Overuse Injuries

What are overuse injuries?

Overuse injuries make up nearly half of all muscle and bone injuries seen by healthcare providers. An overuse injury is not caused by a sudden injury or accident, but rather by doing one certain activity over and over.

Overuse injuries can affect muscles, tendons, ligaments, and bones. Stress fractures are an example of an overuse injury to the bone. The constant stress on the bone causes it to break. Ligaments are strong bands of tissue that attach bone to bone and can also be injured from overuse. They may be strained over time and become inflamed or even tear. Tendons are strong bands of tissue that attach muscle to bone. Tendons can also become strained and torn from overuse. Common tendons injured from overuse are the Achilles tendon in the lower back of the leg and the patella (kneecap) tendon.

How do overuse injuries occur?

Overuse injuries occur from stress on the bone, muscle, tendon, or ligament. Over time these stresses cause the tissue to become inflamed and weaken. Usually it is a certain activity that causes the injury. For example, a runner may have a stress fracture in a foot bone from too much running. Or you may injure a tendon in your elbow from doing a lot of hammering or typing.

What are symptoms of overuse injuries?

Common symptoms of overuse injuries are:

• muscle aches and soreness
• swelling
• decreased strength or speed
• pain with exercise or activity

How are overuse injuries diagnosed?

Usually the diagnosis can be made from a detailed history of your symptoms and a physical exam. You may have X-rays, ultrasound, MRIs, or CT scans to check if you have a stress fracture or any tissue that is torn or damaged.

How are overuse injuries treated?

Overuse injuries are commonly treated by the following methods:

• Rest: You need to take time off from the activity that caused the overuse injury. This lets your body repair and heal.
• Ice: Put ice on the injured area for 20 minutes on, then 20 minutes off. You may use the ice as many times per day as you want. Just make sure to not leave the ice on for longer than 30 minutes and don't put the ice directly on the skin. Be sure to let your body warm back up to room temperature before icing again. Use ice after every practice, game, or physical therapy session.
• Physical therapy: Your healthcare provider may send you to a physical therapist. Often you will do some gentle stretching and some strengthening exercises. You may also have ultrasound treatments that provide deep heat to injured tissues and help them heal faster.
• Medicine: Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• If the pain is severe, your provider may give you an injection of a corticosteroid medicine.

How long will my overuse injury last?

Overuse injuries can be stubborn problems. Some overuse injuries can last up to 6 months. However, most get better in 4 to 6 weeks. Everyone's body heals at a slightly different rate. It is important to stick to your physical therapy routine while letting your body heal.

Do not try to rush back from the overuse injury. Make sure that you do not try to do too much too soon. If your injury was caused by knitting, typing, hammering, or some other activity, make sure to go back to these activities very slowly.

If you are returning to playing a sport, you should not return until you have:

• Full range of motion around the injured joint.
• No pain around injured area.
• Strength back to at least 90% compared to the uninjured side.

How can I prevent overuse injuries?

Overuse injuries can be prevented by using common sense and the following guidelines.

• Do not overtrain. Do not exercise too much on any one day. Also, make sure you take days off from training to recover and let your body heal.
• Stay flexible. Dynamic warm-up exercises will help improve joint mobility, improve flexibility, and keep your muscles from getting tight and having greater risk for injury. Examples of dynamic warm-up exercises include jumping jacks, push-ups, and other calisthenic type exercises. Stretch at the end of your workout or as part of a separate training session.
• Do soft tissue massage. Deep tissue massage helps break down scar tissue in muscles and tendons which reduces the risk of injury. Using foam rollers, tennis balls, or other soft tissue tools before exercising helps to prevent overuse injuries.
• Design a well-balanced training program.
  • Pay attention to the muscle groups that are weak. Try to strengthen these weaker muscle groups.
  • Work on inactive muscle groups.
  • Increase the length of shortened and tighter muscles.
  • Correct muscle imbalances.