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Ten Ways to Prevent Overuse Injuries

Keeping active is one of the most important ways you can help yourself stay healthy. Adults of all ages are now exercising more often and approximately 35 million children and young adults between ages 6 and 21 are involved in sports activities. With the increase in exercise and sports programs, overuse injuries have become more common.

Anyone who consistently engages in a physical routine on an ongoing basis is vulnerable to "overuse injury." These are injuries that result from repeated movements that "overuse" or cause wear and tear on the bones, muscles, ligaments, joints and nerves. Performing the same activity over and over again (such as running, throwing a ball, or lifting) can cause microscopic tears which lead to small amounts of bleeding and swelling within the injured area.

Athletes, musicians, dancers, and others who participate in activities involving repetitive or forceful movements often suffer overuse injuries. An overuse injury can also happen if you begin an activity or sport and do too much too soon.

Overuse injuries can include muscle strain, tendonitis, shin splints, stress fractures, and patellofemoral knee pain. These types of injuries are common and often occur because of a training error.

In runners, this may mean running too far, too fast, or too soon. In fact, up to 70 per cent of runners develop injuries each year.

What Factors Usually Cause Overuse Injuries?
   • Training errors are the most common cause of overuse injuries. These errors involve rapid acceleration of the intensity, duration or frequency of your activity.
   • Overuse injuries also happen in people who resume a sport or activity after being injured and try to make up for lost time.
   • There are also technical factors. Always use proper technique to avoid causing overuse injuries. Even slight changes in form may cause an injury.
   • Some people are more prone to overuse injuries, usually because of anatomic or biomechanical factors. Imbalances between strength and flexibility around certain joints predispose one to injury. Body alignment - like knock-knees, bow legs, unequal leg lengths and flat or high arched feet - are also factors.
   • People may also have weak joints or body areas due to old injuries, incompletely rehabilitated injuries or other anatomic factors.
   • Equipment - like the type of running shoe or dance shoe, and terrain – whether a surface is hard or soft – can also make a difference.

Overuse injuries may be prevented in most cases by following 10 basic principles:

   1. Set realistic goals. Always use common sense and take it easy when starting any new exercise program, especially if it’s been a while since you’ve worked out. Do not run more than 45 miles per week. There is little evidence that running more than 45 miles per week improves performance, but there is significant evidence indicating that running more than 45 miles per week increases the risk of overuse injury.

   2. Proper warm-up is key to any successful exercise program. Five to ten minutes of easy aerobic activity, pedaling a bike or light jogging should get your muscles warmed up sufficiently.

   3. Gentle stretching to the point of moderate tension and holding that position for 10-30 seconds is recommended after your muscles are warmed up. Ideally, you should stretch all your muscles, but if time is limited, then concentrate on the muscles active in your workout.

   4. Proper technique is important in any exercise program. In weight training, certified trainers are sometimes helpful in this regard. Running coaches are helpful in developing personalized running programs and good technique.

   5. Increase intensity gradually. Do not increase running mileage by more than 10 percent per week. Vary your exercise routine. Follow hard training or running days with easy days.

   6. Do not exercise or run through pain. "No pain, no gain" is nonsense. Pain is a warning sign that something is wrong and should not be ignored. Initially, ice and rest may be beneficial. See your doctor for persistent pain that doesn’t go away after one week.

   7. Rest and recovery time is vital to any program. The body needs time to recuperate and regenerate, especially after a rigorous workout. If you're feeling sick or haven’t had enough sleep, you may want to defer your workout.

   8. Proper equipment is important. This applies to a golf club of appropriate length, a tennis racket with correct grip size, quality shoes, and protective eyewear. A good pair of running shoes can do wonders to prevent injuries. Make sure to replace running shoes after 500 miles of wear since shock absorbability is significantly diminished at this point. Eye protection is also important in certain high-risk sports. 3mm polycarbonate lenses should be used in protective sports eyewear. These are the thinnest and lightest lenses available and are also impact resistant.

   9. Drink lots of fluid. Dehydration can lead to impaired athletic performance and other health consequences in the long term. Water is important before, during, and after exercise. Drinking at least 8 ounces of water before exercising is ideal.

   10. Cooling down is equally as important as warming up. Gradually slowing down allows the body to adjust and further reduces the risk of injury.

Following these principles does not guarantee that you will not experience an overuse injury but it definitely reduces your risk. Most overuse injuries can be prevented with the proper conditioning and training and by using common sense. If you have any questions about your exercise or sports activity, please consult your physician.