What is an overuse injury?
An overuse injury is caused by “doing too much.” The continual stress placed on the body during physical exertion causes the breakdown of tissue, whether it be bone or tendon. When athletes’ demands on their bodies surpass their physical ability, overuse injuries arise, such as stress fractures, tendonitis, and bursitis.
What is a stress fracture?
A stress fracture is a micro fracture in the cortex (outside layer) of bone that is a result of repeated physical stress placed on the skeleton that exceeds its capability to remodel for support. Stress fractures differ from regular fractures because they develop over time rather than from one trauma. They often occur in the weight bearing bones of the lower leg and foot. Stress fractures are the most serious type of overuse injury.
How do these injuries develop?
Often stress fractures occur when muscles become exhausted from excessive force and begin to transfer weight onto the bone. This leads to weak sites in the bone that with repetitive activity will become a stress fracture. This can occur as the result of a sudden increase in the intensity of training, which suddenly demands too much from bones that are not used to repetitive stress. A change in equipment, such as footwear, or in playing surfaces, such as from grass to turf, can serve as the variable that also causes stress fractures.
What are the symptoms of overuse injuries?
Athletes with stress fractures usually complain of pain that seems to worsen over time. This is the first signal that the bone cannot withstand the physical stress to which it is being subjected. This pain is often felt at the time of impact. Pressing on the sight of a stress fracture will elicit great pain and there may be swelling around the affected area. As activity is modified to eliminate discomfort, the pain associated with a stress fracture should subside.
Who is most susceptible to stress fractures?
Medical studies have shown that female athletes are more susceptible to stress fractures. This is attributed to the more frequent occurrence of reduced bone density, eating disorders, and infrequent menstrual cycle in women. Athletes who participate in running sports and repetitive loading sports, such as ballet and figure skating, have a greater risk of developing stress fractures because the repetitive stress of the landing on a hard surface can cause injury.
Adolescents are especially susceptible to stress fractures because their bones are expected to support more weight while participating in more rigorous activity. In addition, growth plates, regions of developing cartilage in children’s bones that act as centers of the rapid cell production, are especially susceptible to stress fractures, increasing the risk of injury in young athletes. Although all of these factors increase the risk of injury, conditioned athletes can also suffer stress fractures.
What do I do if I develop a stress fracture?
If a stress fracture is suspected, a physician should be consulted to rule out the possibility of more serious injury through physical examination or diagnostic imaging. Like other overuse injuries, the basic treatment of stress fractures involves relative rest and avoidance of all activities that aggravated the injury while maintaining fitness by engaging in pain-free activity.
The amount of recovery time depends on the seriousness of the injury, but most stress fractures heal within 6 weeks. Recognizing the risk factors and modifying behavior accordingly is key in the healing of an overuse injury. Resuming full participation in athletics should be a very gradual process so that the bone can properly adapt to the increased load. During this process applying ice, elevating the injured area, and applying compressive wraps will reduce discomfort and inflammation.
How can these injuries be prevented?
Overuse injuries can be avoided by following safe training procedures. This can be achieved by exercising according to the guidelines below:
Gradually increase the intensity of
training. Many overuse injuries
occur as a result of a sudden
increase in the intensity in
training. Effective muscle strength
increases at a faster rate than bone
strength, which can create an
imbalance that causes injury if
exercise is increased too rapidly.
Athletes should focus on allowing
their body to adjust to more
strenuous activity to prevent
exceeded their physical capability.
Use proper equipment. Wearing
equipment that will add support to
your body during activity is very
important. Runners should make sure
to wear sneakers that are not worn
so that they have adequate shock
absorption that will protect their
bones from overuse injuries.
Include calcium in your diet. It is
important to keep bones strong and
capable of withstanding the
pressures placed on it.
Maintain appropriate muscle
strength. Proper conditioning will
provide muscular stability to the
bone during activity. Imbalance in
muscle strength can lead to overuse
injuries, so uniform strengthening
of all muscle groups should be
Athletes should pay close attention to the physical limitations of their bodies by quickly responding to pain and allowing rest when needed. It is important to recognize injuries at their earliest stages and to treat them appropriately so that play is not impeded.