Avoiding Overuse — Podcast Interview with Dr. Anthony Manzella

Listen or Read Ferraro Spine’s Monthly Podcast Interview!

Topic: Avoiding Overuse – Injuries in Runners/Athletes

Below you will find an easy to read transcript of Dr. Anthony Manzella’s interview on the razorcast™ monthly podcast. You can click the video to listen to the podcast or read the easy to follow transcript below. Enjoy!

Podcast Interview:

RC: Hello everyone, this is Liz Harvey coming to you from our razorcast™ studios in New York City where we are dedicated to bringing you top quality advice from many of the leading expert professionals across the United States.

In today’s episode, we are speaking with Dr. Anthony Manzella. Dr. Manzella is the director of Physical Therapy at Ferraro Spine & Rehabilitation which is a multi-specialty wellness facility serving northern NJ and the NY metro area for the past 18 years.

Dr. Anthony Manzella is a graduate of the University of Medicine and Dentistry of New Jersey.  He developed his passion for health and wellness by training and conditioning some of the area’s most successful middle school, high school and college athletes. Dr. Manzella is a Performance Enhancement Specialist and he routinely works with athletes as well as patients going through rehabilitation.

Dr. Manzella is widely considered to be one of the top doctors of physical therapy in the country and he is also a contributing member of our national network of industry professionals.

Today we are going to talk about a very important topic:
Avoiding Overuse – Injuries in Runners and Athletes

RC: Hi Dr. Manzella how are you today?

Dr. Anthony Manzella: Hi Liz I’m doing great. How are you?

RC: I’m doing great, thanks so much for joining us and I’d like to jump in.

Question 1: Athletes have to train and practice so how can they possibly avoid overusing their bodies?

RC: So I know so many runners, myself included, and it seems like we’re always injured somehow. So how can we possibly avoid overusing our bodies?

Dr. Anthony Manzella: Well first, it’s important to understand what an overuse injury is. So really overuse injuries occur as a result of repetitive micro-trauma to the soft tissues. So it’s just that repetitive motion of doing the same motion over and over again that causes our body to break down. You know what’s important to understand is really what it comes down to is human biology. The body has this tremendous ability and a capacity to adapt to physical stress. It’s how we get stronger and improve function.

That being said, once we get past a certain point, we start to break down. Really what it comes down to is our remodeling ability. So our soft tissues, our muscles and connective tissue remodel by basically breaking down and then building up. But if there’s too much breakdown such as trying to do too much too soon as we see many of us do. We get injury.

So where do we get injury? We get injury to the area that’s most stressed. So if you have a deficit in the way that you’re running and you’re over pronating or your foot is collapsing too much, you’ll tend to get stress on the inside of your knee. So that’s an area of too much stress. So if we do the same activity such as running, those areas will tend to break down. So the usual suspects to overuse injury usually are the folks that are doing too much too soon. Also poor technique in the activity such as that runner that I discussed. Or say you know a runner that’s over striding and that’s landing on the outside of the base of his support. So every time his heel strikes the ground or foot strikes the ground he’s basically putting the brakes on. So inefficiency is in the way of the technique of the activity.

Also there’s times where the cause is imbalances in strength and flexibility. So it doesn’t allow us to perform the activity efficiently. And then there’s also kind of weak links in the kinetic chain such as maybe an old ankle sprain or knee tendonitis because our body will compensate from those old injuries and affect the way that we move. So really the prevention step would be really balance in your approach to training. Vary the activity. So if you’re a runner, bike sometimes. If you’re running, change direction, run backwards, run sideways, skip, shuffle… You don’t see many people doing it and you kind of look silly but think about how your body is going to perform and the injuries you are going to prevent. And all those people that are just running straight are just breaking their bodies down over time. So that’s one way that you can kind of get your mindset right for looking a little silly and being a little goofy.

The other prevention step is to work on the individual athlete’s weak area. So if there is a technical error in the way that they’re running or moving or there is imbalances, really you have to seek out some professional advice whether it’s from your coach or your trainer. If it’s a movement deficit then the person probably to go to would be a skilled physical therapist that is close to you.

Question 2: Which sports or activities produce the most overuse injuries?

RC: Okay and besides running which sports or physical activities produce the most overuse injuries?

Dr. Anthony Manzella: You know the most overuse injuries that I see you know they are a lot to do with running and usually resulting from running is knee, hip, ankle injuries. Or we also see a lot of tennis players with pain on the outside of their elbow. And we have a variety of different patients such as the youth patients participating in little league and having more inside elbow pain and then we have swimmers with shoulder pains. There’s kind of commonalities in these different sports however the reasons for the over-stress can be many different things. So it’s important that you get the right sound advice versus finding a protocol or exercises on the internet to kind of self-treat. It’s better to seek out professional advice and get specific exercise instructions, specific self-massage instructions to help with the issues that you’re having.

Question 3: What are the long term effects of overusing a certain body part?

RC: Okay and I know you touched on this a little bit but what are the long term effects of overusing a certain body part?

Dr. Anthony Manzella: The long term effects would be further breakdown of the area. So if you have a tendonitis or inflammation of the tendon in your knee from running, it’s only going to get worse if you don’t take care of it. So you’ll have degeneration of the knee. You’ll have chondromalacia which is a softening of the cartilage underneath the kneecap. The other thing is you have secondary issues/secondary problems resulting from the way that you’re moving and basically you’re going to compensate in the way that you’re functioning because of the fact that you’re having some pain and having some irritation of an issue. And the worst thing that happens is usually that degenerative change to that area. So the patient that doesn’t take care of that knee tendonitis, down the line becomes complete degeneration where the joint is bone on bone and then we’ll require an invasive surgery such as a total joint replacement.

Question 4: How do you treat someone with an “overuse” injury?

RC: Okay and how do you treat someone with an overuse injury in your office?

Dr. Anthony Manzella: Really it’s a two-step process. First we will access the individual patient. We’ll get a history of that patient and find out their story along with understanding if they are training, what their training schedule is and how they’ve progressed. Really understanding that is sometimes the most important and then from there we go into both a localized and global movement assessment where we assess the individual joints and both the upper and lower extremities and then along with a global movement assessment where we look at various common movement patterns that may be effected. And then we go into more of a sport specific biomechanical assessment so if we have a runner we’ll go into a running specific position and kind of see how the body gets in and out of positions required for a given activity such as running.

Then from there, we go onto treatment. You know the first goal with these type of athletes is to reduce stress to the inflamed area. So we use a series of different modalities, both pain and physical modalities such as manual therapy to that area to improve the circulation to the area but also to reduce the inflammation of the area so we help speed up the healing process.

And the next would be to build in certain exercise strategies to address the movement deficits and compensations we found and slowly ramp the activity back up. So first we may need to ramp down the activity but then you know slower we’ll ramp it back in as we see fit and kind of just closely monitor how the person’s feeling and moving so that we make sure that we position that person for success for the long term.

Question 5: How long does it take to recover from an overuse injury and can athletes ever fully recover?

RC: Alright and that leads me to my last question. How long does it take to recover from an overuse injury and can athletes ever fully recover?

Dr. Anthony Manzella: You know that’s a loaded question and it definitely does vary with the person. But if you really get to the cause of something which a lot of times you can, you can really help someone fully recover. Now the timeline can vary from days to months and it really depends on the severity of the condition, how the person heals, whether the patient is in season or training for an event and other kind of individual factors. But most can recover very quickly once the primary stressor is altered because you’re giving the body an environment to heal itself and that’s really what it’s about.

RC: Great thank you so much Dr. Manzella. We know you’re really busy so I just want to thank you for your time and help today.

Dr. Anthony Manzella: Oh no problem. Thanks for talking to me.

RC: And for our listeners across the country, if you are interested in speaking with Dr. Anthony Manzella, you can either go online at www.ferrarospine.com or call (973) 478-2212 to schedule an appointment.

On behalf of our entire team at razorcast™, we want to thank you for listening and we look forward to bringing you more top quality content from our country’s leading industry professionals.

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