Don’t Let Overuse Injuries Slow You Down

It’s that time of year where most of us make resolutions to get fit, lose weight and start exercising more. However, nothing stops well-intended and well-motivated fitness goals like pain and injury.

Overuse injuries are any type of injury that occurs in a muscle, tendon or joint as a result of repetitive trauma. There are many factors that can lead to an increased risk of injury; from outdated gear to muscular imbalances. Certain medical conditions may also predispose you to overuse injuries, so it is always advised to consult your physician prior to starting an exercise program. Common overuse injuries can range from tendonitis and arthritic flare-ups to stress fractures.

Here are some ways to prevent overuse injuries:

1. Start slow with your exercise routines. Remember, it has likely been a long time since you bench-pressed 245 pounds — and it took a lot of training to get there. Whatever your activity, start out at a level that you are sure you can handle, and make sure you have no pain with the activity. Pay attention to how you feel two hours after the workout, that evening and the next day. If you are pain free, aside from a little muscle soreness, then you know you did not overdo it and you can progress the next day’s routine. Gradually progress by adding reps or time before increasing the intensity of the workouts. Take two “off” days per week from training to allow for recovery and focus on stretching exercises. Performing stretching exercises during your normal workout times reinforces good habits and consistency as well as gaining flexibility and correct muscular imbalances that may contribute to increased risk of injury.
2. Change up your routine and check equipment. Variety is the key. Overuse involves repetition, so cross training and doing different movement activities may lessen the risk of tissue breakdown. There are many other fitness benefits to cross training as well. Shoes lose their cushion after about six months or 300 miles of use, so replace that old pair that you dug out of the closet with new ones to protect your feet, ankles and knees. Make sure any other fitness equipment is good working order before using.
3. Proper stretching is vital. Think of your muscles as rubber bands — flexible, elastic and pliable. Now picture that 10-year-old rubber band that has been abused for most of its life and has just been discovered in the back of the drawer after five years of non-use. It may appear cracked on the surface; it certainly feels more brittle; it doesn’t bounce back very well any more; and, sure enough, if stretched too far, it snaps. This is potentially your muscles after months or years of disuse leaving them at higher risk of injury. Fortunately, unlike the aged rubber band, our bodies have the ability to regain flexibility and elasticity with proper warm-up, stretching and exercise. To properly stretch, you should warm up with a five- to 10-minute general conditioning exercise to raise the heart rate just enough to break a light sweat. Stretches should be performed to a mild intensity — a three to four out of 10 on a stretch intensity scale and held for 30 seconds. You should avoid repeated bouncing while stretching because it triggers the muscles natural guarding mechanism and may actually cause increased tension in the muscle. Consult your physician or physical therapist to identity which muscles to stretch and proper position to correct potential muscular imbalances.

Frequently asked questions and answers on overuse injuries:

Q: How do I know when to push through pain or back off?

A: The old rule “no pain, no gain” may not be the best philosophy for someone just starting an exercise program or struggling with injury. As a general rule, if you feel repetitive popping, sharp pain near a joint, or pain in a joint while performing an exercise, do not keep pushing through. This means that there is either improper technique or muscular imbalance leading to increased stress on the tendons or the joint causing inflammation and pain. If you feel fatigue, or a burn in the middle of the muscle that diminishes within seconds with rest, this is likely “good” muscular pain that can be pushed into.

Q: I feel fine while I am exercising, but the next morning I have significant pain that keeps me from being able to exercise or even function. What can I do to prevent this?

A: First, consult your physician because this may be a sign of degenerative joint disease or arthritis. The delayed pain you are feeling is likely due to inflammation that builds in the hours following an aggravating activity. When the body is warmed up and the adrenaline is flowing, we may not sense the irritation; but as the inflammation builds through the night, stiffness and pain ensue the next morning. First, modify or avoid the aggravating activity to reduce the irritation. Secondly, cool down with gentle stretching and apply an ice pack to the affected area for 10 to 15 minutes to inhibit the inflammatory response thus reducing stiffness and pain the next day.

With questions to be addressed in future columns, contact Dunker at jeremy@sageorthopt.com or 301.874.9200.

Editor’s Note: Dr. Jeremy Dunker co-owns Urbana’s Sage Orthopedic Physical Therapy with his wife, Stephanie. Dunker will be writing Vital Signs on a bi-monthly basis for The Town Courier.