How do I know if I'm injured? A look at overuse injuries.

We all have aches and pains that seem to sometimes come out of nowhere. Obviously, if you have a traumatic injury, you usually can tell if something is wrong or not (swollen and bruised ankle sprain anyone?) but what about the knee pain or elbow pain that just starts without any big event or injury.

We're going to dive into what an overuse injury is. This is one of the most common things we see as PT's. The good news is, they respond well to physical therapy and often don't require any imaging (MRI, x-ray, etc), medication, or surgery.

Overuse injuries happen because a load (exercise, new or increased repetitive activity) exceeds the ability of the tissue (tendons, ligaments, muscles, joint surfaces, bones) to heal. Your body is made to adapt. Applying loads to it help get it stronger. That's why things like lifting weights make you sore but ultimately help you build muscle bulk. The same thing happens to your other tissues, it's just much more slow than muscles. This is why often times when we hear about words like 'tendonitis,' or tendinopathy as we now call it - one of the most common overuse injuries. Overuse injuries can range from very mild to severe and acute to chronic. We'll have more on that for you later.

You see, tendons and other tissues besides muscle have much less blood pumping through them all the time than our muscles do. That blood flow through the tissue is what helps it heal when you overload it and break it down (again, a normal thing that happens and makes our tissues stronger). That can quickly get out of balance though if you're doing too much too quick. You end up breaking the tissues down faster than they can heal. This leads to pain, abnormal movement patterns, inability to perform exercise and eventually pain all the time, even with normal daily activity. If left untreated, it can result in tears or stress fractures.

If these overuse injuries are given rest and time, they will feel better, but really won't truly heal all the way without some rehab. The typical report we get from a patient goes something like this...

"I've been running a lot more lately and my Achilles tendon started to hurt. I ran through it for a while then it got so bad that I had to stop. So I gave it rest for a few weeks and the pain went away but as soon as I started running it came right back."

That tendon (or other tissue) needs more than just rest in order to heal. It needs some physical therapy. You see, overloading of tissues like tendons causes breakdown and pain, but those same tendons need loading in order to heal, just in a very specific way. Your physical therapist can help guide you through that and get you on the right track. You PT can also identify other things such as weakness or mobility problems that might cause too much load on a tissue in the first place, accelerating the process of breakdown.

Check out the video (from our YouTube Channel) below from Max Emery, our PT at our East Nashville clinic as he discusses the different stages of an overuse injury and what to do about it if you're in a particular stage.

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