Application of modalities in overuse syndromes

Abstract

Improper techniques are often the cause of overuse syndromes. Unless the technique is corrected, the patient is doomed to recurrence. The same is true of improper posture, especially in the lower extremity and trunk areas. The pitcher or tennis player should have his or her style analyzed for proper form. The runner should have his or her muscular imbalances corrected by exercise and orthotic appliances. As with all other modalities used for treating painful conditions, proper evaluation of the etiology and the rectification of the cause is important. When athletes are underway in their sports seasons, it is often difficult to convince them to accept the ideal healing conditions needed to eliminate the problem. Management of the condition with any modality while maintaining an active lifestyle often brings about ethical scrutiny. However, it is the belief of the authors that noninvasive modalities do not provide the pain relief that would enable the athlete to tolerate activity beyond a significant injurious stress level. The modalities allow the athlete to regain the criteria for return, strength, and range of motion more successfully. Short-term goal setting is imperative to proper return. Several plateaus should be successfully completed before full return to activity is allowed. Tennis elbow, for example, may be allowed an initial period of 5 minutes on alternate days, gradually increasing to full activity every other day. Patients are often so anxious to return to activity that they overdo, leading to a decrease in function with a rapid return to the results of inflammation. The goals of successful rehabilitation of the overuse syndrome are pain-free range of motion, strength, and endurance. The use of cold, heat, electrotherapy, and exercise allow the athlete to reach his or her goal of returning to activity more quickly with a reduced risk of reinjury.