When we contemplate how injuries occur, most of us think about a single moment of trauma or forceful impact. However, many injuries are caused by overuse – the accumulation of repeated “micro-impacts” that can eventually lead to larger tears or fractures in bone and the surrounding tissues. While not as gruesome or immediately painful as injuries from severe trauma, overuse injuries can be just as frustrating (if not more so) for folks who like to stay active, because diagnosis, treatment, and recovery can take much longer for injuries with a gradual onset. Plus, overuse injuries have a nasty habit of returning again and again. What follows is a list of common overuse injuries, how they’re treated by a shoulder specialist, and how to prevent them from keeping you sidelined from the activities you love.

Tennis Elbow

One of most well-known manifestations of overuse is so-called “Tennis Elbow.” The injury is marked by a burning sensation in the outer part of the arm where the humerus (upper arm) meets the two bones of the lower arm, and can result in a weakening of grip in the affected hand. Despite its nickname, the onset of lateral epicondylitis is not restricted to the tennis court, and in fact a related injury that affects the inner arm is called golfer’s elbow. Treatment can come in the form of an arm brace, ibuprofen, extracorporeal shock wave therapy, or even elbow surgery.

Shoulder Bursitis

A less familiar overuse injury is shoulder bursitis, which is when a bursa in your shoulder – fluid-filled sacs responsible for reducing friction of movement – become inflamed. It manifests in a dull or sharp pain at the shoulder that can spread down the arm and get progressively worse over time if aggravated. Inflammation of the bursa is usually caused by rotator cuff impingement from repeated overhead arm movement (e.g. tennis, golf, weight-lifting, gymnastics), and like most overuse injuries, is treated with a healthy dose of rest, ice, bracing, and anti-inflammatories. A key to prevention is strengthening of the rotator cuff.

Stress Fractures

The most common overuse injury in the lower (leg) extremities is the stress fracture, which is generally a small, “hairline” fracture in the foot or shin caused by repeated impact. Major factors that can contribute to stress fractures include exercise on unfavorable terrain (e.g. cement, asphalt), improper equipment (e.g. not using appropriate shoes), or ramping up a training regimen too quickly. The main ingredients for treatment of stress fractures are rest, immobilization, and physical therapy. Stress fractures can be prevented by regular stretching, strengthening, and prescription or over-the-counter shoe inserts.

You should see a common pattern through each overuse injury: they all require significant periods of rest for treatment. For many athletes, this is actually the most painful part of the injury because it separates them from doing the very activity that brings them joy, and they can be left with the unsettling sensation of “cabin fever.” That is why prevention tactics such as devising an incremental workout plan, cross-training and engaging in core strengthening, and wearing appropriate equipment is vital. Consult your primary care physician or orthopedic specialist to determine what may be best for your particular needs. If you’re in the Washington area, reach out to any of the orthopedic specialists of Seattle.