They say insanity is doing the same thing over and over and expecting
 a different result.  Simply resting an overuse/chronic injury until it 
feels better then 
returning to sport only to see the problem arise again is (by 
definition) unnecessarily insane.  Resting and resolving symptoms won't necessarily correct an injury brought on by mechanical overuse.  The repeating stresses that bring on 
overuse injuries in an athlete must change, or the same resulting 
repeating injury will occur; to think otherwise is plain crazy (pun 
intended).  When an injury occurs, most athletes are told to treat the 
area with some type of physical modality to reduce their symptoms (i.e. 
ice, ultrasound, electrical stimulation, etc.), rest, and return to 
activity when feeling better.  They treat the resulting symptoms instead
 of addressing the source of the problem, return to activity, and, at 
some point, incur the injury condition again.  This is the insanity of 
chronic injuries. If you are in this category, there steps to take to 
stop the madness........
As athletes at all levels are 
now training year-round at higher and higher levels to achieve better 
performance, there is an inevitable accompanying risk of injuries to 
soft tissues.  Muscles, ligaments, tendons, and bones subjected to 
stresses that exceed their capacities result in injuries.  Sometimes 
this is an acute strain, but more often than not, it is a gradual onset 
of pain that eventually disrupts workout patterns and routines if not 
handled correctly and/or rested.  Ultimately, overuse injuries are 
caused by mechanical inefficiencies and/or imbalances of the body.  We 
all have differing areas of mechanical inefficiencies and thus have 
varying areas of soft tissue overload. This is why two people performing
 exactly the same workouts might have two different areas of soreness or
 injury following a workout. It is also why treating or rehabilitating 
an injury with the same methods for two different people might not yield
 maximum recovery results for both athletes.  Injury treatment regiments
 and injury rehabilitation programs should be individually constructed 
for every person, addressing the source of their problem to help reduce 
their symptoms and developing a specific plan accordingly.
In
 any soft tissue/overuse type of injury, determining the mechanical 
causes and developing correction strategies is the biggest challenge for
 the sports medicine specialist. What causes IT Band Syndrome in one 
athlete might be different than the cause of the same condition in 
another.  The same holds true for patellar tendonitis, plantar 
fasciitis, metatarsal stress fractures, SI joint/back pain, etc.  
Athletes should be leery of a particular technique, product, or method 
that claims to "cure all of problem X".  There is no shortage of 
products being advertised reporting to be the complete remedy for all 
sorts of sports related maladies.  Pick up any fitness related magazine,
 and you will find the supposed sure fire cure for whatever sports 
related injury you might have.  Sadly, there are no immediate shortcuts 
to solving a chronic injury problem.  Most of these products can assist 
in treating the symptoms of injury and get pain to subside in the short 
term, but long term, the problem will most likely return unless other 
changes are made.  Some products can help to correct the mechanical 
problems leading to injury, but must be used specific to the injury 
condition to be effective.  It all seems quite confusing and leaves many
 people with chronic injuries feeling hopelessly helpless.
If
 you suffer from repeated injuries in particular areas, there are five 
general rules to follow to guide you to a maximum recovery with smallest
 chance for repeated injury:
1. Identify a sports 
medicine professional qualified and experienced in diagnosing mechanical
 problems and muscular imbalances in athletes and who has a track record
 of correcting these problems.  To help you with this, look for a certified athletic trainer (ATC), sports physical therapist (PT) or physiotherapist with experience in these areas.  Ask around for recommendations from 
higher level athletes, professional sports teams, or major colleges, or seek out professionals who work with athletes 
at the highest level.  They will be most familiar with these correction 
strategies.
2. Develop an understanding of the injury 
and it's causes and work with the specialist to develop a plan which 
corrects the problem's source, not just treating the symptoms. This must
 include a corrective exercise plan to address the identified mechanical
 issues which are causing the problem.  (If the person you are working 
with can't do this, you picked the wrong person)
3. 
With your sports medicine professional, develop a comprehensive 
corrective exercise plan to address your mechanical inefficiencies and 
adhere to it religiously!  Good sports medicine professionals will help 
you do this while working around your planned workout schedule.  This 
may include the use of specific devices or therapeutic techniques to help
 address the underlying mechanical problems that have resulted in 
injury.
4. Every good corrective exercise program will involve development and coordination of the core muscles during this program.  Without a strong core for a solid foundation, other corrective exercises may not be effective in the end.  (More on this in an upcoming blog) 
5. Be cognizant of your limitations while 
recovering from the injury, adjust your workouts accordingly until the 
problem is resolved, then develop a progressive return to specific 
activity plan taking advantage of your new mechanical corrections. 
(alternative methods to maintaining your conditioning while injured was 
the topic of two previous blog posts).
6. Don't be 
closed minded to the fact that some of your workout choices, athletic 
gear (shoes, bike, racquet, etc), and workout conditions may be 
contributing to your problem.  Be prepared to make changes in areas 
within your comfort zone.  Athletes who find the right sports medicine 
professional and trust and adhere to their recommendations typically 
respond the best. 
As promised in the last blog, we 
will focus on providing information to help guide you through all of the
 misinformation.  The next five blogs will focus on information from the
 five tips above to arm you with information to win the overuse injury 
battle and avoid the chronic injury asylum.
Until then, train hard, train safe, and train smart!
 
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