How to Avoid Overtraining Injuries

Overtraining is a common concern, and something that we should all be aware of (both physical therapists and clients). Learn more about overtraining injuries, how to prevent them, and get the right guidance for training from this article published on MoveForwardPT.com, an informational site created by the American Physical Therapy Association. For more questions please call at 619-756-7500.

 

Overtraining is a concern for all people pursuing fitness – from recreational or elite athletes to people who exercise to lose weight and stay in shape. Overtraining injuries are musculoskeletal injuries that occur due to more activity or exercise than your body is used to, and may happen to anyone who increases intensity or changes type of activity. Overtraining syndrome includes overtraining injuries, but also encompasses general fatigue and other symptoms.

Signs and Symptoms

If you experience any of the following after working hard to meet advanced fitness goals, overtraining may be a cause.

  • Physiological: increased resting heart rate, increased blood pressure
  • Physical: decreased appetite, upset stomach, insatiable thirst, sleep disturbances, increased frequency of sickness and infections, general feeling of increased difficulty and fatigue throughout the day, abnormal muscle soreness, pain occurs that is different than typical muscle soreness
  • Behavioral: personality changes, decreased motivation, altered concentration, lowered self-esteem, decreased ability to cope with stress
  • Performance: Increased heart rate during activity, decreased strength or endurance, impaired movement and coordination, multiple technical errors.

Avoiding Overtraining Injuries

No matter the activity (running, swimming, weight lifting, etc), when working to improve your fitness you need to push yourself in order to see results. But pushing yourself too hard can result in injuries that are detrimental to your fitness goals. Here are some tips to avoid overtraining injuries:

Don’t increase exercise difficulty level too quickly. Exercise needs to be progressed steadily at a gradual pace. Following a structured plan that increases your activity incrementally and safely can help you stay healthy and pain free. For example:

  • For running, increasing difficulty may include increasing speed, running up or downhill, increasing duration, and use of intervals, where you alternate intensity over time.
  • For resistance training, increasing difficulty may include increased weight, repetitions, sets, and decreasing the amount of time to perform the same amount of exercise.

Pay attention to your body.Your body is smart. If it feels like you are developing signs of overtraining, then take a break, lessen your activity, or rest.

Ease into it. Particularly if you are new to fitness or altering your exercise activities, take it slow. Don’t expect to make up for several months of inactivity with a few weeks of exercise. Aim for long-term consistency, not overnight success. People who try to do too much too soon often end up injured or frustrated and give up on their fitness goals altogether.

Avoiding Overtraining Syndrome

Overtraining syndrome occurs when an active individual or athlete increases activity faster than the body can adapt or is unable to recover from a sustained high level of activity. Your body then lets you know that you’ve done too much too fast through a variety of physical responses.

There are several signs and symptoms that may indicate overtraining syndrome but are also symptoms of other problems

Every active individual is unique. Your pain may be due to overtraining, but it also may be due to other health issues. For example, heart rate changes, general fatigue, and other systemic symptoms may be due to a more concerning condition. Physical therapists are educated to evaluate and treat a variety of conditions. If you have any of the above signs a physical therapist can help to determine the seriousness of the signs and what your next course of action for your health.

Here are some tips to avoid overtraining syndrome:

Take a break. If you have a scheduled rest day in your plan, use it, you’ve earned it!  Your bones, joints, and muscles need rest days to stay healthy.

Get rest. Recent studies are supporting the important role of sleep in the health of active people and athletes.  This is when our bodies’ build and repair and our immune system recovers.

Eat well. Proper nutrition is essential to the health of your body. Do not severely restrict calories when exercising. Make sure to eat proper nutrients, including plenty of lean meats, fruits and vegetables.

How will a physical therapist help me meet my fitness goals?

Physical therapists are movement experts, and work with people of all ages and levels of activity. During a visit, a physical therapist can:

  • Check your flexibility, strength, and endurance of muscles to support your desired level of activity.
  • Ensure that symptoms are due to overuse or overtraining and not something more serious.
  • Identify training errors to ensure a safe fitness plan, no matter your previous level of activity.
  • Correct biomechanical problems in form with your chosen activity to avoid overuse of a susceptible body part.
  • Provide appropriate training plan to minimize risk of injury and help you safely meet your fitness goals.

The Effects of Pronation Distortion Syndrome and Solutions for Injury Prevention

Issues starting at the foot and ankle can cause distress to other regions of the body. Read this article by Scott Lucett, MS, NASM-CPT, PES, CES who is a Senior Research Director for the National Academy of Sports Medicine for great insight on this topic! Then come see us at San Diego Sports Physical Therapy for great exercises. 619-756-7500

Dysfunction at the foot and ankle complex can lead to a variety of musculoskeletal issues in other regions of the kinetic chain that can eventually lead to injury. In this article, we’ll review the common postural distortion pattern, Pronation Distortion Syndrome, its effects on the kinetic chain, and corrective solutions to decrease injury risk.

Introduction

Pronation distortion syndrome is characterized by excessive foot pronation (flat feet) with concomitant knee internal rotation and adduction (“knock-kneed”). This lower extremity distortion pattern can lead to a chain reaction of muscle imbalances throughout the kinetic chain, leading to foot and ankle, knee, hip and low back pain.

It has been shown that excessive pronation of the foot during weight bearing causes altered alignment of the tibia, femur, and pelvic girdle (Figure 1) and can lead to internal rotation stresses at the lower extremity and pelvis, which may lead to increased strain on soft tissues (Achilles tendon, plantar fascia, patella tendon, IT-band) and compressive forces on the joints (subtalar joint, patellofemoral joint, tibiofemoral joint, iliofemoral joint, and sacroiliac joint), which can become symptomatic (1,2). The lumbo-pelvic-hip complex alignment has been shown by Khamis to be directly affected by bilateral hyperpronation of the feet. Hyperpronation of the feet induced anterior pelvic tilt of the lumbo-pelvic-hip complex (3). The addition of 2-3 degrees of foot pronation lead to a 20-30% increase in pelvic alignment while standing and 50-75% increase in anterior pelvic tilt during walking (3). Since anterior pelvic tilt has been correlated with increased lumbar curvature, the change in foot alignment might also influence lumbar spine position (4). Furthermore, an asymmetrical change in foot alignment (as might occur from a unilateral ankle sprain) may cause asymmetrical lower extremity, pelvic, and lumbar alignment, which might enhance symptoms or dysfunction. An understanding of this distortion pattern and its affects throughout the kinetic chain becomes particularly important for recreational runners and walkers as the accompanying stressors to the soft tissues and joints can lead to Achilles tendonitis, plantar fasciitis, IT-band syndrome, and low back pain.

Assessment

When assessing for pronation distortion syndrome, both static and dynamic assessments can be done. When performing either a static or dynamic assessment, have the individual take their shoes off and make sure you have the ability to see their knees as well. During a static assessment, from an anterior and posterior view, look to see if the arches of their feet are flattened and/or their feet are turned out. When performing a dynamic assessment, such as the overhead squat, look to see if the feet flatten and/or turn out and if the knees adduct and internally rotate (knee valgus). These compensations can also be assessed both from an anterior and posterior view. For many, it’s easier to see excessive foot pronation from a posterior view in comparison to an anterior assessment, so assessing in both positions can help in confirming your findings.

Corrective Exercise Strategies for Pronation Distortion Syndrome

Functionally tightened muscles that have been associated with pronation distortion syndrome include the peroneals, gastrocnemius, soleus, IT-band, hamstring, adductor complex, and tensor fascia latae (TFL). Functionally weakened or inhibited areas include the posterior tibialis, anterior tibialis, gluteus medius and gluteus maximus. Following NASM’s Corrective Exercise Continuum programming strategy can help address these muscle imbalances that may be contributing to the distortion pattern (5). First, inhibit the muscles that may be tight/overactive via self-myofascial release. Key regions that should be addressed would include the peroneals, gastrocnemius/soleus, IT-band/TFL, bicep femoris and adductor complex.

The next step is to lengthen the tight muscles via static stretching. Key muscles to stretch include the gastrocnemius/soleus, TFL, bicep femoris and adductor complex. Hold each stretch for a minimum of 30 seconds perform 1-2 sets of each stretch.

Once the overactive muscles have been addressed, activate the underactive muscles. Key areas to target with isolated strengthening are the anterior tibialis via resisted dorsiflexion, posterior tibialis via a single-leg calf raise, gluteus medius via wall slides and gluteus maximus via floor bridges. Perform 1-2 sets of 10-15 repetitions.

Finally, perform an integrated exercise to improve muscle synergy to enhance neuromuscular efficiency and overall movement quality. An example integration exercise would include a multiplanar single-leg balance reach while maintaining neutral foot and knee alignment. Perform 1-2 sets of 10-15 repetitions.

Summary

Pronation distortion syndrome is a common lower extremity postural distortion pattern that can lead to other movement dysfunction patterns throughout the kinetic and ultimately injury. By incorporating static and dynamic assessments of the foot and ankle complex can help to identify this distortion pattern. Once identified, following a systematic corrective exercise strategy can help to improve functionality and movement quality, leading to decreased risk of injury.

References

Powers, C.M. (2003). The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. Journal of Orthopedic & Sports Physical Therapy, 33:639-46.
Powers, C.M., Chen, P.Y., Reischl, S.F., & Perry, J. (2002). Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot & Ankle International, 23:634-40.
Khamis, S., & Yizhar, Z. (2007). Effect of feet hyperpronation on pelvic alignment in a standing position. Gait Posture, 25:127-34.
Levine, D., & Whittle, M.W. (1996). The effects of pelvic movement on lumbar lordosis in the standing position. Journal of Orthopedic & Sports Physical Therapy, 24:130-5.
Clark, M. C., & Lucett, S. C. (2011). NASM Essentials of Corrective Exercise Training. Baltimore, MD: Lippincott, Williams and Wilkins.
– See more at: http://blog.nasm.org/fitness/the-effects-of-pronation-distortion-syndrome-and-solutions-for-injury-prevention/#sthash.l1qfwl4p.dpuf

Walking Aids

If you’re using any walking aids, make sure you’re using the correct form by reading this article from MoveForwardPT. Then come see us at San Diego Sports Physical Therapy for more help today!

Physical therapists, who are experts in restoring and improving motion, recommend that elderly adults who use canes and walkers as walking aids be properly assessed and fitted by a physical therapist to avoid fall-related injuries.

With emergency rooms experiencing 47,000 fall-related visits annually from senior citizens due to improper use and fit of walking aids*, assessment by a physical therapist can help reduce the number of these dangerous incidents by ensuring appropriateness and proper fit of the walking device.

Tips for Using Walkers and Canes:

The walker or cane should be about the height of your wrists when your arms are at your sides.
When using a walker, your arms should be slightly bent when holding on, but you shouldn’t have to bend forward at the waist to reach it.
Periodically check the rubber tips at the bottom of the cane or walker. Be sure to replace them if they are uneven or worn through.
Physical therapists also advise against borrowing walking aids from friends and family. This often leads to improper fit and misuse, and can result in further injury. Your physical therapist can also evaluate your walking aid and determine if it is in proper working condition.

Find a physical therapist in your area.