Saturday, January 5, 2013

Overuse Injuries

Oh how i enjoy taking two sides of an issue to see which explanation is the more supportable (it's a science thing).  Sometimes the counterintuitive explanation is the correct one.  Knowing this, and knowing 'words have meaning' - we enjoy picking apart words, diagnoses, explanations, etc…

We can't help but chuckle when hear the term "overuse injury" used to 'describe' running injuries.  In googling it (in quotes) gives you about 83,500 results.  The top 3 are definitions.  Definition: Chronic pain and injury refers to the sort of physical injury, ... are sometimes referred to as cumulative trauma or overuse injuries.  Overuse injuries, otherwise known as cumulative trauma disorders, are described as tissue damage that results from repetitive demand over the course of time. The term refers to a vast array of diagnoses, including occupational, recreational, and habitual activities. Overuse injury
Sports medicine A sports- or occupation-related injury that involve repetitive submaximal loading of a particular musculoskeletal unit, resulting in changes due to fatigue of tendons or inflammation of surrounding tissues; OIs include tennis elbow and golf elbow. 

From emedicine: "cumulative trauma" sounds more like blows from a hammer than feet landing on the ground doing something as natural as running.  We assumed these definitions might be silly because it is so common to describe running as feet slamming on the ground, or pounding the pavement.  But obviously, some of us realize running has been with humans for millions of years - an adaptation used to survive.  Running is as natural to humans as breathing, or the muscles used to balance or stand; or having a beating heart.  These are muscle contraction too and not likely to hurt or be sore due to 'overuse'.

If you've been running non-stop since childhood with a form that is natural to the variable compliances of the muscles and tendons at your natural cadence with appropriate protection yet proprioception- we DOUBT seriously that you'll have an injury from overuse!!  It's more aptly an issue of underuse.

An explanation or diagnosis of an injury, condition, whatever must have the distinction between proximal cause, ultimate cause, fundamental cause.  There are chains of causes some proximal, some ultimate.  Some medical professionals have fancy terms for things that nothing more than a regurgitation of the symptoms.  " i have pain in my foot arch"  "oh you have plantar fasciitis"   which is what you said to them!  

I am hurt due to an inflammation of a tendon, that's proximate.  The tendon is inflamed because of a muscle imbalance, that's an ultimate cause.  There is a muscle imbalance because of a form issue, biomechanics, leg length discrepancy, neuromuscular disconnect, or simply NO feedback mechanism of your bad form due to your overly cushioned shoes.  
Think about it, and don't settle for lame diagnoses.