, a normal video will work. Now record yourself working for a few hours, longer than 30 minutes, to assure the most natural state to be reached. After your work day, go back and watch the video. Where is your head falling? Is your chin poking out? Are you leaned over to get closer to the screen? These are the most commonly seen desk bound positions I see. The two best ways to counteract this habit are daily stretches provided by your health care practitioner, and setting little time based reminders on your computer or phone to re-adjust your posture. If you are not sure which joints have become stiff overtime, consult a professional (with your video in hand) and they will guide you through stretches to target the problem areas. With our reminders, either set them for a return to proper posture, and/or microbreaks of getting up and going for a quick walk to reset the body.

An overuse injury can happen from being too active and it can also occur when we are too sedentary, the sliding scale of how active to be is always a challenge. Many of my patients often find themselves on both ends of the scale, sitting 9-5 in horrible posture, then finding themselves going for runs or to the gym daily to try and counteract the work day. Just like many things, the best way to avoid overuse injuries is balance. This balance will come in the form of knowing when to take that rest day, or knowing when our body may need a walk instead of a run. Combining body awareness, stretching and activation, and adequate equipment (if that may be footwear or office tools), is the best way to stay healthy and active this winter season. As we dive into the cooler times of the year, don’t forget about walking spaces such as malls and community centers to stay moving during these winter months. 

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