Prevent Overuse Injuries | Health, Medicine and Fitness

chris woolston
How to protect yourself from sports injuries?
You wear your goggles faithfully on the racquetball court, you never rollerblade without your pads and helmet, and you stretch like a fanatic, but you’re always injury-free. What’s going on?
Although safety precautions are essential, it is not enough to avoid projectiles and cushion your falls to avoid injury. Athletes often overlook measures that can protect them from problems like sore knees and sprained ankles. There’s no surefire way to relieve sports pain, but the following tips can definitely help you stay in the game. Here are some tips for preventing the most common aches and pains.
Overuse injuries. Many people associate sports injuries with broken bones and torn tendons, but in non-contact sports the vast majority of injuries occur gradually. Stress that builds up over weeks or months can cause painful kneecaps, stress fractures, shin splints, pulled muscles, tight hamstrings, Achilles tendon tenderness, or burning pain at the heel. These issues strike most athletes at one time or another. Doctors call them “overuse injuries,” but you don’t necessarily have to train very hard or long to get them. Worn-out shoes, uneven running surfaces, and oddities in body structure can all contribute to pushing your muscles, tendons, and bones beyond their limits.
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Here are some tips to prevent overuse injuries:
- Don’t push through the pain. True discomfort is a signal that something is wrong or that you are asking more of a part of your body than it can provide at the moment.
- Gradually increase your workouts. If you’re a runner, don’t increase your mileage by more than 10% per week.
- Run no more than 45 miles per week. Running further than that doesn’t pay off: it probably won’t improve your endurance and it will certainly increase your risk of injury.
- Run on soft, flat surfaces.
- Alternate tough training days with easy days.
- Get new running shoes every 500 miles. With use, shoes lose their ability to absorb shocks.
- If you pronate (the inside of your foot bends over) or have another alignment issue, you may be able to prevent injury by wearing an over-the-counter shoe insert. Ask your doctor if such inserts might work for you.
- Women and teenage girls need to make sure they get enough calcium, either through their diet or through supplements. Stress fractures are 10 times more common in women than in men. Improve your chances of avoiding them by making sure you get enough of the minerals and vitamins that are essential for bone formation.
Can certain stretches or other exercises reduce the risk of overuse injuries?
Many people stretch before and after training. Stretching helps you increase range of motion and prepare for activity, but according to recent reports from Sports Medicine and the American Journal of Sports Medicine, there is no clear evidence that it will prevent injuries from overwork. To prevent these injuries and help heal existing injuries, exercises that actually strengthen your muscles will be much more effective than those that just stretch them.
Here are some strengthening moves that can help prevent common overuse injuries.
- Pain around the kneecap. Check with your doctor if you regularly have pain around your kneecap. If the front of your knee hurts when climbing stairs and stiffens during long periods of rest, your kneecap is likely being pulled out of its groove during your workouts. Your doctor may recommend that you strengthen your inner thigh muscles, which tend to be weak compared to the outer muscles. If your doctor approves, try this exercise: Stand with your back against a wall and your feet 6 to 8 inches from the wall. Slowly slide your back lower onto the wall until your thighs are parallel to the floor. Make sure your knees don’t go past your toes. Hold for about 10 seconds or until your upper thighs get tired. Stand up straight to let your muscles recover for a moment. Try to do ten repetitions each day.
- Painful shoulder. Swimmers, tennis players, weightlifters, and others who repeatedly raise their arms above their head often experience pain in the front or side of one shoulder. To avoid this problem, work on strengthening the muscles in your rotator cuff, the shoulder muscles that connect to the arm bone. Here’s a simple exercise you can try: Do a simple shrug: raise both shoulders as high as you can, squeeze them together, and relax. Work up to 25 shrugs twice a day. (Consult your doctor, of course, if you regularly suffer from shoulder pain.)
- Hamstring draw. To help prevent hamstring injuries, try this exercise: To strengthen the hamstrings, lie on your stomach, tuck your abs in to protect your lower back, engage your thigh muscles, and slowly raise a leg. Hold it in the air for two seconds, then carefully lower it and relax your thigh muscles. Try three sets of 10 reps each day with each leg.
- Tense Achilles tendon. The Achilles takes a beating during running and aerobics classes, especially if your calves are too weak to handle their share of the load. To strengthen your calves, stand up straight, raise yourself up on the balls of your feet, then lower yourself slowly. Keep doing this until your calves get tired. Repeat this routine twice a day.
Ankle sprains. Ankle sprains are among the most common sports injuries, although they are not always caused by overuse. Although there may be an element of bad luck behind most sprains, there are steps you can take to keep luck on your side. If ankle sprains are a common problem for you, see your doctor. She may recommend ankle braces or lace-up stabilizers or semi-rigid orthotics. These devices are especially important if you lack strength, flexibility or good balance, which can help you avoid injury (see below). Incidentally, a study from the University of Oklahoma found that, contrary to popular belief, high-top shoes did not reduce the risk of ankle sprains.
Are there exercises that can help prevent ankle sprains?
Strength, flexibility, and good balance make an ankle sprain less likely, and you can improve all of these qualities with stretches and exercises:
Calf stretch. Experts say performing this stretch on each leg before and after a workout can reduce the severity of any future ankle sprains. Face a wall with one leg slightly forward and one leg slightly back. With your front leg bent at the knee and your back leg straight, rest your hands on the wall and lean forward, keeping your back heel on the floor. Continue to bend over until you feel the calf of your back leg extend slightly. Hold the position for 15 to 30 seconds. Then, with both heels planted on the floor, slightly bend the back leg and hold the position for another 15-30 seconds. This shifts the focus into your calf, so you’re stretching the whole area.
Ankle exercises. Doing three sets of these exercises every other day (10 to 15 reps per set) can make your ankles stronger and more stable. Don’t forget to do both pegs:
Take a two-foot piece of tubing (or use a rubber resistance band available at sporting goods or medical supply stores) and tie it in a loop. Sitting in a chair, secure one end of the loop around the leg of a heavy table or other sturdy object, and place the other end around the top of your foot. You need to be far enough away from the end of the grounded loop for the tubing to stretch properly. With your heel on the ground, move your foot up to the right and then up to the left.
Now stand with one end of the loop in your hand and the other end around the sole of your foot. Keeping your heel on the ground, lift the front of your foot, then press down on it as if pressing the accelerator, using the loop to provide resistance.
Finally, stand on one foot, lightly touching a chair or table for balance. Slowly lift your heel off the ground, then slowly lower it.
Basic concepts of injury prevention. ACSM Fit company page. American College of Sports Medicine
American Academy of Orthopedic Surgeons. Exercise safely.
Knapp TP, Garrett WE. Stress fractures: general concepts. Sports Medicine Clinics;16(2):339-354.
Ballas MT, et al. Common Running Injuries: Diagnosis and Management. Am Fam Physician;55(7):2473-80.