You caught the fever with March Madness gearing up and you’ve been playing pick-up games for a couple of weeks. But all of a sudden, your knee is killing you. What’s the problem?

Sounds like a classic case of an overuse injury, according to Dr. Luke Fraundorf, a Marshfield Clinic orthopedic surgeon.

“An overuse injury develops slowly over time,” he said, “and is caused by repetitive stress on tendons, muscles, bones or joints.” Such injuries are different from acute structural injuries such as a pulled hamstring or a bone fracture.

Common overuse injuries include patellar tendinosis (jumper’s knee), shin splints, and Achilles tendonitis at the back of the heel.

Overuse can occur at any age

“These injuries can occur in the young or old,” he said. “While treatment varies slightly for the different injuries, mainstays include relative rest, anti-inflammation and physical therapy.”

The good news is you won’t normally need surgery for these injuries. Let’s break them down:

• Jumper’s knee is inflammation of the patellar tendon, which connects the knee cap (patella) to the shin bone (tibia). This tendon allows the leg to straighten. Symptoms are typically an ache below the kneecap after activity. Treatment usually involves rest, icing, anti-inflammatories such as ibuprofen and physical therapy.
• Shin splints are marked by inflammation of the tissues surrounding the shin bone between the knee and ankle. “This is caused by a rapid increase in training, repetitive running or jumping on hard surfaces, or lack of appropriately cushioned footwear,” Fraundorf said. “This can cause severe pain if not treated.” Treatment again is rest, ice, anti-inflammatories and appropriate flexibility and strength training. Shin splints can often recur. The earlier you seek treatment, the faster your recovery will be.
• Achilles tendonitis, or repeated micro-tears to the Achilles tendon at the back of the heel. “This can occur quickly or over a long period of time,” Fraundorf said. “It often causes pain and stiffness before, during and after exercise.” Like shin splints, it’s often associated with rapid increases in training, like at the start of a sports season. Again, rest, anti-inflammatories, icing and physical therapy are the treatments. You may benefit from inserts for your shoes to decrease the stress on the Achilles tendon.

Avoid too much, too fast, too soon

To prevent these injuries, pace yourself by always beginning new activities or sports at a low intensity and gradually build up. Wear shoes with good arch support and replace them at least every 500 miles.

Ask your doctor about appropriate strength, flexibility and conditioning prior to activities. And always warm-up before doing high-level activities.