Overuse Injuries

Overuse Injuries and How to Prevent Them

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Medically reviewed by Misty Seidenburg

The human body is uniquely designed to adapt to increasing loads over time. Our bones, muscles, and connective tissues get stronger as the intensity of physical activity gradually ramps up. Gradually is the key word here. If you go too hard too soon—without giving your body the chance to adapt—you increase your risk of painful overuse injuries.

What Is an Overuse Injury?

An overuse injury is a microtrauma to a muscle, ligament, tendon, or bone caused by overtraining or repetitive demands on the parts of the body over a long period of time. Unlike an acute injury that happens suddenly, you may not realize you have an overuse injury until it has already occurred.

Who Is Affected by Overuse Injuries?

Overuse injuries in children are becoming more common, especially as we are seeing young children playing competitive travel sports that require year-round training.

Their developing bodies may not be equipped to handle the stress of repetitive throwing, kicking, running, and arm and hand motions. Repetitive stress injuries can impact the growth plates as well as lead to long-term injuries that are not easily treated.

While overuse injuries are common in athletes who perform the same motions over and over, anyone who frequently repeats the same movements is at risk. Whenever you place an excess load on the body without giving it time to break down and rebuild the affected tissues, you can damage these structures.

Many overuse injuries are work-related, affecting people who perform the same physical tasks throughout their day. People who spend a lot of time typing or using a mobile phone and other tech devices can also develop overuse injuries of the hands, wrists, and arms.

Other Risk Factors for Overuse Injuries

There are a few more factors that increase the risk of overuse injuries:

  • Training load errors
  • Training frequency errors
  • Body composition
  • Significant differences in leg length
  • Limited joint range of motion
  • General muscle tightness
  • Muscle imbalance and/or weakness
  • Unsupportive equipment, shoes, and surfaces

Overuse Injury Symptoms

Stiffness and/or soreness in the affected tissues are typically the first signs of microtrauma. You may notice these symptoms the day after activity, and they may dissipate when you resume activity again.

If you continue to aggravate your injury and cause more damage, you might experience:

  • Inflammation: redness, swelling, warmth at the injury site
  • Ongoing pain: discomfort that never completely goes away even after activity
  • Functional impairment: difficulty completing activities without the need for assistance

Overuse injuries not only cause physical symptoms. They can impact one’s ability to do the sports and activities that enhance their overall quality of life. Whether that is a high-level competitive sport, or a hobby like sewing or gardening, treating and preventing repetitive strain injuries is essential for returning to activity safely and avoiding permanent impairment.

What Are Common Overuse Injuries?

Overuse injuries can affect nearly every part of the body. Here are some of the most common repetitive stress conditions we see in the physical therapy clinic:

  • Bursitis: inflammation of the small, fluid-filled sacs causing pain and inflammation in the affected area
  • Carpal tunnel syndrome: compression of the median nerve within the carpal tunnel in the wrist, leading to pain, numbness, and tingling in the forearm
  • Jumper’s knee: overuse of the knee joint, as with frequent jumping, which inflames the patellar tendon that connects the kneecap to the shin bone
  • Little league shoulder: repeated throwing with improper mechanics or without rest can cause shoulder pain and swelling, usually in teens
  • Osgood-Schlatter disease: constant pulling of the patellar tendon on the area beneath the knee causes a painful bump to form on the shin bone, also common in tweens and teens
  • Runner’s knee: dull pain at the front of the knee where the knee connects to the bottom of the thighbone, common in runners
  • Sever’s disease: inflammation of the growth plate in the back of the heel, the leading cause of heel pain in young children
  • Shin splints: pain, swelling, and soreness in the shin bone, common in runners and dancers
  • Stress fractures: small cracks in a bone, caused by repetitive force like frequent jumping or running long distances without downtime
  • Tendinopathy: tiny tears in a tendon caused by overuse, commonly affects the wrist, knee, heel, shin, and shoulder
  • Tennis or golfer’s elbow: inflammation of the tendons that attach to the elbow, caused by frequent arm and wrist motions

This list of overuse injuries is far from complete. Always see your healthcare provider and physical therapist if you have pain, stiffness, or other unusual symptoms.

7 Tips for Treating and Preventing Overuse Injuries

Now, let us focus on how to treat and prevent repetitive strain so you can stay injury-free while you work, train, and play.

1. Take a break.

Take time off from activities that engage the injured parts of your body and aggravate your condition. You won’t be down for long. Recovery does involve some exercise. But it is important not to cause further damage to an existing overuse injury.

(Note: some stress fractures and more severe overuse injuries require longer periods of strict rest. Always follow your healthcare provider’s guidance in this regard.)

2. Practice PEACE and LOVE.

The emerging approach to treating soft-tissue injuries shifts the focus from ice and anti-inflammatory medications that may interfere with tissue recovery.

The PEACE and LOVE treatment protocol focuses on elevation, compression, and gradually increasing load in stages. Talk to your healthcare provider and physical therapist if your symptoms don’t improve or they get worse with at-home care.

3.Gradually increase your activity with physical therapy.

After an overuse injury, you may be hesitant to resume your sport or exercise program. It is natural to be concerned about reinjury. Physical therapy is ideal for patients who are recovering from a repetitive stress condition or want to be proactive about preventing them.

Physical therapists are “movement experts” with unique insight into how the body’s muscles, bones, and connective tissues function together. They identify issues with form, mechanics, technique, and posture that increase the risk of injury.

They help you manage current symptoms and introduce stretching and strengthening exercises to prevent them from recurring. Together you and your physical therapist will introduce physical activity and load at a safe, gradual pace that gives your body time to adjust.

Treating overuse injuries takes time. Your injured tissues can take several weeks to months to heal completely. Your physical therapist helps you stay focused, patient, and positive every step of the way.

4.Switch up your training.

Cross-training is essential for all-around strength and for maintaining that fitness during your recovery period. Variety in your workouts allows you to work all the muscles throughout your body, using them in different ways to prevent injuries.

5. Warm up and cool down with stretches.

Prepare the body for activity with sport-specific dynamic stretches to increase your flexibility, range of motion, and coordination. After your workout, take time to cool down with static stretches. These are also beneficial for increasing the range of motion and decreasing the chance of muscle strain and stiffness.

6. Use the right equipment.

In some cases, improper equipment can place undue stress on certain body structures. For example, soccer players who don’t wear supportive, well-fitted cleats may be more prone to stress fractures. If the cleats aren’t effective at absorbing some of the shock of movement, that force is transferred to the muscle.

If the muscle becomes fatigued, that force is transferred to the bone which can crack under the pressure. Always use the right equipment for your activity to make sure you are easing the stress on your body.

7. Listen to your body.

Pain is your body’s way of sending a message that something is wrong. Listen to your body’s cues and never try to push past the pain. If symptoms continue, make an appointment with your healthcare provider and schedule a physical therapy evaluation for an accurate diagnosis and plan for rehabilitation. Find a physical therapy clinic near you.

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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