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Sport Overuse Injury Patterns: What are they and what can you do about them



Sports Specific Overuse Injury Patterns: What you can do about them

Lack of soft tissue research

As I continue to research the realm of injuries related to overuse and the risk factors involved I find insufficient research on the state of tissue tonicity and how tight and bundled muscles can in fact predispose the sport specific overuse injury. Each sport requires unique movement patterns and demands that an athlete recruits specific muscles to perform. 

Repetitive movements performed in any sport tax and stress the body. 

The body naturally adapts to these stresses and depending on the condition of the athlete, can accommodate to the demand of the sport.  What happens is when the body is not given adequate recovery time or support, the muscles get stuck in tightened states and are not able to rid the body of lactic and hyraulonic acids. This can be due to a number of reasons including:  

Why do you get Tight?

  1. Hormones
  2. Chronic dehydration
  3. Too much sitting and inactivity
  4. Trapped nerves and arteries
  5. Bursts of activity after long periods of inactivity
  6. Whiplash or traumatic fall
  7. Inflammation
  8. Sudden growth spurts

A great article about Why you are so stiff

Yael Averbuch,  plays for FC Kansas and the Women's National team uses the STARwrap with her intense training regiment.

Yael Averbuch,  plays for FC Kansas and the Women's National team uses the STARwrap with her intense training regiment.

This seems logical to me, as a sports massage therapist working with elite and normal athletes and noting these repetive patterns with soccer players, or MMA fighters.  Normal patterns of pain related to their sports are common and consistent with a large number of the athletes that I treat. I will find for example, hamstring as well as hip/groin tightness in soccer players based on the movement patterns of sprinting, instep passing, and shots.  I found that incidence of soccer injuries the most common subtypes of severe injuries were hamstring strains (n=83, 12%), MCL injuries (n= 63, 9%), quadriceps strains (n=48, 7%) and adductor pain/strain (n=42, 6%). Although this study admits identifying causal patterns in injuries could not be found, the data still gives a clear indication as to what areas of the body soccer players normally get injured.  

Although MMA is an extremely dynamic sport and the overall athleticism of high level fighters is impressive, my experience consistently reinforces how hip hypertonicity to a large extent causes lower back pain and knee pain. Hip tightness as it relates to the skeletal and spinal systems to me clearly contributes to the function of the femur head in the hip and the lumbar spine.

Donald 'Cowboy' Cerrone, one of my favorite clients resourcing the STARwrap. Cowboy fights for the UFC Lightweight Title this December in Orlando.

Donald 'Cowboy' Cerrone, one of my favorite clients resourcing the STARwrap. Cowboy fights for the UFC Lightweight Title this December in Orlando.

My point is not making an overarching statement about the causes of any overuse injury pattern. Afterall, most athletes have different backgrounds of injury histories and training practices. For sure certain sports are more dangerous than others for risk of injury. My point is that a pattern can be established for normal sport related overuse of specific muscles and their affect on specific joints. Thus prevention and treatment is possible to avoid overuse injuries by exploring the known patterns and learning your own unique pattern of muscle use for your sport. These tight, bundled, overused muscles that predispose athletes to injuries can be released and restored to a healthier, more full contraction. 

Presently, overtraining syndrome, which is a complex state that involves a large variety of signs and symtoms has only one sole agreement, that it is associated with excessive training and insufficient rest and recovery.

According to my research, there are only two prospective studies published dealing with the prevention of hamstring injuries. This to me seems necessary and obvious to understanding the causes of injuries, the treatment of injuries, but also most importantly, the prevention of injuries.

What can be done about overtraining, overuse, and treatment of injuries?

#1)  Increase blood flow to the area.

What I've found is increasing blood flow to specific muscles related to your sport. If you are dealing with knee pain, or hip pain, check the muscles above and below, left, and right of the knee or hip. If you put some pressure on the muscles and they feel tight, bundled, sore to the touch, they need some blood flow.

#2) Spend more than enough time stimulating the area.

Of course you've perhaps tried the self-myofascial release options of foam rolling, or medicine balls, tennis balls, lacrosse balls. The key is how much time are you spending stimulating these areas. I recommend spending 30 minutes - 1 hour 3-4 x per week in recovery efforts. This will produce such incredible results for helping your tissue support your joints which directly relates to injury prevention.

#3) Are you getting precise enough with the force. 

The body will adapt to a positive stimulus if the pressure is appropriate. This means you can't force yourself to relax, you must allow the muscle to adapt and absorb the force slowly, over time. This can take 5 minutes or 45 minutes per site. As long as you are opening up and the muscle continues to soften and relax, stay with the therapeutic pain. But if the pain goes up and intensifies, find a new area to treat. 

Why do I care about muscle tissue health?

Muscles that can relax and contract fully have more power and strength. They are also more reactive so agility will improve, speed will improve. Don't believe me, get into those muscle fibers and hang out, and see how your body responds. It's called adaptation and it is quite natural for your body to adapt to whatever stimulus you place on it.

Of course I recommend using the STARwrap as the #1 Choice for precise, wearable, massage therapy. But, of course, I am biased.


Original Publication: Jan Ekstrand, Martin Hägglund and Markus Waldén, Injury incidence and injury patterns in professional football - the UEFA injury study, 2009, British journal of sports medicine, 060582. Copyright: BMJ Publishing

An athlete who trains intensely, yet consistently under-performs, is considered to be suffering from overtraining syndrome (OTS). OTS is a complex state that involves a large variety of signs and symptoms. Symptoms include changes in mood or behaviour, decreases or increases in concentration of different blood molecules, and alterations in immune function. Although several hypotheses have been proposed, each only explains a selective aspect of OTS. Presently, the sole agreement is that OTS is associated with excessive training and insufficient rest and recovery. The hypothesis proposed in this paper suggests that excessive training/competing causes repetitive tissue trauma, either to muscle and/or connective tissue and/or to bony structures, and that this results in chronic inflammation. It is further proposed that traumatized tissue synthesizes a group of inflammatory molecules, cytokines. Cytokines have been shown to coordinate the different systems of the body to promote recovery. Suggestions are made to detect, prevent, and rehabilitate the overtrained athlete.

(C) 2004 National Strength and Conditioning Association


A common soft tissue injury in sports involving sprinting and jumping is the hamstring strain. A major problem with hamstring strains is the high incidence of reinjury. Muscle injuries can be classified as direct or indirect and are typically grouped into three categories according to severity. A number of potential risk factors have been proposed for hamstring strains. Only a few are evidence based and some are mainly based on theoretical assumptions. There is a lack of clinical research on the effectiveness of rehabilitation programmes for hamstring strains. Although the initial treatment of rest, ice, compression, and elevation is accepted for muscle strains, no consensus exists for their rehabilitation. Not much evidence based research has been carried out on prevention of hamstring strain. To our knowledge only two prospective studies have so far been published. As the injuries are common in football and other sports involving sprinting and jumping, there is a need for further research preferably in the form of randomised controlled trials.

Correspondence to: Associate Professor Holmich Department of Orthopaedic Surgery, Amager University Hospital, Copenhagen DK-2300 S, Denmark;