Overuse Injuries - What Causes Them and How to Avoid Them - Part 2

Overuse or repetitive motion injuries are the result of repetitive forces that overtime create so much stress that the tissues finally fail partially or completely. This type of injury is different than sports injuries that are the result of an acute or sudden force that is too much for the tissue to overcome (e.g. a sprained ankle or broken bone). Most parents, coaches and athletes do not readily understand overuse injuries or know how to prevent them from occurring.

As we discussed in Part 1 of this series we mentioned there are three major causes of overuse injuries, particularly in running. The last article discussed increased training load or volume as the first cause of these types of injuries and what a runner should do to prevent this type of injury. In this article we will discuss inadequate warm-up as cause of overuse injury.

A muscle that is not warmed up is less elastic and therefore when put under greater forces like doing tempo or speed work will tear more easily or result in more forces to the ligaments causing them to tear (sprains/strains and tendonitis injuries). Many individuals especially runners have been falsely lead to believe that stretching before they run will help to prevent injury. Unfortunately, the science on this practice is not convincing. Furthermore, any time you attempt to stretch or elongate a muscle when it is not warmed up you run the risk of tearing or injuring the tissue.

So, how should one go about warming up for running or any other sport for that matter if stretching is not the answer. It is not that stretching is bad, it is just that if done to aggressively before there is adequate blood flow in muscle it can lead to injury. Regardless of the sport all activities should begin with lower intensity movements that help to increase blood flow to all muscles that will be in potential use. Easy jogging or cycling for at least 5-10 minutes serves as a good warm-up for almost any sport and prepares the body for more intense running. Vigorous stretching should not occur until after some light warm-up has taken place. I recommend very little stretching if any at all until you have run for at least 5 minutes.

The use of a medicine ball or foam roll to lightly and rapidly roll over the muscles to be used helps to increase blood flow and serves as a good warm-up prior to activity. Once you have completed foam rolling and then 5-10 minutes of easy jogging or shadowing the movements of the activity you are going to be training, then it is okay to stretch the major muscles involved. However, even now the purpose of the stretching prior to begin the intense phase of running or any other activity is to prepare the muscle for that activity, as opposed to trying to improve overall flexibility. So, if one were going to do speed work, after the brief jogging period performing some high knee running, strides and butt kicks will help to move the muscles into a greater range of motion, just like a stretch does, and prepares it for the faster running that is about to occur. If you were going to be sprinting or hurdling the use of ballistic or bouncing type stretches would actually be most appropriate for the activity, provided you have gotten some blood to the muscle first.

So, warming up properly usually does not start with stretching and ideally uses an activity that will bring blood to the area first and then stretch the muscles or attempt to mimic the activity to be performed. Once your are finished with your activity this is actually the best time to attempt to stretch for improving overall flexibility. At the end of your run the muscles are warm and full of blood and can be stretched further than at any other time.