Physiotherapy and Injury Prevention

Overuse Injuries

Would you consider seeing a physiotherapist when you have little or no pain or are injury free?

For many people the answer is no.  Whether sporty or sedentary they consider physiotherapy something to help after an injury, if they have pain or when they cannot manage their daily activities.

But is that the best time to get expert physiotherapy input and advice? Why not get advice and treatment before you start to suffer?

Perhaps it is the influence of the NHS model. Would a GP refer you to NHS physio if the reason was to PREVENT you getting injured, to advise about your wonky back or to help with the niggly pain in your neck?

In my experience the answer is no. They would only consider a referral when the problem got worse and painkillers had not worked.

This reactive approach is not the best way to manage our health and fitness and keep us functioning at our best-whatever our activity levels or lifestyle.

We need to be PRO- ACTIVE in our attitude to our health and fitness and with private physiotherapy we can see you straight away and BEFORE your problem gets worse or even starts.

Enjoying being with your children, avoiding sick leave or enjoying your hobbies all require you to be fit, healthy and pain free.  Preventative physiotherapy is not just for elite athletes and sportsmen!

Remember once a tissue is injured it forms scar tissue which is NEVER the same as the original. Correct physiotherapy and rehabilitation will ensure the best results but it will never be as good as preventing the scar forming in the first place.



Sometimes we are injured due to trauma which is acute and cannot be predicted but many problems we see are actually overuse injuries. These are problems that build up over time, usually with some warning and can often be PREVENTED or at least addressed before they get worse.

What is an Overuse Injury?

This is an injury to a structure or tissue sustained from repeated action that our body cannot adapt to- so causing something eventually to fail.

When we move and exercise, or hold a position, stresses are applied to specific parts of the body. Over time our tissues can adapt. Muscles may become larger, stronger or more flexible. Tendons may become thicker and bone density can change.

However, if exercise or movement or even static positions are applied in such a way that adaptation over time cannot occur then microscopic injuries start to form. This leads to inflammation-the body’s response to injury and eventually the tissue may tear, break or fail.

Signs of an Overuse Injury

The first sign may be stiffness or soreness (especially in the morning) which may disappear once the body is warmed up-after exercise or even a warm shower.

If the stresses continue there may be increasing

  • Either more severe or widespread
  • Swelling
  • Redness
  • Heat
  • Increase in stiffness in the morning or with inactivity.

Unfortunately many patients ignore the warning signs like the odd ache or pain which may ease with rest or stretches but eventually the tissue fails and they have a significant problem.


  • Tennis Elbow: Inflammation of the Common extensor tendon at the outside of the elbow
  • Golfers Elbow: Inflammation of the flexor tendon at the inside of the elbow
  • Bursitis e.g. housemaid’s knee Inflammation of knee bursae-(protective bags of fluid between bones and tendons)
  • Stress Fractures. incomplete cracks in bone e.g. march fracture in the foot
  • Shin Splints  excess pulling of a muscle on the bone covering
  • Achilles Tendonitis or Rupture: inflammation or tearing of the Achilles tendon.
  • Chondromalacia Patella Inflammation of cartilage behind the knee cap
  • Degenerative Disc Disease Bulging or dehydration of spinal discs
  • ITB Syndrome. Inflammation at the outer knee at the attachment of the muscle
  • Osgood Schlatter’s Pain and swelling below the knee-usually in sporty adolescents
  • Patella Tendonitis( Runners Knee) Inflammation of the tendon below the knee cap
  • Plantar Fasciitis. Inflammation in the sole of the foot due to overstretching
  • Sacroiliac Joint Pain. Inflammation of the joints in the back of the pelvis
  • Nerve irritation (RSI or WRULD) Pain or tingling in nerves due to e.g. poor prolonged positions  at a laptop
  • Carpal Tunnel Syndrome Pain and/or tingling in the palm of the hand due to pressure on the nerve in the wrist

Some General Causes of Overuse Injuries

  • Lack of core stability. Puts stress on the rest of the body- shoulders, hips back etc.
  • Muscle imbalance. Joint forces must be equal. (Strong tight muscles versus weak stretched muscles)
  • Incorrect or unsuitable footwear. Some foot types need a more flexible trainer-others one with a firm heel cup and arch support. With the thousands of trainers on sale it is easy to get the wrong sort for YOUR foot and make any issues worse
  • Incorrect equipmentg. a tennis racquet needs the correct strings and grip to prevent straining the elbow
  • Incorrect Technique Whether running, yoga or weight lifting. it is vital you work in a good alignment and position
  • One Sided Weakness/Pain Leads to overuse of the other side and poor alignment
  • Old Injuries/Scar Tissue. A structure is never the same after an injury so will change the way your body works
  • Leg Length Discrepancy. One leg longer causes poor alignment and often  spinal problems
  • Poor and Prolonged Workstation Posture. Holding your body in one position causes muscles to become tired and put extra stress on other tissues such as ligaments, joints etc.

Physiotherapy Treatment

Finding the cause is of course the key to recovery. This may be obvious -or not so a thorough assessment is vital

At Physio- Answers we have the time and experience to ask the right questions about what you do and how you move -often ones that seem rather obscure in order to identify the cause of the overuse injury.

We then look holistically at the whole body-not just the injured body part as the cause of a problem can be somewhere else entirely. For example a stiff big toe can cause back pain. A leg length discrepancy may be the cause of neck pain.

We can reduce the pain with rest and localised treatment but without addressing the underlying causes the problem will return.

Physiotherapy Treatment Will:

  • Relieve pain/ Reduce inflammation With: taping, acupuncture or ultrasound
  • Address Any Imbalances. By mobilising tight structures e.g. shortened muscles, stiff joints or old scar tissue and strengthening weak ones with a specific and controlled strengthening programme.
  • Give Advice regarding your equipment, footwear, etc.
  • Review Your Technique or Posture. Running, sitting at your desk, walking etc.
  • Provide Orthotics/ Supports/Braces/Home Taping Instructions

How to Prevent an Overuse Injury.

The good news is we can prevent these overuse injuries or at least stop them getting to the point of tissue failure if we address them early in their process.

By identifying imbalances, malalignment, weak or tight structures we can predict which tissues are unlikely to cope in the long term. We can also help you with a personalised stretching and prevention programme and review and correct your techniques.

Lastly we can give you the knowledge and information to understand your own body and to know immediately when to come for a professional assessment and treatment.

Then you will not only resolve acute problems fast but will prevent them worsening or recurring in the future.

So whether you have a niggle in your neck , soreness in your foot or back ache after work then make an appointment NOW with us at Physio-Answers and prevent things getting worse.

Too many times we hear: ‘I thought it would get better on its own. But it hasn’t’

So don’t wait! Call us now for an appointment and stop things getting worse.

Be Pain Free and the Best you Can Be

Free Pre-Assessment Offer

Here at Physio Answers, get a 10 minute physiotherapy ‘pre-assessment’ and discussion, to see if physiotherapy is the right treatment for you.