Insidious Onset Injuries

Have you ever had an injury that came on out of blue with seemingly no warning, this is what we call an insidious onset injury. Not only have I experienced this personally, but I see it a lot in my clinic. A patient has been doing an activity whether this is an every day activity or a sports activity and all of a sudden they experience pain in a joint or the muscles. An example of an injury that I’ve had happen to me several times is a sudden onset of calf cramping and pain while running. Every time this has happened I had no pain the day before or at the beginning of that run, then, all of a sudden my calf tightens up and cramps so badly that I can’t take another stride. What’s worse is usually this isn’t something that resolves quickly, it can take a few days or even weeks to get better. So why does this happen?

Generally issues like this arise because of abnormal stress being placed on the joints or the muscles and other soft tissues. Simply put, they’re being asked to do a job that’s either not their job, or they’re being asked to work much harder than they are used to. Lets stick with the calf example for a moment. So why does my calf occasionally get strained and cramp up out of the blue? In my case, it’s because I’m asking the calf to work harder than it’s used to. With running, one of the main roles of the calf is to point the foot down toward the ground to help push off the ground and propel the body forward. However, the calf is not the only muscle that’s supposed to be doing that job. The calf is supposed to be assisted by the muscles that extend the hip (the hamstrings and glutes) and the muscles that extend the low back. Unfortunately for me, these other muscles have called out of work, as my friend who is a chiropractor, would say. And what happens when these muscles call out of work? The ones that show up for work (the calves) have to work harder and do a job they shouldn’t need to do. The calves can handle this for a short period of time but after a while, they become overworked and start to break down for seemingly no reason. In reality there is an underlying movement issue that I’ve had for awhile that has lead to this injury, and if it’s not corrected it will continue to be a problem on and off.

Let’s look at one more example to help you understand how this can also happen to a joint. In this example we’re going to talk about the knee. As you probably know, the knee is a hinge joint, which means its role is to bend and straighten; it shouldn’t move from side to side and it should have very minimal rotation. Side to side motion and rotation are supposed to happen below and above the knee, at the foot/ankle and the hip. Frequently in the clinic, when people come to see me for knee pain, I can quickly see that there are abnormal movements happening at the knee and abnormal stresses being placed on the knee. A prime example is the knee may be in a position where it’s facing inward instead of straight forward which would place a lot of twisting and torque on the knee. This generally happens for a couple reasons, (1) the hip joint is too tight, (2) the muscles at the hip aren’t properly controlling rotation of the leg, or (3) there is a lack of stability in the foot and ankle. As a result, someone will come in complaining of knee pain when in reality there is a movement issue in other parts of the leg. Like the muscle example, the knee is being asked to work in a way it wasn’t intended to work. It may tolerate this for a while, until the wear and tear becomes too much and causes arthritis or inflammation in the joint itself.

To quickly summarize, insidious onset injuries, or injuries that occur out of the blue with no apparent cause, are generally due to a movement issue resulting in abnormal stress being placed on joints and/or soft tissues. Looking back, some of my patients are able to identify some signs that indicated there was a problem brewing. Most often they will describe these signs as stiffness, tightness, or soreness. They may also have experienced different insidious onset injuries in different areas of the body that have since resolved. As the body learns to compensate and place the stress elsewhere, pain and symptoms can move around. The morale of the story is, if you have experienced an injury or multiple injuries that have occurred for seemingly no reason, you likely have an underlying movement issue that is placing abnormal stress on your muscles and joints. To avoid these injuries in the future and stay healthy and active in the long term, you have to identify and correct these movement issues. If you want to find out the cause of your injuries and correct any underlying issues, a thorough physical therapy evaluation and treatment can help. To find out the cause of your pain and stiffness you can schedule a free discovery visit by clicking here. We’d love the opportunity to help you and look forward to hearing from you.