In a previous blog we introduced the term “overuse injury”. To review, an overuse injury is irritation or damage to muscle, tendon, bone or nerve tissue caused by repetitive microtrauma or strain to a specific body part. It can be caused by improper technique or general overuse. Common complaints are aching, tenderness, general pain, cramping, weakness or tingling and numbness. The upper extremity is one area of the body that is especially prone to overuse injuries. The shoulder, elbow and wrist all can be affected by repetitive activities due to strain.
Shoulder
The shoulder is a joint that is made for mobility and not stability. The muscles of the shoulder provide a support system to ensure that the joint moves properly in a pain free motion. The shoulder is vulnerable to injury due to a variety of factors. Repetitive motion, muscle weakness, or diminished joint space lending to impingement or “pinching” of the muscles and tendons that travel through the shoulder joint space can all contribute to increased risk of injury. Most commonly, repeated overhead reaching found in certain occupations, repetitive lifting, and repetitive throwing are a few activities that put the shoulder joint at increased risk for injury. The repetition of some of these activities can lead to fatigue which causes impaired ability for the rotator cuff to provide proper joint positioning, further increasing risk of injury and impingement.
The first signs of overuse injury in the shoulder present as pain that can be described as sharp, aching, and/or burning. Symptoms can progress to a limitation in joint range of motion due to pain and weakness of shoulder muscles. If not addressed, overtime an overuse injury can progress to severe tendinitis or inflammation of the rotator cuff tendons. In extreme cases tear of the rotator cuff tendons or labrum of the shoulder joint can be observed if the strain goes unaddressed too long. It is important to seek treatment at the first sign of pain to remedy the issue prior to progression to a more severe injury that may ultimately require surgical intervention.
Elbow
The elbow is another joint that is at risk for overuse injury. The muscles that attach to the inside and outside of the elbow are prone to tendonitis and irritation especially if there is weakness at the shoulder and scapula, or “shoulder blade”, musculature. “Tennis elbow” and “Golfer’s elbow” are common injuries that affect the outside and inside of the elbow respectively. These injuries are due to the nature of the repetitive motions from swinging the tennis racket or golf club.
Repetitive lifting, turning, twisting or pulling objects with job duties can also play a role in overuse injury at the elbow. Initial signs of irritation at the elbow joint are aching, burning, weakness or limited range of motion at the elbow. If not addressed, pain can progress and can limit use of the elbow and thus participation in work and/or leisure activities.
Wrist
Finally, the wrist is another joint that is prone to injury with overuse activities. The most common overuse injury in the wrist is called “carpal tunnel syndrome”. The carpal tunnel is located on the palm side of your hand at the wrist and is the passageway where nerves, tendons and ligaments are housed. Inflammation or irritation in this area can cause burning, aching pain and weakness that limits function of hand and wrist. Computer use, whether typing on keyboard or use of a mouse, is a common activity related to carpal tunnel syndrome, especially with poor wrist mechanics. Other factors that can contribute to wrist pain are repetitive gripping or flexing of the wrist required for certain job activities, such as turning a screwdriver multiple times throughout the day. If not addressed, pain and weakness can progress, limiting the function of the hand and potentially causing nerve damage in severe cases.
How can overuse injury to the shoulder, elbow and wrist be prevented?
Ensuring proper body mechanics with activities is essential. Performing stretches and mobility exercises to maintain normal range of motion at joints can help reduce risk for overuse injury. Strengthening exercises for the upper extremity including shoulder, elbow and wrist musculature are important. Additionally, strengthening the core muscles can help provide a stable base when performing activities and lessen risk for injury as well.
If you have tried the above recommendations and still are experiencing pain or limitations, physical therapy can help! Hands on techniques including soft tissue mobilization and dry needling can help control pain and promote healing. Individualized training on exercise and stretches as well as education on how to correct issues with mechanics during repetitive activities can help to diminish pain and prevent return of overuse injury with your work, leisure or sport activities.
Contact us TODAY to make your appointment with Dynamic Physical Therapy and Wellness to help you Perform better, Live better, and Get better!