Know Your Options For Treating Overuse Injuries

Cortisone Injections are performed by a licensed physician and involve an injection of cortisone directly into the injured tissue. It’s usually mixed with a numbing agent like lidocaine. It’s used to suppress inflammation. The physician may use fluoroscopy (X-ray-guided technology) or a diagnostic ultrasound to determine the best location for the injection.

Pros: It provides quick pain relief and is covered by insurance in most cases.

Cons: The relief is short-term. It comes with a recommendation of time off from training. The side effects are potential fascia/tendon rupture and skin irritations. While it may decrease inflammation, it does not result in a positive change in tissue. Plus, it can be an expensive procedure.

Grade: D

This should be a last resort before looking into surgical options. Definitely consider PRP before taking this step.

Before deciding on a treatment option, it is best to consult a sports medicine clinician. Furthermore, in order to optimize your treatment choice, it is crucial that a biomechanical assessment be performed by a licensed physical therapist to determine the underlying cause of injury. Remember that these treatment tools are only as good as the hands that wield them. Most of these injuries are preventable, fixable and require a team approach to most effectively recover.

My experience treating endurance athletes leads me to recommend ASTYM and eccentric exercise as the most effective treatments of overuse injuries from those discussed above. While ASTYM and Graston are very similar, I give a slight edge to ASTYM since it was developed by a physician and physical therapist, and they continue to advance the research. ASTYM is taught more as a treatment process or philosophy. Our athletes and clinicians prefer an active treatment approach that allows continued training, focuses on normal tissue healing and is backed by research.

Nate Koch is a physical therapist and certified athletic trainer. He owns Endurance Rehabilitation in Scottsdale, Ariz.

FILED UNDER: Training TAGS: Active Release Technique / ASTYM / Eccentric Exercise / Graston Technique / Injury Prevention / Overuse injuries / Platelet Rich Plasma Injections / running injuries / triahtlon injuries