Overuse injuries: How to prevent an overuse injury

With many of us changing the type of exercise we may be doing, our physiotherapist Michael Scardamaglia covers how to prevent overuse injuries. Common sites of overuse injuries include the achilles, plantar fascia and knee.

What is an overuse injury?

Overuse injuries are very common amongst the active population and can present as many different conditions such as tendinopathy, neural irritation or even stress fractures. These injuries usually occur in correlation with a period of underloading or normal loading followed by a spike in activity which far exceeds the individual’s previous levels of training.

How does someone develop an overuse injury?

• Drastically reducing their physical activity for a period of time and then increasing their load straight back up again without an adequate build up
• Doing too much, for too long without proper rest and recovery in between.

Let’s use a runner as an example. We know that our runner usually runs 40km per week and has been doing this for the last 4-6 weeks. Now let’s say hypothetically our runner has to reduce the amount of kilometers he/she is running due to circumstances outside of their control and can only manage to do 25km/week for the next month. After a month of 25km/wk our runner attempts to increase back up to 40km/week and begins to notice he/she has a sore achilles tendon. This type of presentation is very common for physiotherapists to see and is a textbook example of an overuse injury.

How do I increase my physical activity after a period of time off without injuring myself? 

For those who are doing more intensive physical activity, following the acute to chronic workload ratio will be the safest way to increase your activity. This will require you to do no more than 1.3x the previous month’s weekly average amount of physical activity in order to reduce our risk of overuse injury to less than 4%. So for our 25km/week runner this means that any greater than 32.5km/week will place him/her in a higher risk bracket for overuse injuries.

So what can we do to reduce the risk of developing an overuse injury following a period of time off? 

1. 1. Gradually increase our activity/training loads over consecutive weeks to ease back into our regular routine.

• Use the acute to chronic workload principles to ensure you do not exceed 1.3x your current weekly average
• Adjusting the intensity of your physical activity initially by reducing the duration, weights, resistance or pace, but no less than 0.8x the previous week’s average.

1. 2. Ensure you are completing a proper warm up which involves flexibility, mobility, muscle activation and movement skill work.

• Foam rolling can be a quick and easy way to tackle some mobility work
• Dynamic stretches to stimulate blood flow to the working muscles
• Activation work using a theraband is a fantastic way to work your muscles in a controlled manner before exercising
• Movement skill work for those who are more active may involve some (E.g. high knees running, skipping, bounding, change of direction)

1. 3. Find alternative methods of exercise if you cannot go to the gym, for a run, ride or walk in the interim (see our blog posts regarding general home exercises for <50s and over >65s)

For those who are further interested in learning how to properly set out their exercise regime following a period of time off, our physiotherapists are happy to help guide you through to achieving your goals whilst staying injury free. Call us today or book online.