TRAIN SMART TO PREVENT OVERUSE INJURIES

Autumn sky. Taken by PKSenagore. All rights reserved.

A SLIDESHOW ARTICLE BY WEBMD.COM, “Guide to Overuse Injuries” covers a few problems that don’t typically arise because of repetitive use in sport participation like carpal tunnel syndrome and trigger finger. However, the remainder are conditions that runners, walkers, and other athletes might commonly suffer: plantar fasciitis, bursitis, tendinopathy/tendinitis of the elbow, jumper’s/runner’s knee, shin splints, ilio-tibial band syndrome, and stress fractures.
 
Because nearly every sidelining problem I've developed over the past 40+ years has been caused by  overtraining, and named in this list, I thought the slideshow information could save others from a similar fate.

In the first part of the article, each malady is briefly explained.  The common theme is that repeated performance of a physical motion over time can cause irritation leading to inflammation of soft tissue structures like ligaments, tendons, bursa, muscles, and bone.  Even a stress fracture of bone involves inflammation. The end result of inflammation is pain.
 
PREVENTION: The next part of the slideshow (starting with slide #10) discusses prevention, the focus of this blog post.
 
First, a warmup of about 5-10 minutes is recommended in which a low intensity aerobic activity is performed to "loosen up" muscles and other soft tissue structures. Pumping blood at an increased heart rate to those tissues will literally warm them. You will know you’ve accomplished this task when you feel, well, warmer, and want to remove any extra clothing worn for the session. Warm-ups could also involve dynamic stretching and mobility routines.
 
The next prevention recommendation is to “take it slow” aimed at beginners or those starting a new program.  If you’re a long-time, experienced runner, cyclist, or aerobic fitness equipment user you may tempted to skip this piece of advice and see what’s on the next slide. STOP.  This slide’s message should be interpreted more broadly.  Understand that regardless of experience level,  efforts to increase speed, distance, weight, or intensity in training will increase your risk of overuse injury.  Incremental training progressions should be gradual and should be confined to one dimension at a time (speed or distance, for example, but not both simultaneously).
 
The article’s third important prevention tip, "do it right,” is about technique and form.  However, performing an activity with proper technique is not a simply matter. 
 
There are both mental and physical aspects to learning sport-related moves.   I know how a single-leg dead lift should be performed, but it takes significant work to gain the strength and balance to accomplish just a few perfect repetitions. 

Deficiencies and inequalities in muscular strength, mobility, balance, and endurance have prevented me from moving as I wanted or should at various times in my running career, an orthopedic surgeon has explained. So, I unconsciously compensated.  When compensated movement occurs repeatedly, body parts and tissues may move in unnatural ways, he said more than 20 years ago, which is what leads to tissue irritation, then inflammation, and worse. 
 
A physical therapist further explained that as fatigue sets in during an extended effort proper form is most likely to break down.  Near the end of a long race there can be much more wobble in my stride or cycling than at the start, she said.  I'll notice a greater ache in one joint or tissue is because it is likely taking the brunt of the beating inflicted by sloppy form brought on by fatigue. And ok, maybe also because I am tired and mostly focused on just finishing, not proper form
 
The key to following this prevention directive, “do it right” is to adhere to a solid comprehensive training program that works not merely on increasing mileage to cover a specific distance.  Rather one that builds overall endurance by improving strength, mobility, and balance, and prepares both body and mind for a level of performance that does not risk injury.
 
The last bit of prevention advice “Mix -it -up” supports the above discussion.   It makes the point that other aerobic and strength efforts can be substituted for the one that is repeated day after day. Like swimming for running or biking and yoga for strength. To my mind, changing-up physical training to include other types of activities accomplishes two goals in preventing over-use injury:

1. Less time is spent repeating the same motions that increase injury risk
2. More time is spent time developing needed physical capabilities

 
[The last two article slides cover treatment, a huge topic that will not be discussed in this  prevention-focused blog post.  ]
 
With fall being a big season for endurance race training, and many athletes gearing up to take on the more difficult portions of their schedules, a bit of a reminder about the risks involved is timely. Webmd.com cautions us to warm up sufficiently, plan training progressions that are graduated, and take a well-rounded approach to training for overall endurance that includes a mixture of exercises.
 
One last piece of advice should be added to the webmd.com list: REST when the schedule calls for a day to recover.  More training is not likely to translate to better performance.  The best strategy for success in an upcoming competition may be to train to stay healthy to insure participation, rather than be sidelined by injury.
 
RUN & MOVE HAPPY!
 
https://www.webmd.com/pain-management/ss/slideshow-overuse-injuries

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164361/

https://beginnertriathlete.com/cms/article-detail.asp?articleid=2056