Overuse Injuries

Most clinicians agree that younger people are more prone to traumatic injuries, whereas older people tend to have a greater percentage of overuse problems. Of course, both groups get both types of injuries. The difference may be due to the biological changes that slowly occur in joints and tissues, as well as the type of activities different age groups participate in. Some of the tissue changes that occur with arthritis, especially during the inflammatory stages, are similar to those of aging—loss of fluid, decreased elasticity, and increased susceptibility to tearing (Buckwalter and Mankin 1997). The cartilage that covers joint surfaces becomes vulnerable to injury caused by tissue fatigue, which is further aggravated by lack of blood flow to the inner parts of that tissue (Hertling and Kessler 1996). Overuse injuries are related to improper equipment and exercise progression, as well as an imbalanced exercise program.

Shoes that do not provide proper support or good cushioning for the feet are a common contributor to overuse injuries. Lack of support or cushioning affects the way force is transmitted throughout the lower extremities. Shoes that allow excessive movement at the ankle are connected to knee pain, and correction of the shoes can significantly ease the pain (Hanes 1996).

Advancing your program too rapidly has been identified as one of the biggest predictors of overuse injuries, in part because of problems caused by an imbalanced program. As I discuss in the next chapter, a slow progression allows your bones and tissues time to adapt to the new stresses that unaccustomed exercise places on them. Gains in strength take time, and lack of strength around a joint can increase the stress that is transmitted to ligaments and bones, which increases the chance of an overuse reaction. An imbalanced program has a similar effect. Inadequate strength or flexibility in an area may lead to poor biomechanics and possible injury.