The Difference Between Overtraining and Overuse

Overtraining

Blog contributed by
Dr. Yurkewicz

Overuse injuries in runners happen in part due to poor mechanics, but overtraining also has a role in developing injuries. Most runners who are experiencing problems, are training inappropriately. Your body needs time to recover after a strenuous workout. If you continue to push without having a period of rest, it will lead to further breakdown of your body and eventually have problems with injuries.

Many of the overuse injuries that were described in the newsletter can be avoided with proper training practices. The goal of a training program is to allow for variation in intensity, frequency, and duration of the activity, while having periods of rest in between. When first starting out, slowly progress into more intense workouts.

Signs of overtraining can be decreased performance, easy fatigability, overuse injuries, mood disturbances and others.

If you develop any these symptoms, a full work-up ( including blood work) is often needed to make sure nothing metabolically is wrong. That combined with a decrease in  intensity of your workouts for 2-3 weeks, can help point to the cause.

The best prevention is to have varied workouts, and allow adequate rest periods in between workouts. Most “athletes” can exercise 4-5 days a week, giving them adequate rest periods. Exercising 7 days a week is not recommended. Treatment for overtraining is rest, which can be frustrating, thus take the proper steps to avoid it.

Overuse

Proper stretching before and after exercise is very important, focusing on static stretches after a light warm-up. Most advise against dynamic stretching at this point.

Also when running long distance in high amounts, it’s important to make sure the shoes are well fitted, and that you are replacing them every 400 miles.

Another aspect that is often overlooked in runners is proper quadriceps and hamstring strength ratio. For example, if you can lift 100 lbs with your quadriceps during knee extensions, you should be able to lift 70 lbs with your hamstrings during knee flexion. Thus a ratio of 70% is a goal. This provides the best strength and stability around the knee joint itself.

As far as biomechanical aspects go in regards to proper running technique during the phases of heel/foot strike and push off, any abnormalities may present themselves as an overuse injury often involving the knee, hip or back in runners. A thorough evaluation, possibly including a dynamic gait analysis may need to be performed, as orthotics may be needed to correct the abnormality present. This in turn will lead to proper force distribution while running and prevent the overuse injuries.

If you have an injury that is preventing you from doing your exercises, sport or any type of activity, please contact the PinnacleHealth Sports Medicine Center: www.pinnaclehealth.org/sportsmed

Benefits of Excerising

Michael Yurkewicz, DO

If you aren’t in the right physical condition for the exercise you’re about to undertake, you could do your body more harm than good by jumping into a physical challenge. Whether you are a younger or older athlete, talk with your doctor before starting a new program. An evaluation may be in order to make sure you’re in the right shape to begin.

A sports medicine evaluation will look for subtle underlying cardiac and musculoskeletal disease that could be problematic for the athlete.

For the cardiac evaluation, the first step is to identify risk factors for cardiovascular disease. There are several factors including a family history of heart disease, smoking, hypertension, high cholesterol, impaired glucose tolerance, obesity, and a sedentary lifestyle. All of these can increase one’s risk for heart disease and thus increases risk of death during exercise. 

A cardiac evaluation helps to prevent those athletes with underlying cardiac disorders from participating in activities that could increase their risk for sudden cardiac death.

The American College of Sports Medicine stratifies adults into low, moderate and high-risk groups, and recommends testing based on which group they fall into.

Low Risk- Men <45years old and women <55 years old who are asymptomatic and have no more than 1 risk factor

Moderate Risk- Men >45 years old and women >55 years old who have 2 or more risk factors

High Risk- Any adult with any cardiac symptoms as above, including history of peripheral vascular disease or stroke, as well as underlying pulmonary

disease (COPD, asthma), or metabolic disease (diabetes, thyroid disorders)

If you have cardiac symptoms such as chest pain with exercise, shortness of breath with exercise, dizziness/syncope with exercise, or palpitations, your doctor may recommend a prompt EKG and echocardiogram; for the very young, a visit to a pediatric cardiologist may be in order.

The extent of the evaluation depends on the athlete’s age and underlying medical problems. Diagnostic testing may be used in certain older athletes prior to starting a regimen given your history and physical exam findings. For some, testing can include exercise stress testing.

Based on the findings of your evaluation, your physician will decide which type of exercise would be best and may recommend lower intensity exercise or moderate intensity exercise. Most doctors would advise against vigorous training as we age.

It is important to keep in mind that once started in a program, if any new symptoms develop, including unexplained decline in performance, stop the activity and seek prompt evaluation by your physician. 

Hydration

Michael Yurkewicz, DO

Adequate hydration prior, during and after exercise is of upmost importance to avoid potential complications of dehydration. As we exercise our body produces heat, in order for our body to dissipate the heat created, we begin to sweat, thus losing water. This loss of water can lead to serious complications if one is not properly hydrated, replacing what is lost. Such complications can include muscle breakdown, and kidney failure. Studies have been done in collegiate athletes, weighing football offensive lineman before and after practice. They found that during vigorous exercise they would lose 2-3 lbs. of water weight. Thus they found and began emphasizing replacing this water loss after practice to equal out the amount lost.

For every 1lb lost, one should consume 16oz of fluid, preferably water. Do not wait until you feel thirsty, as thirst is a late manifestation, and it could be too late. And remember to take frequent breaks to allow for hydration during exercise.

Adequate hydration is important regardless of the activity, but when combined with environmental factors such as high temperature, its importance is greater. When the temperature and humidity rise, our body’s natural ability to dissipate heat becomes impaired, this we are unable to get rid of the extra heat produced by our working muscles. This can lead to mild symptoms such as cramps, and heat exhaustion, to potentially devastating heat stroke. Symptoms can include but not limited to, muscle cramps, fatigue, dizziness, mental status changes, and elevated rectal temp.

If symptoms do arise, promptly remove from environment, orally rehydrate, apply ice to head, under arms and groin, and get to medical facility for prompt evaluation.

Michael Yurkewicz, DO
PinnacleHealth Sports Medicine Fellow

Sports Medicine Fellowship Program

Michael Yurkewicz, DO

Dr. Yurkewicz is board certified in Family Practice and is currently completing his one-year Primary Care Sports Medicine fellowship at the PinnacleHealth Sports Medicine Center.

Dr. Yurkewicz received his Medical Degree from Lake Erie College of Osteopathic Medicine.  He completed his Family Practice residency through PinnacleHealth and during his third year he was the chief resident.  Dr. Yurkewitzh received his undergraduate degree from Pennsylvania State University, The Behrend College, where he obtained a B.S. in Biology.

Over the past three and half years, Dr. Yurkewicz has covered many sporting events, including local high school football games, the Keystone State Games, Lebanon Valley College Ice Hockey team, Lacrosse and Injury Clinic, as well as conducting numerous pre-participation sports physicals. When not at the PinnacleHealth Sports Medicine Center, he is the team physician for Bishop McDevitt High School, under the direction of the Sports Medicine Program Director, Dr. Michael Cordas.