Simplifying Overuse Injuries

Training injuries suck. They're an absolute nuisance, and they feel like the get in the way of the places you want to go. I've had my fair share of them, and unfortunately for many of my peers in their lates 20's and older, they aren't too uncommon. But they're also highly avoidable, and if we can simplify how they happen we can reduce our chances of suffering from them.

Now, I'm not a doctor, or a physical therapist, so I'm not going to diagnose anything or give you medical advice. I have been around the block when it comes to training, and training others over the last decade to have developed some relationships with medical professionals who've helped form this understanding. In that time, the best simplification of training injuries I've found was found in a formula popularized (and maybe created/trademarked) by the staff at Pre-Script.com. The formula?

I = F>T

This equation being Injury (I) is equal to, or caused by, Forces or Stressors (F) greater than Tissue Tolerance (T). Forces or stressors can be acute as a result of physical trauma, but when it comes to training it's usually a reference to cumulative stressors placed upon the body. Tissue Tolerance is the total amount of stress muscle, tendon, ligament, or bone structures can recover from or take in a single effort. It's probably one of the best simplification of how injuries happen. Let's break down why this is true, and how it applies to our training.

A chart outlining the frequency of going beyond a tissue's tolerance for load. But mechanically, or physiologically.

If you've ever been hurt and gone to see a doctor, what's the first thing they tell you to do? Rest. Don't do anything that aggravates the injury. Why? Because when it comes to injuries, the fastest way to alleviate symptoms and pain is to eliminate the forces that are putting the tissue above its tolerance for recovery. Think about it! If your knee is constantly hurting, what feels good? Sitting down and not putting pressure on the knee! Remove the forces acting on the knee, and the pain tends to go away.

So how do we solve this? We need to understand stressors that are happening during training in order to prevent overuse injuries.

Common training injuries are force based. This being a cumulative amount of forces placed upon soft tissue and bone structures that the body cannot heal from before the next exposure. There's always a recovery time needed to recover from the stressors of training. For example, if you're completing heavier lifts (above 85-90% of a 1RM), you want 36-72 hours before exposure to the same or higher loads in the same movement pattern. Similar strategies should be considered for high impact exercises.

The other reason we get training injuries is too high of a metabolic stress. This means we aren't replenishing essential nutrients in order to support a few key things:

-Muscle Protein synthesis

-Bone Remineralization

-Glycogen store replenishing

The more we go above what we can recover from metabolically, the greater chance we run into injuries that happen as a result of malnutrition. This can also cause hormonal issues and run into things that may leave us with less fitness than what we started with.

Here's the kicker:

Force and metabolic stressors are intertwined and we have to be careful about finding our tolerance.

I wish it was as simple as "don't lift so heavy so often" or "drop your mileage." But realistically, metabolic stressors work in tandem with mechanical ones. We have to learn to progress into the total amount we can tolerate. Let's take it back to once you already have an injury. What is the first thing they have you do in physical therapy? Raise the force tolerance of the tissue. If we can raise our tissue tolerance in regards to forces and metabolic stress, we'll be able to train harder.

What this really all boils down to, if we're trying to look at preventing training injuries (and like I said, simplifying them) we need to learn to progress cautiously and make sure we're allowing the body time to recover. A lot of times we go all in on intensity and going "gung-ho!" on whatever we're training for. But we have to find a progression and let the body adapt to higher tissue and force tolerances if we want to prevent them.