ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, July 23, 1996 TAG: 9607230025
SECTION: EXTRA PAGE: 3 EDITION: METRO
COLUMN: Personal Health
SOURCE: JANE BRODY
As millions of recreational runners, tennis players, golfers and swimmers have sadly discovered, you do not have to be training for the Olympics to suffer the pain and physical limitations of overuse injuries. Among the walking wounded are runners with shin splints, stress fractures and Achilles tendinitis; racquet and club swingers with tennis and golf elbows; and swimmers with sore shoulders.
Many try to play through their pain, unwilling to interrupt their activities and hoping against hope that whatever is wrong will work itself out. But all they do is make matters worse.
Typically, they further complicate their injuries and lengthen the amount of time it takes to heal. For example, by trying to run despite shin splints, which are injuries to the calf muscle where it attaches to the bone, you risk developing a stress fracture in the shinbone.
Pain talks, and you would be wise to listen. Pain tells you that something is not right with your body and how you are using it. It is a signal that your body is working against itself.
Coping with the pain is not just a matter of popping over-the-counter painkillers and icing down the injured part after your workout. Getting rid of the pain requires the proverbial R and R, rest and rehabilitation, and, most likely, adjustments in how you perform your activities, including the intensity with which you pursue them and the equipment and techniques you use.
Overuse injuries result from repeated microtrauma, causing inflammation and sometimes tissue damage. Without sufficient rest between activity sessions to permit healing, these mini-injuries finally add up to a big hurt, which diminishes performance and eventually makes it impossible to continue the activity.
Repeated tissue damage that is not given the opportunity to heal can result in hairline fractures, inflamed joints and muscles, strained ligaments and torn or inflamed tendons. Those with a high tolerance for pain or a stubbornness that will not let them quit, even temporarily, can suffer injuries that ultimately sideline them for months or impair them permanently.
To many of the afflicted, it just does not seem fair. Companions who pursue the same activity with equal or greater vengeance seem able to keep at it month after month, year after year, without being injured. Why should some be singled out to suffer? Contributing causes come both from within the athlete and from outside influences.
Some people have biomechanical abnormalities that increase their vulnerability to overuse injuries. For example, runners whose feet pronate - that is, the arch falls inward with each step, which slightly twists a bone in the lower leg - are at increased risk of shin splints and stress fractures. Many people have muscular imbalances or weaknesses that result in uneven stresses on their joints, increasing the risk of injuries such as strained ligaments in the knee, inflamed shoulders, Achilles tendinitis and tennis elbow.
One of the most common biomechanical factors leading to chronic microtrauma is an inherent inflexibility that is compounded by a behavioral factor: the failure to do adequate stretching exercises before and after activities that stress muscles and joints.
For example, running, basketball and hiking tighten the calf muscles, which in turn strains the Achilles tendon each time your foot pushes off the ground. Eventually, this strain can add up to Achilles tendinitis, a degeneration of this vital band of tissue, which connects the heel bone to the calf muscle.
Another common problem is the failure to get into shape before plunging into a stressful activity. Nearly all sports activities favor one set of muscles over another. The overused muscles are subject to chronic fatigue, leading to weakness, a loss of flexibility and eventual injury. The underused muscles become relatively weaker with time, placing the tissues in adjacent joints at risk of injury.
Errors in technique and the wrong choice of equipment are common factors in injuries such as tennis elbow, which occurs when a tendon degenerates because of chronic stretching beyond its ability to recover.
Reducing the risk may require changing to a racquet with a properly fitted grip and less stiff frame, along with a few lessons on how to stroke the backhand properly and perhaps, when playing, the use of a small brace just below the elbow.
To head off overuse injuries, be sure you are in good enough shape to take up your chosen activity, be it tennis, running or hiking. Start slowly and build up gradually.
In addition to practicing the particular techniques that your sport or activity requires, you should be building muscle strength and flexibility. Overall strength and flexibility training is as important for weekend athletes and ordinary exercisers as it is for Olympic competitors. So is an adequate warm-up before plunging into vigorous activity.
Changes in the frequency, duration and intensity of your activity should always be gradual. Do not expect to be able to run a marathon within three months of starting to run. Or, after years of weekend tennis, do not expect to survive a two-week stint at a tennis camp intact.
Alternate your activity days with days taking a break from that activity; on those off days, you can do an activity that uses different muscles. For example, you might alternate running with cycling or swimming. Those who do the same strenuous workout day after day keep damaging the same tissues without giving them adequate time to heal.
If an activity leads to discomfort, do not ignore it. The sooner a proper diagnosis is made and treatment is begun, the faster you will be back at the game. Consult a physician specializing in sports medicine, who should be able to zero in on the likely cause.
The doctor is likely to prescribe anti-inflammatory pain medication, icing of the injured part and definitely some time off from the activity that is causing the problem. In the meantime, however, other activities should be recommended to maintain muscle strength and flexibility.
A referral to a physical therapist for rehabilitation and conditioning to increase fitness is often the quickest - and most lasting - route to a speedy return to a favorite activity without risking further injury.
You may also benefit from some mechanical aids, such as orthotic devices in your shoes, new shoes, a brace or tape for the injured area, a new racquet, a different playing surface or professional instructions on how to use your body to avert injuries.
Once you are free of pain and get the go-ahead to start your preferred activity again, it is crucial to begin slowly, with low-intensity workouts, and to build up gradually, over weeks or months, to your former level.
LENGTH: Long : 117 linesby CNB