Overuse injuries are a common reason for clients to present to Elite Myotherapy. Put simply, an overuse injury can be referred to as a sudden increase in exercise or training load which doesn’t allow the tissues of the body time to sufficiently adapt – something our bodies are incredibly good at. For example, this Atlas Stone lift below… he likely would have required a life-time of training to adapt and complete these without injury.
A client presented to Elite Myotherapy at the beginning of June 2017 after four months of pain on the inside of his shin and foot with a goal of returning to training at the gym. He had previously been to practitioners that had provided symptomatic relief through soft tissue massage and dry needling, however not able to completely resolve his symptoms and allow him to return to training.
The management of overuse injuries includes reducing the current aggravating load, reducing symptoms and education regarding load management, and then gradually increasing strength and mobility back to pre-injury level and above.
On assessment of the patient, we found that he had experienced a harsh increase in the amount of walking prior to his injury. We also found significant weakness when completing single leg calf raises which could have been secondary to muscle atrophy from disuse – only able to complete 10 repetitions. Also, he had limited ankle movement and ‘flat-feet’ which may have been adding to the original overload of muscles in his lower leg.
In our initial sessions, we focused on reducing symptoms by providing arch support in his feet through rigid taping, which provided immediate relief with walking, alongside dry needling throughout his lower limb. We also educated on injury mechanisms, prescribed pain free isometric heel raises to begin his rehabilitation, along with self-ankle mobilisations using resistance bands.
We then progressed his exercises using therabands, weights and ultimately gym-based equipment with a focus on kinetic-chain strength and strength of the small muscles of the foot. He has now returned to full training at the gym, almost symptom free.
The take away message from this case study is that when an overuse injury occurs, it is imperative that it is properly managed by gradually increasing the load back into the injured tissue, alongside manual therapy techniques and probably most importantly – education. This education can be applied to most training and exercise programs and may help to prevent further injury by ensuring our tissues are properly adapted for our chosen goals or exercise regime.
Chris Calabrese – Elite Myotherapist