Overuse Injuries

john miller physiotherapist

Article by John Miller

What is an Overuse Injury?

Overuse injuries refer to injuries sustained from repeated action (such as repetitive strain injury) as opposed to acute injuries, which occur in an instant (such as a sprained ankle).

Overuse Injuries

Overuse Injuries Can Occur to the Following Structures:

Exercise applies stress to the body. Your body adapts by thickening and strengthening the various tissues involved.  Hence, muscles get stronger, firmer and sometimes larger, tendons get stronger and bone density increases.

However, if exercise is applied in such a way that adaptation cannot occur, the excessive overload can cause microscopic injuries, leading to inflammation, which is the body's response to injury. 

Signs of Overuse or Inflammation include:

  • Swelling (which may be unnoticeable)
  • Warmth to the touch
  • Redness
  • Impaired function of the part.

All of these signs may be present but not noticeable in the beginning stages.  Often the first sign may be stiffness or soreness (especially in the morning) which may disappear with warm-up. Continued use may cause continued damage and the pain will last through and past warm-up and may be even worse after activity is finished.

The Four Stages of an Overuse Injury:

  1. Discomfort that disappears during warm-up.
  2. Discomfort that may disappear during warm-up but reappears at the end of activity.
  3. Discomfort that gets worse during the activity
  4. Pain or discomfort all the time.

Injury identification and treatment in stage 1, allows continuing activity as long as the injury does not worsen.

A stage 2, activity may continue at a modified pain-free level while being treated.  Treatment must continue until completely healed.

If the injury progresses to stage 3, activity must immediately cease. The supervising physiotherapist will allow a return to activity after identifying the cause and you are completely symptom-free. Competitive athletes, depending on the individual circumstances, may return to activity.

If the injury progresses to stage 3, activity must immediately cease. The supervising physiotherapist will allow a return to activity after identifying the cause and you are completely symptom-free. Competitive athletes, depending on the individual circumstances, may return to activity with stage 1 symptoms.

What Causes Overuse Injuries?

  • Lack of appropriate muscle strength or endurance
  • Poor core stability
  • Muscle imbalance (strong tight muscles versus weak stretched muscles)
  • Inflexibility
  • Malalignment or Biomechanical issues (e.g. flat foot, squinting patellae)
  • Training errors
  • Faulty technique
  • Incorrect equipment.

By far the most common cause of overuse injury is training errors.  Moreover, the most common error is "too much, too soon".

How to Prevent an Overuse Injury

We can prevent overuse syndromes.  Some of the ways to prevent this injury include:

  • Warm-up (including stretching) and warm-down (including stretching) before and after all exercise.
  • Use proper equipment (e.g. jogging shoes for jogging, a racquet that is the right size with the proper grip size and strings strung to your level of play).
  • Increase at a rate no faster than 10% increase per week (distance, speed, weight, etc).
  • Practice and concentrate on correct technique.
  • Condition for 2-3 weeks before starting - strength and flexibility.
  • Listen to your body - pain is a warning that something is wrong.  Early identification and treatment will allow you to continue your activity.
  • Identify and correct the cause of pain or discomfort.
  • Ensure full injury rehabilitation, e.g. a sore right leg can cause an overuse injury in the left through compensation.

Common Overuse Injuries

  • Achilles Tendon Rupture
  • Achilles Tendonitis / Tendinitis
  • Bursitis Knee
  • Calf Muscle Tear
  • Carpal Tunnel Syndrome
  • Chondromalacia Patella
  • Compartment Syndrome
  • Cramps
  • de Quervain Tenosynovitis
  • Degenerative Disc Disease
  • DOMS - Delayed Onset Muscle Soreness
  • Femoroacetabular Impingement (FAI)
  • Fibromyalgia
  • Golfers Elbow
  • Greater Trochanteric Pain Syndrome
  • Hip Labral Tear
  • ITB Syndrome
  • Knee Replacement
  • Meniscus Tear
  • Metatarsalgia
  • Morton's Neuroma
  • Muscle Strain (Muscle Pain)
  • Neck Arm Pain
  • Olecranon Bursitis
  • Osgood Schlatter's
  • Osteitis Pubis
  • Overuse Injuries
  • Patella Tendonitis (Tendinopathy)
  • Pes Planus - Flat Feet
  • Plantar Fasciitis
  • Poor Hip Core
  • Posterior Ankle Impingement
  • Retrocalcaneal Bursitis
  • Rotator Cuff Syndrome
  • RSI - Repetitive Strain Injury
  • Sacroiliac Joint Pain
  • Severs Disease
  • Shin Splints
  • Side Strain (Abdominal)
  • Sinding Larsen Johansson Syndrome
  • Spondylolisthesis
  • Spondylolysis (Back Stress Fracture)
  • Stress Fracture
  • Stress Fracture Feet
  • Tennis Elbow
  • Trochanteric Bursitis
  • Call PhysioWorks Book Online

    Common Treatments for Overuse Injuries

    The two most important steps in management of overuse (inflammation) injury are:

    • Remove cause
    • Reduce inflammation
    • Carefully return to activity as the symptoms dictate.

    Professional assessment and guidance is highly recommended for overuse injuries. Not only are you repairing acute symptoms you are also aiming to avoid its recurrence once your training resumes.

    Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Medications?
  • Soft Tissue Massage
  • Brace or Support
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Prehabilitation
  • Running Analysis
  • Scapulohumeral Rhythm Exercises
  • Strength Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • FAQs about Overuse Injuries

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Massage Styles and their Benefits
  • How Does Kinesiology Tape Reduce Swelling?
  • How Much Treatment Will You Need?
  • Rotator Cuff: What is it?
  • Sports Injury? What to do? When?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What Can You Do To Help Arthritis?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Call PhysioWorks Book Online

    Helpful Products for Overuse Injuries

    Overuse Injuries


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    Last updated 07-Sep-2015 02:53 PM

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