So called ‘overuse sports injuries’ eg sore knees, Achilles tendinopathy, rotator cuff strain and shin splints are a regular presentation in the clinic. When people experience such symptoms they often put it down to ‘overdoing it in the gym’, needing new sport shoes or ‘not stretching enough’. They may seek treatment or just wait and hope the problem settles with rest. The signal of pain is a warning that all is not well. What has caused that body part to be stressed? One has to consider the contribution of intrinsic factors that may directly or indirectly lead to the overload on the injured area, such as altered posture, muscle imbalances, stiff spinal joints or poor pelvic control. For example, if a tennis player has a stiff thorax and upper back, in order to generate sufficient power while serving he may overload the shoulder, thus potentially developing a tear in the rotator cuff muscles. Altered muscle function can directly affect the health of our joints. In the torso, the muscle control of the spinal joints and the large ball and socket joints – the shoulder and hip are intimately related.

Addressing the root cause

The nerves which drive the muscles throughout our body exit the spine in close proximity to the spinal joint. Substandard muscle control in the trunk invariably causes some spinal joints to become either stiff and/or overworked. This is associated with local inflammation, which can irritate the adjacent nerve. Sciatica is one manifestation of this. As these nerves supply the joints, muscles and related soft tissues in the limbs, when irritated, they can also contribute to other aspects of altered function in these ‘target tissues’, helping to explain the development and persistence of many limb symptoms such as ‘tendinopathy’, heel pain, shin splints, tennis elbow etc. While it may well be necessary to treat the ‘sports injury’ locally to reduce symptoms, without addressing the intrinsic and spinal factors (by mobilising stiff joints, correcting posture and spinal control), the adverse neural input to the affected area probably does not change, and is therefore likely to recur, if it settles at all.