Rehabilitation after overuse injuries and associated pain

Joints

Pain will be caused by strain put on joints in a way that does not correspond to their anatomy and function. Most of these complaints come from nearby soft tissues and muscles, so therapy mainly consists of learning to change movement patterns with targeted muscle and coordination training while decreasing tension in adjacent muscles using massage and stretching exercises.

Muscles

Overloaded muscles react with stress and pain, sometimes involving tiny fibre injuries causing muscle cramp. The muscle mainly needs rest followed by targeted strength training.

Tendons

Overloading the muscles may affect tendons and tendon-bone attachment sites due to the large tensile forces involved, e.g. in tennis elbow. Rehabilitation mainly focuses on relieving local irritation with rest, electrotherapy, thermotherapy, and anti-inflammatory medication while relieving tension in the muscles affected by massage and stretching; after that, the muscle is trained to prevent tendon irritation on overload.

Ligaments

Overloading ligament tissue usually causes pain in nearby muscles. The goal of rehabilitation is to optimise joint load using strength training with the aim of achieving the appropriate load on ligaments.

Bones

Repetitive bone overloading may result in a stress reaction (bone bruise) or even a stress fracture. The bone will need a long period of rest – about six weeks. During this time, any necessary rehabilitation will be accompanied by tension-relieving measures in the nearby muscles as well as instruction on proper weightbearing on nearby joints.

Growth disorders

Growth disorder is a common term that usually results from a growth spurt leading to improper weightbearing on joints – the bones grow too quickly for the surrounding musculature to adapt to the changing leverage conditions. Rehabilitation aims to train correct weightbearing on joints in children and young people, and provide professional support in strength training.

Heel spur

Heel spur is the result, rather than the cause, of overload. Excessive tension on smooth muscles and the tendon in the sole of the foot attached to the heel leads to excess calcium deposits on the heel in an attempt to “reinforce” the bone. The aim of treatment is to relieve the pain using cushioning in the shoes as well as tension-relieving measures such as stretching and massage. A therapeutic custom insole may be required in cases of heavily deformed arches.

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