How to Minimize Repetitive Stress Injuries

26 09 2011


Dr. Hamid Sadri

Although being active and exercising helps to improve health, it also increases risk of injury. After all, if you don’t move from the couch how likely are you to sustain an injury? By far, the most common type of athletic injuries we treat at 1st Choice Healthcare are repetitive stress injuries or (RSI). As the term implies, these are not single-event traumas such as a sprained ankle, a slip and fall or a bike crash. They are injuries caused by accumulative and repetitive activities that are a part of any sport.

When exercising, the general intention (if done correctly) is to force the body beyond what it is capable of at that time. This causes the body to become stronger, faster, more flexible and agile. This is a natural response that occurs and follows a well known rule referred to as the SAID principle: Specific Adaptation to Imposed Demand. It’s what the athlete desires to accomplish. The basic premise is to cause some sort of micro-trauma to an organ system in the body, allow the body time to repair and recover, then repeat the process and incrementally increase the activity until the desired level of fitness is reached.

Unfortunately, many errors are likely to occur during this process that plague athletes (from novice to elite) and ultimately result in injuries. Although not each and every possibility can be predetermined or prevented, there are some basic strategies that help minimize the possibility of repetitive stress injuries. In this article I will address one of the aspects of this injury-reduction approach and will continue to visit other related elements in future pieces.

Injury Reduction Approach

Here is a simple (and yes, it takes extra time) routine that has proven effective. When starting your exercise session, begin with a 10 to 12 minute warm-up. This should be an activity that imitates the exercise you are about to perform except done in a slower, more controlled manner. The intention here is to drive more blood to those parts of your body that you are about to exercise. This causes the core temperature of the muscle to increase and loosens up the joints in the area so that they both are more prepared to handle the task at hand. In addition, it begins to drive more oxygen and nutrients to those body parts so they can be prepared to perform a higher level of function for an extended period of time.

This should be followed by some form of self myofascial release (SMR). The typical tools we recommend are the foam roller or the stick for the larger muscles and a tennis ball or a golf ball for the smaller areas. Once the warm up is done, you should use these tools to rub the respective muscles, usually for 30 seconds to one minute per muscle area. Be firm, but do not crush the tissue.

This process aids in opening up the myofascial fibers that surround the entire body. As the muscles are forced to perform, they demand increased blood flow which causes them to increase in size and circumference. Loosening the fascial layers allows the muscle to accomplish this more easily and with less effort.

Finally, you should follow this with some old fashioned stretching. There are many schools of thought when it comes to stretching and none has been proven more or less effective than the other except for ballistic stretching, which should be avoided. This is the type of stretching that involves bouncing or rapid and short stretch-release patterns. To keep it simple and easy, you can follow a static stretch routine of 20 to 30 second holds for each muscle group. You are now ready to begin exercising.

Once your exercise bout is complete, you should repeat the SMR and finish by stretching your muscles again. The SMR pushes the biochemical byproducts that have accumulated in your muscles from exercising out of the muscle and back into the circulatory system so they can be “cleaned up” and the stretching helps to restore muscle length closer to the original anatomical length and reverses the shortening that results from repetitive use. This allows for faster recovery and lessens the occurrence of repetitive stress injuries.

Of course, this inevitable question always comes up: “Who has time for all that?”

As mentioned earlier, this is a process that demands additional time from the athlete. However, once you consider how this may make the difference of being side-lined versus remaining in the game, as well as the time and cost of treatment and rehab; it quickly begins to make more sense to follow this routine than not. There are shorter versions that can be implemented and although they are not as effective, they do still aid in accomplishing the desired outcome to some extent. The abbreviated outline of the above process and some variations of it are as follows:

Best: warm up -> SMR -> stretch -> exercise -> SMR -> stretch

Better: warm up -> stretch -> exercise -> SMR -> stretch

Good: warm up -> stretch -> exercise -> stretch

OK: warm up -> exercise -> stretch

Bare Minimum: warm up -> exercise

Bad Idea: stretch cold and exercise without a proper warm up

Dr. Hamid Sadri is a sport chiropractor from Atlanta, Georgia, with over 24 years of experience. He holds certifications from the American Chiropractic Board of Sports Physicians, National Academy of Sports Medicine, National Strength & Conditioning Association, Graston Technique and Active Release Techniques. He has worked with national and international athletes of all levels and was selected as one of America’s Top Chiropractors by the Consumer’s Research Council. Contact:




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