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.  

sportsmedicine.about.com  Definition: Chronic pain and injury refers to the sort of physical injury, ... are sometimes referred to as cumulative trauma or overuse injuries. 

emedicine.medscape.com  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. 

http://medical-dictionary.thefreedictionary.com/ 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!  

Example: 

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.  

Foot Strengthening by Mobility WOD

K Star and Brian fly through these mobility movements that are great lower leg looseners.  Watch this video a few times to get the gist, and find your own nightly mobility movements that work for you.  

The Foot Drills

The Foot Drills 

By Russ Ebbets, DC 

<We did the six drills at the start of each practice. Five of the six drills are done barefooted or in stocking feet. The distance covered for each drill is about 25 meters. Each drill is done once daily. The walking is done at one’s own pace. Total time for the drill with shoes off to shoes on is about four minutes. Pretty simple. 

The six drills, illustrated above, are simply to walk on the outside of the foot (invert the foot), walk on the inside of the foot (evert the foot), walk with a toe-in, or pigeon-toed gain (adduct the foot), walk with the toes pointing out (a la Charlie Chaplin), and with the shoes back on, walk on the heels – this protects against bruising the heel. Done daily these six drills will eliminate shin splints, Achilles’ tendonitis, plantar fasciitis, lessen the chance of a severe ankle sprain and virtually all knee problems. (The famous Rice Study done in the early 90s found that 79% of running injuries are from the knee down). 

One of the reasons I had successful teams is that my athletes made it to the competition day healthy and ready to compete. Season after season was completed with virtually no injuries. It should be noted that there are three problems with the foot drills; they are simple, they are easy, and they are free. It doesn’t involve more than taking off one’s shoes and putting one foot in front of the other. But that is easier said than done. Why do the foot drills work? There is very little muscle in the foot. 

• Most of the balance and proprioceptive sense we get comes from our muscles. 
• The neuromuscular pathway (the communication line) from the brain to the foot is the longest and slowest in the body. This leads to bad, or at best, poor coordination of the foot. If you doubt that, put a pen between your toes and try to write your name. 

The demands of athletic participation - be it running, jumping or quick starts and stops - places tremendous stresses on the foot. In fact, the foot must sustain seven times the body’s weight with simple running, and up to 20 times body weight in some jumping activities. Done repeatedly, this is how an overuse syndrome such as shin splints, plantar fasciitis or Achilles’ tendonitis develops. By challenging the foot with various gaits, one develops a clearer pathway from the foot to the brain. Clearer pathways are faster and more responsible. This gives one better balance and proprioception. Each foot strike becomes more “sure,” the foot contacts the ground without a wobble, however slight that wobble might be. It is because of the “sure foot stride” that the overuse syndrome (Achilles’ tendonitis, plantar fasciitis or shin splints) are eliminated. It has been said that running is a ground contact sport. It is this repeated micro trauma of ground strike, repeated thousands of times than can lead to injury. Other factors, such as running surfaces and proper shoe selection, can influence the incidence of injury. But I will contend with a great deal of assurance that the six foot drills, done consistently, will have a tremendous positive benefit on one’s athletic participation and performance. Applying the simple, easy and free. The last note. The foot drills will also make you faster. I mentioned the slight “wobble” of each foot strike. More accurately described, a “wobble” is lateral, side-to-side motion. Speed is generally straight ahead. If, on each foot strike there is the wobble or lateral motion before there is the forward motion, there is lost time – not much, but some. If one’s ground contact time can be reduced 1/100th of a second (it takes 14/100ths to blink an eye,) the cumulative effect can drastically improve one’s performance. Consider this – if one takes 50 steps in the 100m, 50 x 1/100 = 50/100 seconds, or ½ a second. One-half second is the difference between the 9th place spectator and the Olympic Gold Medallist. In a mile, this reduced ground contact time translates to an 8-10 second difference and in the 10K it means between 50-60 seconds. An improvement made in the blink of an eye, one step at a time. Simple, easy and free.>

Top 10 Mobility Exercises For Runners

Updated: Sep 1st 2011 10:15 AM UTC by Competitor.com

• Mobility Exercises For Runners
• 1. Unglue Your Sticks
• 2. Quads Or Spine?
• 3. The Runner/Split Jerk Dream Mob
• 4. Recovering Your Jumping Calves
• 5. Lower Leg Business
• 6. Heel Cord Love
• 7. Sumo And Medial Chain Business
• 8. Hip Extension/External Rotation
• 9. Hamstring Stiffness
• 10. Mob Those Lower Leg Bits