Few things are more frustrating from a fitness standpoint than overuse injuries. An overuse injury is uncomfortable. Plus, exercising with one affects your form. This can lead to further injury and soreness. At worst, it can put you out of commission for a few weeks. Fortunately, you can reduce your risk of an overuse injury by taking some simple precautions.
What is an Overuse Injury?
Acute injuries are ones you feel at the time they happen. If you tear an anterior cruciate ligament or sprain an ankle, you know something’s wrong right away. You experience immediate pain and swelling. Overuse injuries are more subtle and develop gradually over time. They come from repetitive microtrauma to muscle fibers, tendons, bones or joints. This microtrauma results in low-grade inflammation and soreness. If you continue to stress the injured area, an overuse injury can become chronic.
The problem with overuse injuries is the symptoms are often subtle at first and may not be bad enough to cause you to change how you’re exercising. Instead of modifying your routine, you keep stressing the muscle, tendon, ligament, bone or joint and end up with a more severe injury. Overuse injuries can start out minor and end up being an ongoing problem that takes weeks or months to heal.
What Causes Overuse Injuries?
A number of factors increase the risk of overuse injury. It’s not uncommon for people to develop an overuse injury when they first start exercising. This comes from trying to do too much too soon. If you “overdo it” by pushing too hard too quickly you don’t give your ligaments, tendons, and muscles a chance to grow stronger before subjecting them to more stress. Muscles, tendons, and ligaments adapt to the stress placed on them but they need time to make the necessary adaptations.
Ever take a long break from exercise and come back and try to do the same workout you did before? That’s a quick way to get an overuse injury. After a long break, some degree of “detraining” has occurred and your muscles, tendons, ligaments, and joints aren’t as strong or functional as they were before. Expose them to the same degree of stress and they’ll end up injured.
What’s going on behind the scenes when you’re injured? When you stress tissues without giving them time to adapt, it results in injury. Tissues stressed by overuse develop low-grade inflammation and release chemicals that cause pain. The same principle of microtrauma and remodeling causes muscles to grow when you lift weights – but keep this in mind. Growth and repair occur during the rest period between lifting sessions. Overuse injuries are the result of repeated trauma without adequate time for repair.
Overtraining is another common cause of overuse or repetitive stress injury. Again, you’re stressing tissues without giving them enough time to recover. People training for events that increase their training volume in preparation are at risk for overuse injuries. One study found half of all iron-distance triathletes suffered from an overuse injury over the course of a 26-week study.
How much variety are you including in your workout? Doing the same exercises repeatedly stresses the same muscles and tendons. Runners often develop overuse injuries because they’re using the same muscles in the same way over and over again. Make sure you’re including enough workout variety. Cross train so you’re not repeatedly stressing the same muscles and joints. If you strength train, include flexibility and stretching exercises in your routine for balance.
Other Causes of Overuse Injuries
Anatomical and biomechanical problems can be a contributing factor to overuse injury. Foot issues like flat feet or over-pronation when running can be a problem for some people. A number of individuals have a discrepancy in leg length that puts additional stress on their hips when they run or jump. If you’re experiencing frequent overuse injuries, an appointment with a sports medicine doctor may be helpful to identify anatomical issues that may be contributing. Something as simple as wearing orthotics may help. Always make sure you’re wearing appropriate exercise shoes that provide support for the foot and ankle.
Muscle imbalances can put you at risk for overuse injuries as well. Many people have a dominant side they favor. If you have a dominant leg that you favor during exercise, this leg receives more stress than the other leg, putting you at risk for injury. If you strength train one muscle group and don’t compensate by working the opposing muscle group as much, you’re also creating muscle imbalances that can lead to injury. Identifying and correcting those imbalances can reduce your risk for acute and overuse injuries.
Finally, using incorrect technique and form puts you at risk for overuse injuries by overloading the muscles incorrectly. For example, it’s common for people to “cheat” when doing biceps curls by recruiting their back muscles to help lift and by arching their back. Watch yourself in the mirror when weight training to make sure your form is good. Make sure you’re not swinging the weights or using momentum.
Don’t Ignore the Symptoms
If you experience pain or tightness, don’t exercise through it. A mild overuse injury can become a bigger problem if you pretend it isn’t happening. Alter your workout so you’re not experiencing discomfort and give the overstressed area time to heal. Taking it easier for a few days could mean the difference between a mild overuse injury and a problem that keeps you from exercising for weeks.
The Bottom Line?
Overuse injuries are common – but shouldn’t be ignored. Take these steps to stay healthy when you exercise.
Medscape.com. “Overuse Injury”
Medscape Family Medicine. “High Prevalence of Overuse Injury Among Iron-Distance Triathletes”
American Orthopedic Society for Sports Medicine. “Overuse Injuries”
UVMC Center for Sports Medicine. “Prevention of Overuse Injuries”