Top 5 preventable overuse injuries

Spend a few weeks in any physical therapy clinic and a common theme will begin to arise. The majority of individuals who seek treatment report that pain started gradually, without apparent cause, and got worse over weeks or months. This presentation is usually indicative of an “overuse” injury. Rather than resulting from a single traumatic event, overuse injuries occur as a result of repetitive micro trauma over time. Often, these problems are a result of muscle imbalance or poor body mechanics and can be prevented with a few simple adjustments. So, what are the most common overuse injuries seen at VTPT and how can you avoid them?

1. Low back strain:

Probably the most common problem that brings people to see a physical therapist is low back pain. There are a variety of specific injuries that can occur in the spine, but a strain refers specifically to over stretching of the ligaments that support the lumbar spine. These ligaments provide stability to the spine and they cannot function appropriately if they are too long. This diagnosis has a broad array of causes that are generally related to posture and core stability. Unsurprisingly, the best thing you can do to prevent back problems is to maintain good body mechanics, meaning to move in a careful and efficient way. Here are some guidelines for our most vulnerable times:

Bend at the knees with load in front of you. Lift from the hips and thighs, maintaining a neutral back.

Bend at the knees with load in front of you. Lift from the hips and thighs, maintaining a neutral back.

Push, pull, and carry from your core with body weight over legs. Avoid leaning forward or arching backward.

Push, pull, and carry from your core with body weight over legs. Avoid leaning forward or arching backward.

Sit with feet on the floor, hips and knees bent to 90 degrees. Weight should be on the "sits bones" and back upright, but not arched.

Sit with feet on the floor, hips and knees bent to 90 degrees. Weight should be on the “sits bones” and back upright, but not arched.

 

2. Tennis elbow

Tennis elbow, or lateral epicondylitis, is a condition that occurs as a result of overuse of the wrist extensors. The condition gets its name due to the fact that this muscle group is heavily used in tennis, but it is also common in other sports and individuals who work with their hands. Maintaining strength in the wrist extensors by performing eccentric wrist extension exercises and stretching after activities that use your hands are key in prevention. If you feel tension building in the outside of your elbow, massage the muscle mass using a tennis ball or similar object to help release tight tissues.

3. Plantar fasciitis

The plantar fascia is a thick connective tissue that provides support for the arch of the foot, and is therefore very susceptible to injury in runners and individuals who stand for long periods of time. It also has soft tissue connections to the muscles in the calves and is sensitive to shortening of this muscle group. Repetitive and/or prolonged stress on the bottoms of the feet leads to over-stretching and microtears in the plantar fascia. Proper footwear that supports the arch is key to avoiding this problem. Stretching the calves after exercising or standing for a long time is also important due to the aforementioned connection.

4. IT Band Syndrome

Most people that run or walk for exercise have probably heard of this condition. The IT Band (short for ilitotibial band) is another thick connective tissue that runs from the outside of the hip to just below the outside of the knee to give form to the thigh. It originates from a muscle called the TFL, which flexes, abducts, and internally rotates the hip. When the IT Band gets tight, it can cause not only thigh pain, but also discomfort at the knee joint. Because this particular tissue is notoriously difficult to stretch, a foam roller is recommended to loosen tightness when it occurs. Even better, prevent tightness by strengthening the other muscles in your hips so the TFL and ITB don’t get overused in the first place.

 

Gluteus medius and minimus are facilitated in this exercise to build hip internal rotation strength

Gluteus medius and minimus are facilitated in this exercise to build hip internal rotation strength

5. Rotator cuff impingement

Although this is common in throwers due to repetitive and extreme shoulder rotation, rotator cuff impingement can actually be related to postural problems. The muscles of the rotator cuff do exactly what their name implies – rotate the shoulder. To do this, they pass through a very narrow space that poor posture makes even smaller, leading to impingement of the muscle tendons. Once again, prevention comes back to posture, particularly avoiding that forward head, rounded shoulder position that poor computer and work space ergonomics promotes. Check in with your desk and keep your upper back strong with exercises like rowing and I’s, T’s, and Y’s to provide adequate space for the rotator cuff tendons.

by Birgit

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