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* Please Note: The following article is provided by Body Mechanics for the sole purpose of
educating and informing our current and future patients.
Overuse Injuries
Treatment Options for the Recreational Athlete
By Jeff Ryg, DPT, ATC, CSCS
Atlanta Sports & Fitness Magazine
October 2007 Issue
Being the enthusiastic recreational athlete you are, you spent the season pushing your training, only to push it to (and beyond) the limit. That well-meaning effort was too hard, and now you’re in pain. You may have a common injury often seen by clinicians: Iliotibial Band Syndrome (ITBS)–an athletic overuse condition closely associated with the thigh or the knee, brought on by heavy biking, cycling, running or pound-the-pavement activities.
Despite the best efforts of patients to relieve their symptoms of ITBS, many only seek help after multiple attempts to self-treat their injuries through home-doctored treatments that usually consist of rest, anti-inflammatory medications and advice from health care clinicians–all with minimal relief. The futility of these efforts further restricts the recreation activities of the fitness-avid.
Overuse injuries involve a progressive, low-load stress placed across the tissues of the body, beyond which can be adequately healed within a given time frame. Lower-extremity athletes commonly develop chronic injuries including patellofemoral pain syndrome, iliotibial band syndrome, patellar tendonitis, Achilles tendonitis and medial tibial stress syndrome (shin splints). These restrictive injuries are caused by many factors and commonly involve biomechanical malalignment–imbalance in the athlete’s lower extremities, weakening his or her ability to properly absorb and react to changing surfaces and forces. Largely a result of training errors, biomechanical malalignment can lead to a number of overuse injuries.
The musculoskeletal system, on the other hand, is more resilient to abnormal stresses placed upon it, but the way it reacts is affected by continuous motion involved in recreational athletics and training programs. Poor biomechanical alignment can lead to abnormal weight bearing and external forces placed across the musculoskeletal system, and, in turn may lead to joint degeneration. Poor rehabilitation of a previous injury may further damage other body parts as well.
Other factors athletes must consider is muscle imbalances, particularly in regard to the body’s lower extremity region. Muscle imbalances may be the result of the body’s response to an external load, such as posture, fatigue, overuse or sport-specific activities. For example, research has shown significant differences in the flexibility and strength of soccer players based on position, while others have linked chronic knee conditions with acute injuries. Athletes with these problems have a dominant lower extremity, and may complain of asymmetry in their stride or their ability to perform athletic movements. Oftentimes, muscle imbalances manifest across an individual joint or from side to side, despite an athlete’s efforts to correct it. Runners with chronic hamstring tightness often relate it to a lack of gluteus maximum strength, opposed to a true shortening of the hamstring muscle and repeated groin strain, which may be the result of hip weakness.
Lower extremity overuse injuries often involve athlete training or workout errors. Too often, athletes do not engage in the cross-training necessary to improve neglected areas of the musculoskeletal system, which has been over- or under-developed by their training. Runners, for example, may only change the variety of their runs without changing surfaces, non-impact activities, core stability work or vital recovery time. All systems taxed by the physical demands of a training program must be given time to repair and rebuild before the next training session begins, accomplished by alternating mode, frequency, intensity and recovery.
Many athletes tend to focus only on treating symptoms and not the cause of injury, often frustrated by previously tried but ineffective self-treatments. They are encouraged, however, to seek the advice of a licensed professional trained in advanced education, as well as assessing and treating musculoskeletal conditions. Qualified professionals such as physical therapists and athletic trainers are experienced in bringing athletes back from injury, and can identify and treat body impairments that may lead to future injuries, thereby conditioning athletes to perform more effectively and efficiently. Physical therapists with advanced training and experience in orthopedics also can provide appropriate injury education and create a targeted exercise program.
After correct assessment and treatment, recreational enthusiasts happily can return to their activities, symptom-free, with a better understanding of what causes injuries, and a specific program to prevent them.
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