Overuse Injuries - What Causes Them and How to Avoid Them - Part 3

In the last part of this three part series I will discuss the effects of biomechanical imbalances in the body and improper running technique on overuse injuries. These probably accounts for at least 50% of all sports overuse injuries. A biomechanical imbalance is any imbalance in musculature, ligament laxity or bony architecture from one side of the body as compared to the other (e.g. right leg vs. left leg). Many people ask isn't it common to have on leg shorter than the other? Certainly it is, but most are not aware that the greater the difference and the more stress imposed on that imbalance the greater the risk of injury.

I have lumped technique imbalance together with biomechanical imbalance because having a biomechanical imbalance almost always leads to improper technique (whether it is running, throwing, kicking, hitting, swimming, etc.). Prior to causing improper technique or injury, biomechanical imbalance almost always results in decreased performance and/or more effort required to receive the same result. In addition, the longer someone performs a sport using improper technique the greater the stress on the body resulting in a biomechanical imbalance. Realize that even with proper technique the more years spent doing a sport the greater likelihood of muscle imbalances leading to biomechanical imbalance.

So how does one go about identifying and preventing biomechanical imbalances and poor technique. Making sure you have proper equipment, e.g. shoes to correct pronation if you are an overpronator is a pretty basic example for runners. Performing running drills that focus on proper leg and arm movements like strides, butt kicks and high knees can help to train proper muscle firing patterns for runners. For major deficiencies in the foot, knee or leg the use of a custom orthotic or shoe lift from a qualified doctor or pedorthist may be necessary to run pain free. Make sure to have your spine and trunk muscles checked for misalignments as irritation here can result in tight and/or weak leg muscles leading to imbalances and then changes in running form resulting in injury. Good overall conditioning and muscle tone will allow the body to compensate for biomechanical imbalances for longer periods of time before symptoms or injury occurs. However, the number one prevention tool is earlier detection and correction or awareness of the biomechanical imbalance during training.

It is important for runners to have methods to aid in the early screening of biomechanical imbalances. The following is meant to be a guideline to help detect these imbalances. If detected it is important that they make their sports chiropractor or physician aware of any potential imbalances.

Home detection methods: We'll start at the feet and work our way up.

Pain that occurs every time a person does a specific activity is a pretty good indication that there is some imbalance or injury, even if it goes away part way through the activity.

Feet:
a) examine the soles of all tennis shoes for uneven wear patterns. Excessive wear on the balls or outer portion of the heel or uneven wear from one side to the other is an indication of a possible foot problem.
b) With the shoes off can you slide your finger an equal distance under both medial arches? From the back does it look like the Achilles bows in from one side to the other? Both of these can indicate fallen arches
(Failure to address can lead to ankle sprains, heel spurs, plantar fascitis, Achilles tendonitis, knee or hip problems)

Knees: Standing in front of a mirror look at the knee caps - do they look like they are sitting in the same place on each leg or is one higher, more medial, etc. Do the legs look bowed or knocked kneed? These imbalances can lead to chronic knee sprains, hamstring or quad pulls or Achilles tendonitis.

Put both feet together and then sit down in a chair without moving the feet. Look from above at the point on each lower leg just below the knee cap. Does one leg seem to be closer to you or stick out more than the other. This can be due to a hip or lower back misalignment and can lead to back, hip, knee or foot problems.

Pelvis and Spine: Since all of the major muscles attach to the spine and pelvis it is essential that there be good balance from side to side. Any spinal imbalance can create muscle pulls, sprain/strains, tendonitis, or neurological conditions including subtle muscle weakness. In addition, spinal imbalance can result in problems in any of the extremities as a result of the imbalance in muscles and ligaments leading to abnormal stress or due to nerve pressure. Unfortunately, there isn't enough space in this article to cover all the screening tests available for the spine.

In conclusion, being aware of subtle imbalances and having a good chiropractor or sports doctor to help you do this can go a long way in early detection and prevention of overuse injuries. In addition, practicing good technique also is extremely helpful in preventing overuse injuries.