An Innovative Approach to Understand Overuse Injuries: Biomechanical Modeling as a Platform to Integrate Information Obtained from Various Analytic Tools

A cognitive shift is evident among the medical practitioners, performers, educators, and researchers who deal with over-use syndrome (OS) injuries. These groups now are clearly concerned with prevention as a desired strategy. Realistically the medical community must take on the burden of changing attitudes within the artistic community. Because artistic success or failure often is determined by microincrements of “ability,” performers and educators (individuals in the greatest position of influence over aspiring students) have been slow to change, and thoughtful training often takes a back seat to immediacy of skill acquisition. In our opinion, professionals will adopt alternate practices only if the weight of scientific evidence proves sufficient to challenge centuries of tradition. A clear message to the artistic community requires (1) clarity of definition, (2) convincing methodology, (3) consistent means of situational comparison, and (4) solutions that do not compromise the artist’s perceptions of the end product. Current definitions of OS typically fail to differentiate between physiologic tolerance (a time-based concept) and physiologic limits (momentary impact conditions). The medical community must get the message across that physiologic tolerance is entirely different from physiologic limits. Although diverse methods are used to evaluate OS injuries, individually none can quantify directly physiologic tolerance. This difficulty justifies the use of indirect means to (1) describe accurately the movements that are thought to cause the injury, (2) link external description with internal physiologic conditions, and (3) determine relationships that allow one to quantify levels of injury risk. In this context, biomechanical modeling has the potential to serve as a nexus for evaluating information obtained from multiple methodologies. This article validates the use of biomechanical modeling as a platform of information integration in the evaluation of OS. An examination of modeling theory in terms of typical OS conditions reveals a new mathematical representation, one that may serve to focus future discussions of efficiency related to prevention and effectiveness related to learning.