top of page


Many times it can be difficult determining the cause of injuries. Below are lists of factors we need to consider even before we have a strategy to effectively treat an injury.

1. Physiololgyi; Is there an underlying condition causing this injury. We’ve had patients with cystic fibrosis, anatomical short leg and hyper-pronation of the foot. Infections, possible long-Covid  (especially difficulty breathing). There is a high prevalence of Lyme disease in the northeast. Lyme needs to be considered if there is an unexplained joint pain or fatigue.

2. Repetitive stress; This has become much more common in the last 2 years because of inactivity (remote learning & working). Even if that person is regularly working out, they are spending too much of the day sitting. This is usually causes posterior chain dysfunction.
3. Overuse injuries; If there a too rapid increase in frequency or intensity before the body responds to specific adaptation to imposed demands, there will be a higher incidence of injury to the muscles, bones, tendons, fascia and ligaments.

4. Environmental; Many injuries occur by running on hard surfaces such as cement, blacktop, tight turns, banked tracks, and extreme temperatures that the athlete hasn’t acclimated and are unaccustomed to. Faulty equipment needs to be replaced especially worn training shoes, flip-flops and other poor footwear.

5. Nutritional and chemical; A poor diet and inadequate hydration will have a detrimental effect  will contribute to poor performance and injuries. We can have a positive impact by avoiding processed foods including, candy, chips, luncheon meats, fast foods, soft drinks and most sports drinks. Some antibiotics and steroid medications weaken muscles, ligaments and tendons that can contribute to injuries.

6. Developmental; Pre-pubescent and pubescentathletes are prone to growth plate injuries. These occur primarily to the pelvis, hips and knees. The most common is Osgood-Schloders at the knee.  

7. Trauma-traumatic injuries to muscles and tendons (strains), ligaments (sprains) and the fascia caused by trauma are obviously the cause of injuries. Head injuries must be evaluated for concussion. Cuts and scrapes need to be cleaned and dressed.

8. Poor attitude and stress-increased cortisol and other sympathetic neurotransmitters will stimulate the “fight or flight” mechanism. This is something that can be helpful during competition but chronic stress poorly affects performance.

9. Rest-rest is essential daily, weekly and annually. Lack of recovery from training and competing will increase fatigue, injuries and eventually burn-out. 7-9 hours of sleep are highly recommended daily. 

bottom of page