Wellness Wednesday: How to Keep Repetitive Motions from Turning into Overuse Injuries

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Loudoun County, Va. — Overuse injuries aren’t just sustained by athletes and weekend warriors. In fact, just about anyone can get them. If you have a daily walking routine but do not do any targeted stretching or strengthening, you are prone to overuse injuries. Anyone who plays any type of sport, has a job that requires repetitive posturing or repetitive lifting, or anyone who does not take time to warm up properly before an activity, perform static stretching after an activity, or focus on strength training stabilizing muscle groups will likely sustain an overuse injury at some point.

What is an overuse injury?

An overuse injury refers to any type of injury sustained by a repetitive activity or action. Examples of overuse injuries include:

Inflammation of a tendon, which is a soft tissue structure that attaches muscle to bone

  • Tennis elbow and Golfer’s elbow
  • Rotator cuff tendonitis
  • Biceps tendonitis
  • Patellar tendonitis
  • Hip flexor tendonitis
  • Hamstring tendonitis
  • Peroneal tendonitis
  • Posterior tibialis tendonitis
  • Achilles tendonitis

Hairline fractures in bone caused by repetitive stress or force

Overstretching of a muscle

  • Over time, micro-tears can occur
  • Hamstring strain
  • Shin splints
  • Upper trapezius strain
  • Whiplash
  • Rotator cuff strain
  • Quadriceps strain
  • Lumbar strain

Overstretching or tearing of the fibrous tissue connecting bone to bone

  • Ankle sprain
  • Wrist sprain
  • MCL, ACL, PCL or LCL sprain (knee sprain)
  • CMC sprain (occurs at the thumb joint)

Tendons and ligaments can also fray or tear over time with repetitive use. It’s common as we age to experience these changes in soft tissue structures, but not everyone will be symptomatic. If you are experiencing any kind of pain or discomfort during activity or a sport, it’s important to have an evaluation with an experienced healthcare professional well-versed in biomechanics and anatomy.

Physical therapists, physical therapist assistants and athletic trainers are licensed professionals trained in the treatment and prevention of overuse injuries.

What are signs of an overuse injury?

In the beginning stages of an overuse injury, not all of these symptoms will be present. The first sign of an overuse injury can include stiffness or soreness that disappears after a warm-up. Keep in mind that muscle soreness lasting up to 72 hours can be a normal reaction to new or increased activity. This phenomenon is called delayed onset muscle soreness or DOMS.

However, continued use or repeated activity can lead to damage over time, increasing discomfort and pain to the affected area. If these symptoms don’t improve following a proper warm-up, do not continue your activity or try to “power through” it.

During the first stage of an overuse injury, the discomfort is relieved after a warm-up. The second phase of an overuse injury involves discomfort that reappears toward the end of the activity. The third phase includes discomfort that worsens during your activity. The final stage is discomfort or pain that lasts over time.

Swelling, redness, warmth to the touch and/or impaired function of the affected area, such as loss of range of motion and loss of strength, indicate an injury that requires attention from a physical therapist.

What causes an overuse injury?

Lack of muscle strength or muscular endurance can lead to injury.

You are at risk for injury if you do not routinely strengthen the supporting musculature around your joints. Walking, running or playing a sport alone without a strengthening and stretching program is not enough.

Poor core stability

Your core includes more than just your “six pack” muscles. It includes your transverse abdominus, internal and external obliques, rectus abdominus, gluteals, lumbar extensors, trunk stabilizers, and hip musculature.

Muscle imbalances

If you have strong tight muscles versus weak overstretched muscles, poor posture, or you don’t mix up your strengthening program to challenge different muscle groups, you are at an increased risk for an overuse injury.

Inflexibility or hypomobility

If you have tight muscles, these areas will be put on increased tension during activity, putting you at risk for developing a strain or sprain.

Hypermobility

If you are very flexible, it’s likely you are lacking strength in or around those areas, therefore lacking necessary support around your joints. This can lead to compensatory patterns, which will cause certain muscle groups to overwork.

Poor technique and poor posture

The majority of the general public does not know how to properly lift everyday objects without putting unnecessary stress on the lumbar spine. Improper body mechanics and poor lifting techniques with daily activities such as childcare, cleaning, doing laundry, yard work, mowing the lawn, gardening, raking leaves, shoveling snow, lifting groceries and putting dishes away, can cause strains and sprains.

Most patients we treat also do not know how to perform proper squatting technique. This is true of athletes, too.

Desk warriors, even those with ergonomically correct workstations, often have forward rounded shoulders, forward head posturing and tight pectorals. This can affect shoulder mechanics, neck mobility, core strength, etc., leading to pain and dysfunction.

These poor mechanics will lead to mal-alignment, biomechanical issues, compensatory patterns and overuse of anterior structures over posterior, medial and lateral chain strength and stability.

The most common causes of overuse injuries are poor technique, training errors and muscle imbalances.

How can you prevent an overuse injury?

Warming up prior to activity with dynamic stretching (stretching multiple muscle groups concurrently through a range of motion or stretching with movement) for at least five minutes helps prepare your muscles and joints for more movement. Dynamic stretching increases blood flow and reduces the chance of sustaining a muscle strain.

Static stretching targeted muscles (and holding each stretch for 20-30 seconds each) after an activity will help keep your muscles limber and reduce post-activity muscle soreness.

Proper training techniques, such as incrementally increasing your activity by no more than 10 percent each week, (whether it’s in terms of distance, speed, weight or intensity) allows your muscles, tendons, ligaments and joints to acclimate to the increased stress without overstraining these structures.

Including stabilizing muscle groups into your training is vital to avoiding compensatory patterns and muscle imbalances. Walking is not targeted strengthening. Squats and lunges alone are not enough. Training your biceps, triceps and pectorals is not enough. Sit-ups and crunches are not the ideal exercises for strengthening your abdominals. Don’t ignore your rotator cuff muscles, hip stabilizers, hip rotators, transverse abdominus, gluteals, and postural scapular stabilizers.

Listen to your body. If you are straining or holding your breath during an activity, this is a sign that you are either over doing it or using improper technique. Pain or discomfort is a sign that something is wrong. Do not ignore early warning signs of discomfort or push through pain. Once you identify pain, implementing a comprehensive treatment plan is key to your recovery.

NOTE FROM OUR SPONSOR: If these muscle groups sound foreign to you, or if you are unsure if you are training properly, call our office today at 703-450-4300. We welcome you to come in for an evaluation, whether you’re currently in pain or just want to learn more about injury prevention and optimal training techniques. Your physical therapy team at Loudoun Sports Therapy Center will ensure your full rehabilitation and safe return to your favorite activities.

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Loudoun Sports Therapy Center is a premier physical therapy clinic. We offer outpatient orthopedic and sports physical therapy as well as specialty programs.

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