Monday, April 30, 2012

Overuse Injuries
I originally wrote this piece for my high school, Agnes Irwin, and it was published on the Center for Advancement for Girls website, an initiative of this exceptional all-girls school.  

Overuse injuries are common in sports and are characterized by tissue damage such as muscle or joint injuries that result from gradual and repetitive trauma over time.  Examples of such injuries include but are not limited to stress fractures and tendonitis.  Unfortunately, overuse injuries can ultimately result in limitation of activity.   

In a recent study published in the Journal of Athletic Training, overuse injuries comprise almost 30% of all injuries sustained by college athletes and 62% of these injuries occur in female athletes.  The study investigated 573 male and female athletes involved in 16 team sports during the 2005-2008 seasons.  Over a time course of three years, 1317 injuries were reported.  The male athletes sustained 705 injuries while the females sustained 612 injuries.  Of all injuries sustained, approximately 29% were overuse injuries and 71% were acute injuries.  General stress injuries were the most common type of overuse injury (27%), followed by inflammation (21%), followed by tendonitis (16%).  According to the study no specific event was responsible for the injury, but rather the damage occurred in a gradual manner by way of small and consistent insults in sports such as swimming, long-distance running and rowing.  Contrast these with contact sports such as wrestling, football and women’s soccer in which acute injuries with a specific responsible event are more common.  The highest rates of overuse injuries were observed in field hockey, soccer, softball and volleyball.  Both physical limitation and psychological fatigue are long-term consequences of overuse injuries.  Because the onset of these injuries is so gradual, athletes may be hesitant to address them in a timely fashion.  As a result, many overuse injuries go untreated for long periods of time leading to long-term deleterious health consequences such as arthritis.  

Common causes of overuse injuries include training and technique errors.  There are many types of training errors.  But in general these occur from increasing physical activity too quickly such as intensity or speed and ignoring body strain.  Technique errors involve repeatedly using poor form resulting in overuse injury to a specific tissue.     
The investigators of the recently published study concluded that additional studies need to be performed to determine why female athletes are at greater risk for overuse injuries.  This being said, many of these injuries are avoidable with proper preventive tactics.  Here are my 4 simple tips to help you avoid an overuse injury this season:
1.    Avoid extremes

My motto is everything in moderation and this applies to working out as well.  Always start your work-out with stretches and a warm-up as well as a cool-down after it’s over. Gradually up the intensity and duration of your conditioning program (by no more than 10% per week).  Don’t ever do so suddenly. The physical stress on your bones, muscles and tendons may prove to be too much resulting in an overuse injury.

2. The right stuff

I am referring to technique and tools.  Both are key.  Make sure whatever sport or exercise regimen you are participating in that you are using proper form.  And also make sure you are using the right shoes.  Depending on the sport, different shoes will provide different forms of support.  Worn out sneakers have less stability and less shock absorption capability.  Working out in these shoes can increase your risk of running injury so make sure you replace them.  If you regularly exercise, the recommendation is at least 2x per year.  
3.    Rest and recovery

One of the most important aspects of training is getting adequate rest.  Your body needs time to rest and rebuild so that it is strong enough to endure the stress of training.  In addition to rest, your body requires adequate hydration and proper nutrition to recover.  This means lots of water and a healthy, well-balanced diet incorporating lean protein, fruits, vegetables, nuts, seeds and whole grains.  For more information on healthy eating, see my piece on Grocery Shopping 101.    
4.    Know the symptoms

Persistent pain is not normal, especially if it is interfering with your ability to function or your performance.  Don’t ignore it, because if left untreated, an overuse injury may ultimately prevent you from physical activity altogether.  Talk to your health care provider if you are experiencing pain related to your exercise regimen.

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