There are two types of injuries:

1. Accumulative strain or cumulative trauma

Accumulative strain is a gradual build up of dysfunction (tightness, stiffness, weakness) in muscles or joints. This occurs due to repetitive activity done with poor technique or a sustained poor posture over time. If these bad techniques and postures continue, dysfunctions accumulate across the body until eventually it doesn’t take much force or time for a “strain” to occur. This causes negative signals to be sent to the brain, warning of the damage becoming dangerous. Protective mechanisms and pain are the result. Often when the pain onset seems to occur suddenly, it is actually the movement which was the ‘straw that broke the camel’s back’.

Example: Bianca is an office worker who spends 8 hours a day sitting at her desk, with minimal breaks. She has a tendency to slouch and hunch her shoulders forward to use her keyboard and mouse. She doesn’t have any pain, but her back has been a bit stiff when she goes home at the end of most days for the past two months. While Bianca is doing her laundry over the weekend, she bends over to pick up a jumper from the floor – suddenly she experiences a sharp pain in her lower back. After this point, walking, sitting, and even putting on her shoes is painful. Bianca has injured her back, but what caused this to occur in the first place?  
Answer: Bianca’s sustained poor posture over time  → Accumulative strain in the muscles and joints of the back → Bending over to pick up a jumper (the straw that broke the camel’s back) Acute back injury (protective mechanisms and pain)

To determine if the cause of your injury is accumulative, consider if you were able to perform the same or similar activity previously without pain or injury. If the answer is yes, then it is unlikely that the activity itself was the cause, but rather poor technique and posture which caused the injury to occur in the first place.

2. Non-accumulative strain or sudden trauma

a) A one-off incident with high force causes the injury and pain. 
Example: A motor vehicle accident, falling from a height, slipping and falling, being tackled or hit, etc. 

b) More rarely, diseases cause musculoskeletal pain
Example: Different types of arthritis, infection, and genetic diseases

Which type of injury can physiotherapy help?

Great physiotherapy can relieve the strain to the vast majority of musculoskeletal conditions in both the categories above, very quickly. You don’t have to wait for healing to occur to be able to be pain free and back to full function!

What types of activities can cause strain to accumulate?

  • Pushing beyond your body’s normal ranges (e.g. overstretching)
  • Using a computer for many hours a day without break
  • Sitting for many hours a day without break
  • Driving for many hours
  • Repetitive tasks without many breaks and variation (painting, cleaning, manual work)
  • Repetitive actions in sport … and many more (basically, anything performed for long periods or repetitively)

IMPORTANT: But remember, it’s not the activity that leads to accumulative strain; it’s the way the activity is performed. No activity or exercise is ‘bad for you’, provided you do it with good posture and technique!

How to fix this?

Our physios are here to help you to the best of their ability – and if they can’t fix you, they will help you find someone who can. For traumatic and cumulative injury, Elite Akademy Physiotherapists use the Ridgway Method to: 

1) Problem solve the underlying dysfunction that caused the injury, and 
2) Teach you what kind of muscle control is required for a long term solution of your problem 

For more detail about how we fix injuries, please read: How Does Elite Akademy Fix Injuries?

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