Overuse Injuries are painful joint conditions that can occur in any joint of the body. Repetitive strain from repeat motion and overuse which may transpire in sports or particular jobs and activities can lead to these injuries. Injuries, such as Runner’s Knee, Rotator Cuff Tendonitis, and Tennis Elbow are examples of overuse injuries, which are progressive activity-related injuries linked to repetitive stress that is placed on the tendon, ligament or other joint structure. Individuals with overuse injuries may try to manage their pain on their own for a while. They may attempt to stabilize the knee, shoulder or elbow with a brace, or calm the pain with over-the-counter medications, or even rest the joint a bit in order to find enough relief to be able to play in the next game, continue to work, or participate in their upcoming event.
Doing too much of the same activity strains the tendons, ligaments, and other soft tissue structures. Training error and improper technique may add to the possibility of an overuse injury. Using poor or improper form during training exercises, while running on uneven ground, when swinging a tennis racket, or even with painting walls, can overload the muscles, tendons, and ligaments, and cause an overuse injury. In cases of Runners Knee, for example, the repeated stress from the force of hitting hard surfaces while contracting the leg muscle when running, again and again, results in a weakening of the tendon and ligaments. In overuse injuries, many may think their tendon or ligaments are just inflamed, and although the injury may begin with inflammation, when left untreated, this overuse injury overloads the tendon and ligaments, resulting in degeneration or even in a tear. Many cases of overuse injuries become chronic with instances of recurrence.
In the beginning, pain and tenderness are noted in the affected area after physical activity. As the problem progresses, the pain and discomfort occur during activity. Of course, symptoms vary with the various joints and from person to person, but as the condition advances, swelling and pain will restrict the ability to perform sports or particular activities. Eventually, the pain and symptoms will persist, even at rest.
Chasing and suppressing symptoms with bracing and pain medications may keep the swelling down and provide momentary pain relief, but a knee sleeve, for example, will only give a false sense of security while only temporarily helping the sufferer to function. The debilitating pain, however, will keep the individual and athlete searching for a cure. Is surgery the answer? Surgery prolongs the athlete’s return to sport.[i] Fortunately, there are non-surgical options! Here’s what doctors in New York say about the overuse injury patellar tendonitis, “Due to its common refractory response (difficulty in treating) to conservative treatment, a variety of new treatments have emerged recently that include…Prolotherapy, platelet-rich plasma therapy (PRP), arthroscopic surgical procedures, surgical resection of the inferior patellar pole (cutting away tendon tissue at the kneecap)…”[ii]
At OrthoRegen, the regenerative treatments we use for painful joint conditions include Platelet Rich Plasma and Prolotherapy. But the researchers listed surgery too! Why do surgery if PRP is good enough? And is it good enough to effectively treat overuse conditions? Studies done in Europe demonstrate the effectiveness of Platelet Rich Plasma for those with overuse conditions of the knee, and its ability to improve pain symptoms and functionality, saying, “The most important finding in our meta-analysis is that PRP injections are statistically better than the control group at longer term follow-up suggesting that PRP is an effective and worthwhile treatment for Patellar Tendinopathy. [iii],[iv] A 2018 study agreed that multiple PRP injections offer the most satisfactory results.[v] Athletes are looking to non-surgical therapies such as Stem Cell Treatments, Platelet Rich Plasma or Prolotherapy treatments, because they are showing improved outcomes in those with tendon and ligament conditions like Runner’s Knee.[vi]
At OrthoRegen, using regenerative therapies like Stem Cell Therapy, Platelet Rich Plasma, and Prolotherapy is what we do. By treating overuse injuries with Regenerative Orthopedics, athletes can get back to their sport, and individuals can return to the activities they love. We see substantial, consistent improvements in pain outcomes when treating those with overuse injuries. Regenerative Orthopedics can treat various joint disorders including problems of the tendons, because the injections directed at the weakened tendons and involved ligaments stimulate a string of healing events, which include an increase of blood supply, an influx of reparative cells, and the deposition of collagen cells. When the collagen matures, it will strengthen and tighten the damaged tendons and ligaments.
Why would we treat the ligaments too? The ongoing and recurring joint pain in overuse conditions is rooted in joint instability. Patients with overuse injuries often have concurrent weakness in the ligaments of the joint. These ligaments play a huge role in stabilizing the joint, and when weak, will put more strain on the tendon and other joint structures. The problem of weak ligaments needs to be addressed in treatment. Therefore, we treat the joint comprehensively, and make sure we treat any injured and weakened ligaments as well, in order to achieve the best results. Comprehensive treatment will result in repair and healing of the entire joint, tightening of the ligaments, and strengthening and repair of the tendons, so the joint and all of its structures function normally, and the athletes and individuals who were sidelined by overuse injuries can return confidently and pain-free to the sport and activities they love.
[i] Cook J L, Khan KM, Harcourt PR, et al. A cross sectional study of 100 athletes with jumper’s knee managed conservatively and surgically. The Victorian Institute of Sport Tendon Study Group. Br J Sports Med1997; 31: 332 – 336.
[ii] Christian RA, Rossy WH, Sherman OH. Patellar tendinopathy – recent developments toward treatment. Bull Hosp Jt Dis (2013). 2014;72(3):217-24.
[iii] Kaux JF, Bruyere O, Croisier JL, Forthomme B, Le Goff C, Crielaard JM. One-year follow-up of platelet-rich plasma infiltration to treat chronic proximal patellar tendinopathies. Acta Orthop Belg. 2015 Jun;81(2):251-6.
[iv] Dupley L, Charalambous CP. Platelet-Rich Plasma Injections as a Treatment for Refractory Patellar Tendinosis: A Meta-Analysis of Randomised Trials. Knee surgery & related research. 2017 Sep;29(3):165.
[v] Andriolo L, Altamura SA, Reale D, Candrian C, Zaffagnini S, Filardo G. Nonsurgical Treatments of Patellar Tendinopathy: Multiple Injections of Platelet-Rich Plasma Are a Suitable Option: A Systematic Review and Meta-analysis. The American journal of sports medicine. 2018 Mar 1:0363546518759674.
[vi] Kopka M, Bradley JP. The Use of Biologic Agents in Athletes with Knee Injuries. J Knee Surg. 2016 Jul;29(5):379-86. doi: 10.1055/s-0036-1584194. Epub 2016 May 20.