Overuse what? …
‘It’s an over use injury’, ‘just a little RSI’, or ‘your pain is caused by CTD’
Errrrrrm, well if my therapist has said any of those to me a few years ago I’d have smiled and nodded and still been a little confused as to what was exactly wrong, but the answer is as simple as this
Overuse syndrome is also called Cumulative trauma disorder (CTD) or Repetitive strain injury (RSI), it is a chronic irritation to a body part caused by Micro-trauma.
Micro-trauma is an umbrella term given to small/microscopic tearing of the muscle fibres, the protective sheaths surrounding muscles and the connective tissues, it can also occur in tendons and as microscopic cracks in bone.
Micro-trauma causes a low level of inflammation and bleeding that cannot initially be felt or seen.
It can occur in muscles when they are put under stress or load, and the muscle fibres exceed their optimal loading threshold, like when exercising, playing sport, doing an active hobby or job.
When micro-trauma occurs in the muscle fibres, the cellular cascade of tissue healing is activated, beginning with the inflammatory (acute) stage of healing that lasts approximately 72 hours, when the muscle is then put under load or stress again within that time frame, further micro-trauma can occur disrupting the natural healing process, causing the inflammatory stage of the healing process to be activated again.
Due to the fact that the initial inflammatory response to micro-trauma cannot be felt or seen, a person can repeatedly put excess load/stress through/on a muscle on a regular basis, each time causing further micro-trauma and inflammation, causing the injury rate to exceed the rate of healing. If the muscle is repeatedly loaded without adequate healing time, micro-trauma and inflammation will continue to increase until signs and symptoms of inflammation can be felt, pain, swelling, heat, redness and dysfunction, or the fibres will reach and exceed their optimal loading threshold, resulting in a strain.
The cumulative, repetitive load can also lead to reduced, blood supply, reduced function of peripheral nerves, excessive tissue inflammation, scaring, cell compression, extracellular matrix degradation, muscle fibre loss and cell death.
These changes in the muscle could cause fibre discontinuity, biomechanical irritation, loss of strength, compliance, flexibility, sensory motor feedback, endurance and excessive fatigue.
This is the type of injury that is commonly referred to as an overuse or repetitive strain injury (RSI), these injuries are most common in top level athletes, but can develop in any person who exercises or trains frequently i.e. daily. Or perhaps with more fine motor skills like mouse work at a computer, smart phone usage or excessive time on the Playstration or Xbox! Some sports carry a greater risk of an athlete developing an overuse/RSI injury e.g. long-distance running, and sports that required skilled technique and repetitive movements such as gymnastics, tennis, martial arts and weight lifting.
Over use/RSI injuries can also develop through postural imbalances, change in equipment (i.e. shoes) and improper technique, as well as occupations and hobbies(activities) that involve forceful, rapid, stereotypical, or alternating movements.
Below are some example of these:
Hand & Wrist
Overuse of the hands and wrists are common with many daily activities. Whether you work a desk job at a computer, or are a manual labourer, our hands are doing the routine activities that we all need for most any activity.
As a result, hand and wrist overuse syndrome are a common concern and a frequent source of pain.
- Carpal tunnel syndrome
- Wrist or thumb tendonitis
The elbow joint is a complex joint that combines several different motions. While it is a hinge that bends back and forth, it also allows rotation of the forearm. It is the attachment of the forearm muscles and wrist tendons that are critical to sports and lifting activities.
- Golfers Elbow
- Tennis Elbow
The shoulder joint has the biggest range of movements available in the body. Because of the complex movements, the shoulder relies on muscles, tendons and ligaments to work together to guide the joint through these motions. As a result, overuse tendonitis of the shoulder is very common.
- Rotator cuff tendons
Hips are subjected to large forces by supporting the weight of the body, and direct pressure when sitting or sleeping.
Overuse syndromes can cause pain with every step you take and can prevent you from daily and recreational activities.
- Snapping hip syndrome
- Hip bursitis
Knee & Leg
Knee and shin problems are common sources of overuse problems, especially in competitive and recreational athletes. Sporting activities place significant stress on the knees and legs.
While most workplace problems can be relieved by rest, the only way to limit sports overuse problems is to avoid the sport.
- ‘Shin splints’
- Stress fracture
- Chondromalacia of the knee cap
Foot & Ankle
Until we experience pain we often take our feet for granted, just about everything we do requires us to get from point A to point B. Because of this, overuse problems of the feet can be significantly limiting.
- Achilles Tendonitis
- Tarsal Tunnel Syndrome
- Posterior Tibial Tendonitis
How do we treat these?
Some initial brief / relative rest to initially calm the inflammation, ice, and gentle soft tissue work to mobilise the area, followed by a rehabilitative strengthening programme that’s progressive, starting with light, basic resistance to the damaged structures and building this up gradually, loading the tendon or straining/inflamed structures, so that they have chance to strengthen, heal and adapt to the forces and loads placed upon them, without overloading and re-instating the inflammatory process again.
If you think you have some type of RSI, then please do not hesitate to contact the team at Pea Green Physio, we can start with a mini injury assessment or MOT for £20 to diagnose and give some advice to get you started on the road to recovery!
If you’re a student, then please feel free to enter our July 2018 competition, we are offering a FREE MOT and 30 min Sports Massage via our FACEBOOK page for 3 lucky students, whether you’re studying GCSE’s, A’Levels or Degree or equivalent if you have an RSI or pain due to studying or know someone who deserves this prize you can enter! www.facebook.com/peagreenphysio
To book in for an MOT or treatment call Serena & the team on 01869241411
Or email: [email protected]
Blog written by Caroline Kinnane – Sports Massage Therapist
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