You have some kind of overuse injury, whether it’s tennis/golfer’s elbow, shin splints, jumper’s knee, Achilles tendinitis or something else. Sometimes it’s just annoying. Other times, it’s downright painful, and in some cases, debilitating. You’ve tried rehab, but either saw no progress, pain reduction for a couple of days, or no help whatsoever. Very frustrating.
Original source: here.
So what’s the right approach to take to overuse injuries? That’s exactly what we’ll cover in this article.
You’ll learn:
- Why overuse injuries happen.
- The most common mistakes people (including professionals) make when it comes to rehabbing overuse injuries.
- The 2-phase plan that I recommend to recover from overuse injuries faster than you would otherwise.
Why Overuse Injuries Happen
The reason for overuse injuries is right in the name – you used your muscles, tendons, and/or bones, more than their capacity to be used. Or you gave them too little recovery before using them again.
Let’s hypothetically say that your tendons have the capacity to endure 100 repetitions at one time. As long as you stay below 100, you’re fine. Once you start crossing over 100 on a regular basis, your tendons don’t like you anymore (but don’t worry – I still like you ), and they’re going to hurt you as a message to literally “give it a rest.”
Mistakes in the Recovery of Overuse Injuries
Mistake #1: Not Changing Anything
There are certain motions that caused the overuse injury. The most obvious, sensible, and yet neglected thing to do is to stop or replace the motion that caused the injury. Rest is really underrated (as we’ll talk about in the next section).
It stands to reason that if you continue to repeat the motions that caused the overuse injury in the first place, you’ll either perpetuate the injury, or worsen it. So stop it.
I get that it can be tough, because some movements are so ingrained into your daily life that you often do them without thinking about them – until the pain kicks in – but you need to figure out alternatives to the painful movements.
Case in point. About 3 years ago, I had tennis elbow. What caused it was obvious – tennis. So I stopped playing tennis for a while. But tennis wasn’t the only thing that aggravated it. I noticed that my tendon also hurt when I was putting on my seatbelt, and when I was holding the kettle. The solution was simple – use the other hand to do it.
People unfortunately focus on doing “good stuff” (like rehab, massage, acupuncture, etc.). That’s important. But just as importantly (or even more so), is to avoid doing the “bad stuff” (anything that aggravates it). Imagine you have water pouring into a bucket. But that bucket has a hole in it. Do you pour more water (add in more rehab), or plug the hole (stop doing things that aggravate that body part)? You want both. Because if you’re just doing rehab without resting that body part, your recovery will be much longer than it needs to be.
Mistake #2: Not Resting Enough
Piggybacking on the previous point, one thing you have to do is avoid the movements that aggravate the injured body part. The other part is resting long enough for the inflammation to subside.
After a long battle with overuse injuries, most people will notice that the injured area doesn’t hurt anymore. In that recovery time, the inflammation subsided, but the muscle strength and endurance of the related muscles also declined. So now, it’s going to take even fewer repetitions of the offending activity to trigger the overuse injury again. But the rest period (and with it, the loss of strength and endurance) is necessary.
After the pain subsides, people resume the activities that injured them too soon. Then they’re back to square one. For lots of people, this becomes a lifelong battle. But it doesn’t have to be.
Tendons and bones take way longer to heal than muscles. Because of that, you need to rest longer than you think. Once the tendon or bone doesn’t hurt anymore, wait another month before resuming part 2 of rehabilitation (we’re getting to what “part 2” is).
Mistake #3: Not Exercising Enough
You know how overuse injuries are when you’ve used a part of your body more than it’s capable of being used? One solution is to stay below its capabilities. The other solution is to raise its capabilities. Ideally, you do both.
Let’s go back to our example of the tendon that has a capability to endure 100 repetitions. You might have used that tendon 105 times. So the tendon become sensitive, and its capability is reduced to 98 repetitions. But you keep using it 105 times. So it gets even more sensitive, and its capability is reduced to 96 repetitions, and that keeps going. Until it hurts so much, you’re forced to rest.
As you rest, the endurance of the tendon recovers, but not quite back to where it was pre-injury. Once you’re pain-free for a month, it’s time to improve the endurance of that muscle and tendon. So you improve its capability from 100 repetitions to maybe 120 repetitions.
To sum up, that brings us to…
The 2-Phase Plan to Rehab Overuse Injuries
Phase 1: Aggressive Rest
Seems like an oxymoron, doesn’t it? How can rest be aggressive? We’ll cover that in this section.
But hopefully by now, I’ve made a good case that rest is important. It’s not just a passive activity you do. It helps your tendons, muscles and bone regain their endurance.
The more you keep aggravating those structures, the more you’re standing in the way of the body’s recovery.
First, take an inventory of all the activities (no matter how small) that aggravate your injury. Again, in the case of my tennis elbow, the big thing that made it worse was tennis. But there were other smaller things like putting on my seatbelt, holding the kettle, and others.
Which activities bother your injury? Make a list of them, and come up with an action plan to avoid them or modify them.
The “aggressive” part of “aggressive rest” comes in the form of everything you can do to reduce the inflammation ASAP.
One example would be to offload the overworked structures. For instance, if it’s tennis/golfer’s elbow, you can use an elbow sleeve.
Another powerful anti-inflammatory modality is near infrared laser. One systematic review found it to speed up recovery from overuse injuries. It’s not the cheapest thing in the world, but a few years ago, I bought a Red Rush 360 for my own home use, and have been glad I did. Another effective technique is cross-friction self-massage. The key is frequency. You have to do it for about 2 minutes, 3-6 times per day.
Using aggressive rest techniques, you can seriously cut down on the time it takes to recover from overuse injuries.
Phase 2: Strength Training
Finally, after your tendons, bones and/or muscles have recovered from the inflammation of the overuse injury, they’ve lost some of their strength and endurance due to disuse (which was necessary to reduce the inflammation). It’s now time to firstly, restore the lost endurance and strength. But we don’t just want to go back to our previous levels. We want to exceed those levels, so that there’s a greater buffer between the number of repetitions that we do, and the number of repetitions that we can tolerate.
I can’t cover specific exercises in this article, since there are lots of different overuse injuries, and each injury has its own muscles to be strengthened, but just conceptually, that’s what needs to be done.