Effects of Excessive Load

Overuse injuries are sneaky. At first you barely notice them. They appear as a mild pain, so you ignore them for a long time. Your complaints gradually increase, and you may “suffer” for months. You only see a doctor when the pain prevents you from training.

I have talked to many athletes who consider these pains to be "normal"—but they are not! Pain is your body’s feedback that something is wrong. Take it very seriously and consult a specialist immediately! You need thorough and careful treatment.

Here comes another important problem… it makes things harder that most doctors (even sports physicians) do not attach much importance to these injuries and do not start intensive treatment; they often only suggest: “reduce the load,” “apply compresses and creams,” or “rest a few days and it will go away by itself.”

How does the complaint become chronic?

Chronic complaints will not resolve just because you reduce your load for a few days!

Without treatment, the complaints will hinder your regular training within a few weeks. Moreover, because of the pain you perform certain movements in a “pain-avoiding” manner. The faulty movement, however, causes overload elsewhere. The more you try to move to avoid pain, the deeper into trouble you put yourself.

It’s a vicious circle from which only competent treatment can rescue you!

A common cause of excessive load: lack of skill

The vast majority of overuse complaints stem from poorly executed movements.

Posture, the way the foot contacts the ground during running, an incorrect knee position during pedal rotation, the way you push off or land—these are some examples. In every sport there are many small details that can be avoided by refining technique.

Would you believe, for example, why a footballer has low back pain? At the moment of kicking the kicking leg swings forward while the standing leg supports. The trunk muscles must provide stability for this. If the coach has the players do lots of kicking but does not have them perform exercises to strengthen the trunk and gluteal muscles, the lower back becomes overloaded and the player suffers constant back pain and cannot train.

A common cause of excessive load: improper technical equipment

Technical equipment can also cause overuse complaints.

A poorly chosen running shoe that does not support the arch, an improperly adjusted bicycle seating position or saddle height are typical examples. In the gym, a bad grip width and incorrect execution can lead to the same result.

I have said it many times: it’s not enough just to lift weights! You must do it smartly.

Some typical overuse examples

Recently several athletes contacted me for advice.

Triathlete

One of our excellent triathletes came to me complaining of months-long Achilles tendon pain, which prevented him from training at the required intensity, and he could not complete long runs because the pain would “tell him to stop” after a few kilometers.
He became very discouraged and lost confidence. He even considered ending his career, giving up on the idea of getting rid of his complaints.

Due to extremely intensive training, a lot of running on asphalt, and cycling hundreds of kilometers weekly, inflammation developed at the Achilles tendon insertion (at the heel bone), affecting the periosteum and tendon, which hurt even at rest and when walking, not to mention the agony during running.

With chronic strain, toxins accumulate in the inflamed area and hinder the healing processes. Because the function of inflamed tissue cells is disrupted by changes in cell membrane polarity, the so-called injury current stops. In the sick cell there is no ATP production, no protein synthesis, so the tissue becomes unable to heal “by itself.” In such cases the tissue needs “help.”

His complaints resolved within 5–6 weeks with targeted softlaser and microcurrent treatments, and today he trains at his former intensity and even performed very well in winter and early spring competitions.

Five to six weeks of recovery may seem long, but remember he had been “struggling” with his complaints for over a year before he finally sought professional help. Compared to that, the recovery time is relatively short.

Cyclist

Another athlete came to me with a few weeks of knee pain. Because of his job he trained relatively little during winter, but he naturally attended his team’s season-opening Mediterranean training camp and rode with the team. He shouldn’t have—or not like that! After only a few hundred kilometers over the winter, at the camp they rode over a thousand kilometers a week, mostly in tough mountainous terrain, accumulating a lot of elevation.

During cycling the greatest load falls on the thigh muscles, whose tendons attach to the bones around the knee. The sudden increase in load was such a “shock” to the ligaments and periosteum that it led to complaints that almost made walking impossible.

In such cases, in addition to traditional treatments, softlaser and microcurrent therapies represent the main direction of healing, but it is also necessary to improve the strength of the thigh muscles.

Muscle stimulation is the most effective method for this! If you don’t have enough time to train, support it with stimulation to prevent spring overuse.

Moral of the story? Only increase load suddenly for muscles, joints, and tendons that have been properly prepared!

Footballer

A desperate father called me for advice. His son played for a small-town football club where he was “discovered” and then “taken” by a big Budapest team. But the joy ended there…

In his new team he had to perform a completely different type of training than at his previous club. While at his old club there was a lot of play, long runs, and technical training, the new club emphasized strength and conditioning: lots of bounding, stair running, sprints, and intense drills. He rarely did these at his previous club.

The new coaches made a serious mistake by not taking into account what the player had already been exposed to. Two weeks later he already had knee complaints, but they ignored them. “Don’t whine, just do it!” they said.

Soon he required knee surgery for a meniscal tear, which almost certainly ended his professional dreams.

This promising talent could have been spared ruin if the coaches had at least basic knowledge of training theory, load management, anatomy, and muscle function, and had introduced the boy gradually to the unfamiliar training methods.

Unfortunately they had no idea what they were doing (or, if they did, they acted negligently), as is the case with the vast majority of domestic coaches who have limited knowledge on the subject.

General treatment options and main problem

Most doctors recommend and apply RICE (Rest-Ice-Compression-Elevation) along with NSAID (non-steroidal) and steroidal anti-inflammatory drugs.

Increasingly, PRICE is being promoted instead, where the P stands for Prevention. This assumes cooperation between the doctor, the athlete, and the coach. The critical point is to precisely determine what is causing your pain and to identify the triggering dysfunction. By detecting the error in time, prevention becomes possible.

Without this exact knowledge, permanently eliminating the complaints is not possible.

Overuse requires precise therapy

The treatment strategy for chronic inflammation caused by excessive load should be decided after careful consideration.

Eliminating technical issues

Choosing a sports shoe that provides proper support and matches the hardness of the ground is fundamental.

How you sit on the bicycle matters! The distance and angle between pedal and saddle, the saddle position relative to the crank arm, the handlebar-saddle distance, the saddle tilt, etc., are extremely important for correct power transfer. The effect of a bad setup can only be offset by compensatory overload in certain muscles. If, for example, your lower back hurts at the end of a ride, you are definitely sitting in the wrong position.

I could list specifics for every sport because each has its own specialties. Based on the above, think through your own sport to find where the “error” might originate.

Improving qualification

An experienced coach’s eye can spot technical faults and help eliminate them. That’s why serious sports clubs employ movement therapists. They participate in training, observe the athlete’s movement, recognize anatomically incorrect execution, and help with corrections.

However, in reality today the training plan is often prepared by a distant specialist and the athlete carries it out individually. Most meet their coach rarely, and then more for a chat than for joint training.

To my knowledge, most runners, triathletes, and cyclists train this way. Only a narrow group of professionals are directly supervised on site by their coach.

You get on your bike, you go to the island to run. You conscientiously do what your coach prescribes. The training plan is good and increases the load gradually, yet you develop complaints.

What should you suspect?

You are performing the movement incorrectly!

For example, on the bike you rotate the crank so that your knee points slightly outward. Beside your kneecap, on one or both sides you first feel increased fatigue, but after a few days pain develops. In this case know that you are pedaling incorrectly.

You are not moving in the normal functional axis of the knee joint, but deviating from it, thus loading the joint unevenly. Do not continue training like this because your complaint will become chronic! Meet with your coach, show how you pedal, correct the posture fault, and from now on pay particular attention to performing the movement correctly (within the joint’s optimal range of motion).

Computerized gait and movement analysis labs can help detect posture faults, poor foot strike, unhealthy joint loading, etc. Corrections can be made with insoles, heel lifts, differently designed shoes, or by changing posture or movement patterns!

Medical treatment

I have already mentioned that the medical basis of treatment is conservative RICE or PRICE therapy, and the use of non-steroidal and steroidal anti-inflammatories. Unfortunately, the preparedness of most doctors is limited to these. Steroid drugs may be considered at most for amateurs; they are definitely not appropriate for professionals (doping!).

Many doctors and patients “look down” on most physiotherapy methods because they do not work “immediately.” A steroid anti-inflammatory may temporarily “blow away your complaints,” but it carries great risk! If a faulty movement, technical error, bad shoes, or uneven load caused your problem and you do not change the triggering factor, your complaints may return more severely and with more destructive effects over time.

Physiotherapy procedures (ultrasound, softlaser, magnetotherapy, cold and heat therapy, microcurrent, etc.) require 10–15 or more sessions to exert their anti-inflammatory effect, but they eliminate inflammation effectively (and without drugs). Muscle stimulation treatments help improve muscle strength in critical muscle groups and provide lasting results.

Another advantage is that effective home versions of physiotherapy devices have been available for years, meaning you can treat yourself at home comfortably and without wasting time.

Summary

If you train regularly and complaints arise, DO NOT WAIT until they become severe and hinder your movement!

Pain indicates that something is wrong. This may be technical in origin, a faulty movement, or an improperly dosed training volume. Sit down with your coach or sports physician and review the possible causes.

Eliminate the causes of excessive load: address technical problems, correct the movement, and strengthen weak points in your muscles. This will ensure you can train intensively and effectively. And, most importantly: WITHOUT PAIN.