You have been training for a Half Ironman for six months straight. Everything has been going great; you have a coach, have followed a training plan and are ready to race in a month. You wake up, put your running shoes on, start walking down the stairs, and there is a horrible pain in your knee. The pain wasn’t there yesterday. You didn’t get into an accident. What happened? Everything was going great and your race is a month away. Where did you go wrong?
This is a common situation that endurance athletes get into. The term “overuse injuries” is a very broad term. Most think that the term implies that the injury is specific to an improper training program. This is true when the athlete is not on a training program and is training without direction. In the situation that the training program is properly formed for the athlete and the athlete continues to have overuse injuries, we look at the biomechanics of the athlete.
Biomechanics is the study of the structures and their function in the body. The structures looked at are muscles, joints, tendons, ligaments and fascia. When the biomechanics are improper it makes abnormal movement patterns. These patterns put unusual stress on structures that are not supposed to be used in that manner.
An example of this is the very common iliotibial band syndrome that plagues a lot of the triathlon community. The main muscle that brings your knees up (psoas) becomes tight from sitting all day and riding a bike in a forward (flexed) position. Over time, it causes the muscles that bring the leg backwards (extend) to not work effectively. This process is called “reciprocal inhibition”. By doing so it makes the other muscles (tensor fascia latae) have to bring the leg forward and makes the hamstrings have to bring the leg back. These muscles attach to the iliotibial band. Over time this unusual stress irritates the fascial band, causing pain where it begins (origin) at the hip and where it ends (insertion) at the knee. Typically people start noticing the problem when it has progressed to knee pain.
This is just one example of a biomechanical overuse injury. In these types of situations it is the biomechanical problem that needs to be addressed. If the athlete continues to train with the problem it will not resolve but will instead increase the problem. These kinds of injuries can be confusing because the athlete feels pain in the knee but in reality the problem is coming from the hip. If they are self-treating the knee, the problem will not be fixed either. The biomechanics must be restored to normal function and then strengthened to prevent future problems.
When overuse injuries occur, a licensed Doctor of Chiropractic who specializes in sports medicine can assess the biomechanics to have the problem fixed. Having these types of injuries assessed early on will help prevent prolonged treatment time. Be proactive and keep your body moving properly.
By: Dr. Natalie Bodziony, D.C.