It’s a common thought that more is better, and to some extent, our culture promotes these thought patterns. Eating vegetables is good but eating more is better. Exercising is good yet exercising harder and longer is better. However, neither is true in all scenarios. While the former can lead to a deficiency in other nutrients (all food groups have a purpose), the latter can lead to burnout and/or serious injury.
An overuse injury refers to a micro traumatic damage to a bone, muscle, or tendon that has likely been subjected to repetitive stress and motion without enough time to heal and repair. Examples of overuse injuries include plantar fasciitis, stress fractures, tennis elbow, runner’s knee, swimmer’s shoulder, Achille tendinitis and shin splints. Overuse injuries commonly occur because of repetitive motions on the same muscle group(s).
Risk Factors for Overuse Injuries
Overuse injuries are more likely to occur as we age, regardless of gender. Imbalances between strength and flexibility around certain joints may further predispose individuals to injury. Most adults reach their maximal physical capacity between years 20 and 30. By age 50, there can be an average strength loss of 1.5-5% each year, contributing to a more fragile structure.
“We see overuse injuries a lot, mostly in adults,” says Dr. Robert Morgan, who specializes in sports medicine for OrthoCarolina. “With the upsurge in CrossFit, we now see more adults coming in with upper extremity injuries.”
And it’s not just males competing anymore. There has been a large increase in competitive sports and “weekend warrior” female participation over the last few decades. There has also been a paralleled increase in training related sports injuries among females. Such errors include taking on too much physical activity too rapidly or doing too much without adequate recovery. For example, jumping from running a 5k to a half marathon too quickly without slowly building up mileage. Technique errors, on the other hand, refer to poor form or improper technique that may overload certain muscles.
Diagnosing Overuse Injuries
According to the Council on Sports Medicine and Fitness, there are four stages of overuse injuries:
- Pain in the affected area after physical activity
- Intermittent pain during the activity, without restricting performance
- Intermittent pain during the activity that restricts performance
- Chronic, unremitting pain, even at rest
“The diagnosis really depends on the intensity of the injury and the history of the person,” says Morgan. “The biggest sign of an overuse injury is pain during the activity that goes away when the activity stops. We may start with an x-ray of the body part and then aim for conservative treatment. Oftentimes, it resolves on its own.”
As we age, it’s easier to over use our muscles. Putting too much stress and impact on the body, without allowing ample rest and recovery, can be detrimental to women of all ages. Not only can it lead to injury, but it can also lead to burnout and mental distress as well.
Why Women Especially Need To Be Cautious
Women also deal with a decrease in muscle mass and strength associated with the hormonal changes that come with menopause as well. Furthermore, compared with men, women have shorter and smaller limbs relative to body length, and increased general joint tolerance. These anatomic differences in lower extremities may predispose women to certain overuse injuries, like an increased risk of ACL injuries and stress fractures.
Overuse injuries, over-training and burnout are also on the rise in the U.S. among child and adolescent athletes, as up to 50% of injuries seen in pediatric sports medicine are related to overuse. Young girls with irregular or absent menstrual cycles are also at an increased rate of stress fractures. This is because low estrogen status is responsible for decreased bone mineral density and osteoporosis. Estrogen is essential for protecting skeletal muscle from osteoclasts, cells that break down bone tissue. Participation in certain athletic disciplines that encourage lower body weights and thinness, like ballet, figure skating, gymnastics and distance running, also pose a higher risk.
Avoiding Overuse Injuries
It’s more important than ever to include a proper warm-up activity before exercise, stretch and modify activities as needed.
To avoid overuse injuries, gradually increase your activity level when taking on a new form of physical activity (allowing 6-12 weeks of buildup). Also, use proper form and gear, pace yourself, and mix up your routine to allow the body to use different muscle groups. Since stress fractures occur from cumulative repetitive forces, adding in cross training and a variety of exercises on alternate days can help too.
“For optimal recovery, we recommend taking a break from the activity that is causing pain,” Morgan adds. “Add in some cross training to stay active so you’re not losing fitness, and use ice and anti-inflammatories as needed.”
Dr Morgan also suggests individuals then work on improving their form or technique. For example, if starting back into running, try a running form technique check at a running store or adding inserts in.
The threat of overuse injuries can be a cautionary reminder for all of us, undermining the importance of slowly increasing activity and prioritizing adequate rest and recovery. It’s a good idea to talk with your doctor or physical therapist before starting a new activity or ramping up your routine. Also, eating a well-balanced diet with calcium and Vitamin D, and eating enough to sustain activity is essential as well.
To learn more about sports nutrition and healthy exercising, check out OrthoCarolina’s wealth of knowledge in their online blog posts HERE.
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Sarah is a Registered Dietitian, writer, blogger, runner and recipe developer in the Lake Norman area. She’s also a new mom to a baby girl, and is still transitioning to the steep learning curve of first time motherhood. She writes about nutrition, running and healthy recipes on her blog, Bucket List Tummy. To see what she’s up to or find her checking things off her bucket list, follow her on instagram – @bucketlisttummy_rd.
