Over Use Injuries in Athletes

Written by Bruce Greene, MD, MHA

Recreational and competitive athletes usually sustain 2 types of injuries – acute and overuse. Examples of acute injuries are wrist fractures, ankle sprains, shoulder dislocations, and hamstring muscle strains. Overuse injuries occur more frequently but are more difficult to diagnose. Examples of common overuse injuries are: tennis elbow, runner’s knee, jumper’s knee, achilles tendinitis, and shin splints.

Mechanism of Overuse Injuries:
Exercise and activity are important for bone, muscle, tendon, and ligament health. Exercise and activity help an athlete get stronger and reach athletic goals. This process is called breakdown and remodeling. This is a delicate and not always predictable process. If the athlete performs excessive exercise, breakdown exceeds remodeling and an overuse injury occurs.

What are the main factors that cause overuse injuries?
Training errors are the leading cause of overuse injuries. Most frequently, the athlete tries to increase the intensity, duration, or frequency of activity too rapidly. The key to avoiding these injuries is to pay attention to proper technique. Coaches and trainers can be very instrumental in preventing recurrent overuse injuries. Athletes with flatfeet, knocknees, bowlegs and unequal limb lengths are particularly vulnerable to overuse injuries. Occasionally, improper shoe wear and hard training surfaces can increase overuse injuries.  If you think you may have sustained an overuse injury, you should consult a Sports Medicine specialist for a complete history and physical examination. Rarely, a bone scan or MRI may be necessary to confirm the diagnosis.

Treatment:

• Decrease the intensity, duration, and frequency of the activity
• Alternate difficult and easy workout routines, and consider inserting cross-training routines
• Ensure proper warm-up before and after exercising
• Apply ice after an activity
• Take anti-inflammatory medications (Motrin, Advil, etc) when necessary and medically approved

If these steps are not helpful, then consultation with a sports medicine specialist may be necessary.

Prevention:
Proper training is the best prevention!  Don’t increase your intensity by more than 10% each week. This also applies to mileage increase among runners. It is important to allow the body adequate time to recover from physical exercise.