Overuse Injury

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KEY POINTS

• An overuse injury is caused by doing the same kind of activity often and repeating the same movement over and over.
• You will need to change or stop doing the activities that cause pain until the injury has healed.
• Treatment may include stretching and strengthening exercises, wearing a splint, medicine, or sometimes surgery.
• To help prevent overuse injuries, be careful about how much you exercise on any one day, and use proper form and posture during your activities.

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What is an overuse injury?

An overuse injury is caused by doing the same kind of activity often and repeating the same movement over and over. Overuse injuries are very common.

What is the cause?

Repeated stress on a bone, muscle, tendon, or ligament can cause the tissue to get swollen, weak, and painful. Tendons are strong bands of tissue that attach muscle to bone. Ligaments are strong bands of tissue that connect one bone to another to form the joints.

Usually it is a certain activity that causes the injury. For example, if you run a lot, you may get cracks in a foot bone from too much running. Or, if you do a lot of hammering or typing, you may injure a tendon in your elbow.

What are the symptoms?

Symptoms may include:

• Pain
• Swelling
• Decreased strength or speed

Pain usually gets worse with exercise or activity.

How is it diagnosed?

Your healthcare provider will examine you and ask about your symptoms, activities, and medical history. Depending on your injury, tests may include:

• X-rays
• CT scan, which uses X-rays and a computer to show detailed pictures of the injured part of your body
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the injured part of your body
• Bone scan, which uses a radioactive chemical to look at your bones

How is it treated?

You will need to change or stop doing the activities that cause pain until the injury has healed.

Your healthcare provider may recommend stretching and strengthening exercises and other types of physical therapy to help you heal.

You may need to use a splint for a few weeks to support the injured body part or keep it in the right position while it heals.

If the pain does not go away, your provider may give you a shot of a steroid medicine. If you have a complete tear in a ligament or tendon, you may need surgery to repair it.

Overuse injuries often get better within a few weeks with self-care, but some injuries may take several months or longer to heal.

How can I help take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• To help relieve pain and swelling:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time. Use ice after every practice, game, or physical therapy session.
  • Keep the injured part of your body up on pillows so that it is above the level of your heart when you sit or lie down.
  • Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
    • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
    • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
  • Put moist heat on the injured area for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Moist heat may help relax your muscles and make it easier to move the injured body part. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Don’t use heat if you have swelling.
  • Do exercises or wear a brace as recommended by your healthcare provider.
• As your injury heals, make sure that you don’t try to do too much too soon. Once the injury has healed, go back to the activity that caused the injury very slowly.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent overuse injuries?

Here are some of the things you can do to help prevent overuse injuries:

• Be careful about how much you exercise on any one day. You might want to try cross training. Cross training is doing different types of exercise, for example lifting weights one day and swimming the next day. Because you are not doing the same exercise all of the time, you limit your risk of injury by not stressing the same joints and muscles all the time. You should also take days off from training to recover and let your body heal.
• Listen to your body. If you have soreness or pain, take a rest day or try a different exercise that does not stress that area.
• Warm-up before you exercise. Do dynamic warm-up exercises. These exercises increase blood flow to your muscles, lubricate the joints, and increase flexibility. Some examples of dynamic warm-up exercises are jumping jacks, squat thrusts, and walking briskly. Stretching after your activity may also help. If you have pain after exercise, putting ice on the painful area may help prevent injury.
• Do soft tissue massage. Use foam rollers, tennis balls, or other soft tissue tools before exercising to help prevent overuse injuries. Deep tissue massage helps break down scar tissue in muscles and tendons and lowers the risk of injury.
• Design a well-balanced training program. Try to strengthen the weak muscle groups.
• Follow safety rules and use any protective equipment recommended for your work or sport. For example, when you exercise, wear shoes that fit properly and are made for the activity.
• Use proper form and posture during your activities, whether the activities are sports or job-related. For example, if you play tennis, be sure your tennis stroke is correct and that your tennis racket has the proper grip size. Make sure that your hands and wrists are supported when you use a computer.