Cumulative Injury Cycle

Cumulative Injury Cycle (CIC)

Many conditions arising in the foot and lower limb can be attributed to the CIC, or the CIC can commence as a result of an injury and lead to further injuries developing. The CIC is a cycle in which  one factor can contribute to the development/progression of other factors in the cycle, leading to increased tissue damage, increased pain and delayed recovery times.


In some instances you may have previously tried one treatment (eg: stretches or icing the painful area) and have gained a small amount of relief, however the pain is still present and/or the pain has returned. This may indicate that you are in the Cumulative Injury Cycle and will need a more thorough assessment in order to determine the root cause of your condition so as to commence the most appropriate treatment program for you.



What Does It All Mean?

The CIC is a self-perpetuating cycle that feeds itself and can worsen a biomechanical/musculoskeletal problem. For example; swelling in and around a muscle (which may be caused from injury, poor biomechanics etc…) does not allow for free movement of the muscle/s to occur, due to swelling and/or scar tissue. This in turn increases the friction between muscles and fascia, resulting in decreased ranges of movement (eg: tight muscles and fascia). Tight muscles and/or fascia are more susceptible to injury. Injured tissue results in swelling… and so the cycle continues.

Types of Injuries

1. Acute Injury – Eg: Ankle sprain. This type of injury results in inflammation developing as blood rushes to the area to begin repairing the damaged structures.

2. Repetitive Injury – Occur when repetitive movements are performed with very little rest time in between. This results in overused, fatigued and weak musculature. In relation to podiatry; poor biomechanics/foot function placing repetitive stress on musculature as the muscles are trying to compensate for inefficient joint motions (eg: fallen arches resulting in the leg muscules working harder to stabilise the foot/arch)

3. Constant Pressure / Tension – Occurs as a result of poor posture/biomechanical alignment. Constant pressure/tension on structures decreases blood flow, interferes with nerve input and can inhibit cell repair.



Weak & Tight Structures: If a muscle is constantly under increased tension (ie: tight) it eventually becomes weak, and when a muscle is weakened the body’s response is to tighten the muscle/s up in an attempt to stop the abnormal function.

Friction / Pressure / Tension: If there is an increase in these factors in and around soft tissue structures the structures are not able to freely move throughout their normal ranges of motion.

Decreased Circulation / Oedema (Edema): Increased friction / pressure / tension placed on blood and lymphatic vessels will disrupt the flow of blood and lymph fluid into and out of an area. This means that your body may not be able to clear up any swelling due to the vessels being under pressure, or alternately you may not get adequate blood flow to an area due to pressure on the vessels. These processes can happen simultaneously.

Adhesions/Fibrosis: When the body is attempting to heal injured structures it repairs the areas with more fibrous tissue than what was there originally. Fibrous structures are not as elastic or strong as normal connective tissue, and these tissues adhere to surrounding structures resulting in increased friction/tension and/or decreased range of motion.

Tear or Crush: Some of the types of physical disruption/injury that can occur to the body’s tissues. A tear injury may be an ankle sprain or a torn muscle/tendon.

Inflammation: This results from the tissue injury and begins the ‘healing’ process in which adhesions begin to form, at which point the cycle continues to weaken and tighten the tissues.

As you can see, this is a cycle that will continue to self-perpetuate unless the cycle is broken.



FTSPodiatry utilises a number of therapies and treatment methods in order to combat each aspect of the cycle so as to obtain the best possible treatment outcomes for our patients.



Orthotic Therapy

Lower Limb Soft Tissue Therapy / Manual Therapy

Dry Needling

Sports Taping

Exercise Prescription


The above information is for informative purposes only and should not be used as a diagnostic and/or treatment tool. Undertaking a treatment/rehabilitation program without advice from an experienced health professional may lead to injury. In order to correctly diagnose your condition and commence an appropriate individualised treatment program it is advised the you contact Forster Tuncurry Sports Podiatry for further assessment.


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