OVERUSE INJURIES ¦ Those Sneaky Little Buggers! - Blog

[Guest Prosoft Admin]

You’re walking along the creek at one of our beautiful parks.  As you stand there you hear the faint sound of a drop of water behind you.  Slow.  Consistent.  Persistent.  Drip.  Drip.   Drip.   You turn and see this reliable drip coming from some rocks above you, falling repeatedly on the same spot on a rock below just at the creek’s edge. 

But this rock appears different than the others.  Right where the drop of water is hitting you notice the rock has a “carved out” sort of appearance.  Almost like a bowl. 

How did the rock get like that?  Could stupid little drops of water really have caused that?  That strong, hard rock?  In Rock-Paper-Scissors wasn’t it the strong rock that crushed the scissors? 

Did this little, tiny, soft drop of water literally wear away that rock?  Just look at all the other rocks nearby.  No “bowls”  to be seen.  Flat surfaces, sharp edges.  No smooth curves sitting comfortably right in the middle of the rock. 

You come to the only reasonable answer….YES – that drop of water actually broke down the hard rock over time.

SMALL STRESSES OVER TIME CAN BREAK DOWN EVEN OTHERWISE RESILIANT OBJECTS.

                                                WOW!  That sounds a bit like our bodies doesn’t it?

OVERUSE STRESSES.  That’s the topic of this week’s radio show segment.  From sports like Fencing, like what our guests Felicia and Iris teach at their training center here in Rochester, to runners and throwers and swimmers and volleyball hitters and many others…athletes who perform the same repetitive motion over and over are at risk for overuse injury.

A fractured bone or a muscle strain are much easier to deal with, at least in several important ways.  An acute injury sort of demands care doesn’t it?  Everyone sees it, including the coaches and maybe even your parents.  Acute injuries often involve more obvious and debilitating pain…maybe some limping around or inability to move your arm or body normally.  Those sort of injuries beg professional intervention.  Everyone sees you got hurt and for the most part are usually “on board” with seeing a Physical Therapist or going to the Doctor to get your recovery started.

But what about those other injuries we see…OVERUSE INJURIES.  Less glamorous.  Less obvious.  Oftentimes no grimmacing pain.  No writhing on the field in agony.   It just crept up on you, seemingly overnight but in the back of your head you can think back to weeks or even months, and in some cases years ago when that nagging soreness started.  Over time it gradually grew to more moderate pain and then those feelings of a lack of strength or power, feeling less exlposive, poorer reaction time.  Not getting to those same balls as quickly.  Not able to stay with those same players defensively.  Having trouble getting out of the chair or going down stairs hours later or the next morning.  Maybe a sore shoulder or arm pushing up off the ground or putting on a seatbelt. 

They may not seem a big deal at first but they can be just as troubling as an acute injury or even moreso. 

They present a real challenge because oftentimes athletes are able to keep playing through the symptoms for a little while, or even longer, adding further insult to injury. 

I call it…..LIVING IN MEDIOCRITY.   You’re not bad enough to be bad, but not good enough to be good.  Mediocre.  Still performing.  Not necessarily stinking up the joint.  But also not really improving as expected.  Not really performing as well as you’d imagined the season might go. 

Looking in the mirror and admitting that you’re hurting, whether it’s a little or a lot, is the first step.  You’ve got to recognize that it’s not normal to be in pain from playing a sport.  Temporary soreness – sure.  Hurting after an unusually hard set of practices or new drills – ok.  Stiff and tender after getting bumped into hard – to be expected for a few days.

NOT RECURRING, CONSISTENT, SAME SYMPTOMS DAY AFTER DAY, WEEK AFTER WEEK – NEVER RELENTING. 

Athletes often have to deal with temporary bumps and bruises.  It’s just a part of sports.  Sooner or later a part or parts of your body will get sore.  But it should be temporary and it shouldn’t be the same area recurring over and over again.  That’s a sign of something not right.  Often – an OVERUSE INJURY.

At PEAK PERFORMANCE Physical Therapy & Sports Training we’re experts at trying to unravel the mystery of what went wrong.  The real key is understanding biomechanics and troubleshooting exactly how this might have occurred. 

Keep reading on and I’ll get a little more detailed about how these overuse injuries can develop and give some hints on preventing them.

OVERUSE INJURIES…”How did I end up here?”

That’s not always what athletes literally say when I see them for an overuse injury.  But – it is what I know they’re thinking.  They say it in other ways.  They ponder whether that old ankle sprain might be behind all this.  You can see the look of disappointment, puzzlement, and sometimes even regret as they think back to when it first started being noticeably sore or limiting. 

For some it’s just a few weeks ago – a little sore.  Not a big deal.  But something just isn’t feeling right. 

For others, like Anthony that I saw recently (names changed to protect the “innocent”)…it’s literally going back, as a 14 year old, to 4 years ago when the pains first started in his knees.  I think his mom was both shocked and at the same time feeling a bit guilty and embarrassed.  What took so long?  Is this mere procrastination?  I guess I’d call it something not good…but not just procrastination.  There’s some ignorance here…just literally not realizing it was something warranting getting looked at, mixed in with a little denial – the athlete wanting to believe “it’ll all be fine in a few weeks” (years later) or “it’s just a small thing” (that’s making a 14 yr old take the stairs like an 80 yr old man…come on!  Add all that to a little willful neglect in some cases – just wanting to avoid being told to take time off or to deal with the hassles and costs of treatment…and now you’ve got –

            …you guessed it :    an overuse injury. 

No loud “pop” for teammates to shudder at.  No ambulance carting you off for X-rays.  No being helped off the field and wrapped by the Athletic Trainer in a bag of ice for the second half. 

Just days and weeks and months and sometimes years of ignoring what your body has been trying to tell you in those gentle and soft spoken and kind words of that subtle soreness you never had before, in that stiffness that didn’t used to be there, in that appreciation of icing after practice you didn’t used to need. 

So how did this happen?  It seemed to come out of nowhere.

Or did it?

There’s a ton of reasons athletes can develop overuse injuries.  It’s not a “one size fits all” sort of situation. 

VOLUME. 

For some it’s literally just simple overuse.  Too much.  Too many swings.  Too many throws.  Too many landings during running.  Your body does have a “breaking point” to some degree.  It’s not made to tolerate whatever it is you happen to throw at it.  Just because you wanted to.  Just because the athlete next to you can handle it.  Just because a coach decided it.  Gradual progression of activities is one way to minimize the chance of overuse so that tissue tolerances are built up in small amounts over time, giving the body resiliency and tolerance.  That doesn’t guarantee a lack of stress but oftentimes athletes come in with “overuse” injuries that originated from a few weeks of “too much, too quick” in terms of new drills, conditioning work, or playing a ton of games in a short time without optimal preparation.  OVERUSE. 

But there are a number of factors that can facilitate that overuse happening sooner rather than later.

SAME SPORT YEAR ROUND.

While many athletes either by their own choice of just simply loving one sport so much or by the pressures to excel seemingly demanding dedication to only one sport, this sort of non-stop unrelenting frequency of same movement patterns certainly makes overuse injuries more likely.  While I can’t offer statistics on this, I’ve talked to and heard about numbers of college coaches and even pro athletes comment on how there is value in avoiding limiting yourself to just one sport constantly throughout the whole year. 

The skill development and grooving and perfecting of technique may take a little “hit” from not getting as many touches on the ball, or as many swings, or shots practiced…but in the long run your body will also have avoided the higher number of high intensity repetitive motions that can add up to eventual injury, and also may benefit from the varied athletic stimulus of playing a different sport.

POOR TECHNIQUE.

Here’s where sport coaches are so important.  Everyone knows how to throw a ball or hit a volleyball or shoot a basketball.  Any athlete can figure out eventually how to swing a bat or hit a forehand in tennis.  But there are optimal techniques to increase effectiveness and efficiency, in order to be successful and to minimize stress on the body. 

An athlete who is “coming over the top” too much on a baseball pitch or who approaches the volleyball net too squared up and not turned enough to cock their body and arm for a hit, or who misinterprets instructions to “be on the balls of your feet” to mean heels 2″ off the ground is at risk for developing injury.  The watchful eye of a good coach can go a long ways in helping athletes prevent injury by catching and correcting these types of flaws early on.  Athletes need to be proactive in seeking help as they practice new skills and even as they refine “old” skills. 

POOR BIOMECHANICS.

Here’s one of the  spots we at PEAK PERFORMANCE really can be helpful at.  Our bodies work as a system.  As a unit.  It’s not just a bunch of separate parts.  They really must integrate together to perform all these athletic tasks we do.  Skill training will end up having limited benefit if you’re a swimmer, for example, and your shoulder blade lacks the retraction ability for proper recovery phase.  A tennis player serving the ball must have good trunk rotational ability or they’re at risk for an “all-arm” style swing and down the road that “drop of water” is going to be wearing away at their rotator cuff or labrum.

It even ends up meaning you have to understand and look at opposite ends of the body.  I”ve got a volleyball player right now who is stressing her shoulder in part due to a long history of knee pain.  The limited jumping ability equates to having to swing faster at her sets and sometimes contacting the ball at the wrong time or point in it’s trajectory, leading to shoulder tendonitis. 

INADEQUATE REHAB FOR PRIOR INJURY.

Another big one for us at PEAK PERFORMANCE  is poorly or untreated injuries from the past.  These can absolutely come back to haunt you.  Just recently I saw another young high schooler, we’ll call him Ben.  He came in for knee tendonitis but actually the reason seems to be that his untreated ankle sprain from a while ago hadn’t actually recovered adequately.  He resumed sports once it only “hurt a little” and at this point has no pain, and doesn’t perceive any limitations in his ankle.  Upon testing though, I found more than a 30% deficit in one of his key ankle motions – dorsiflexion.  It’s the one where in a squat the knee if folding over the foot on the ground.  If you don’t have this motion then you’ll likely get early heel rise and increased loading at the knee and/or collapse of the knee inwards to try to “cheat” the loss of ankle motion in it’s normal path.  Either way it adds up to trouble.

 

IF YOU OR YOUR YOUNG ATHLETE HAS AN OVERUSE INJURY…          STOP PROCRASTINATING. 

GET IT LOOKED AT TODAY. 

COME IN AND SEE IF

WE CAN GIVE YOU SOME ANSWERS

ON HOW TO HELP RESOLVE YOUR PROBLEM

AND

HOW TO PREVENT IT FROM COMING BACK.