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Overuse Injuries

Joint and other musculoskeletal overuse injuries can happen at any age if you engage in regular exercise and physical activity. For example, you can overuse your muscles, bones, joints, ligaments, and tendons when you participate in athletics; but you also can get overuse injuries from repeated activities such as gardening and certain household chores. Some overuse injuries such as carpal tunnel syndrome come from activities such as typing too frequently and for too long.

Many overuse injuries result from doing too much exercise too soon. But overuse injuries also occur in experienced exercisers who don't give themselves time to rest and recover.

Musculoskeletal Injuries

Two types of injuries — large (macro) trauma injuries and small (micro) trauma injuries — can affect the muscles, bones, joints, tendons, and ligaments that comprise your musculoskeletal system. Macrotrauma injuries such as ankle sprain, joint dislocation, and ruptured tendons result from a single traumatic or forceful blow or event. Microtrauma (or overuse) injuries result from frequent, repeated use of muscles, tendons, ligaments, joints, and bones.1

Microtrauma injuries include small tears in fibers and connective tissue of the muscles as well as sprained ligaments, strained muscles, and overstretched tendons. Microtraumas often cause swelling that you cannot see or feel to the touch, but they can cause tightness, discomfort, tenderness, and pain.

Overuse (microtrauma) injuries develop over time and include:

  • Achilles tendonitis
  • Bruised and blackened toes and toenails
  • Corns, calluses, and blisters
  • Carpal tunnel syndrome of the wrist
  • Golfer's elbow (medial epicondylitis)
  • Jumper's knee (patellar tendonitis)
  • Little league elbow (overuse of the medial epicondyle apophysis)
  • Little league shoulder (overuse of the proximal humeral physis)
  • Rotator cuff tendonitis of the shoulder
  • Runner's knee
  • Shin splints (inflammation of tissue of the tibia)
  • Tendonitis (also known as tendinosis or tendinopathy)
  • Tennis elbow (lateral epicondylitis)

Symptoms of overuse injuries include:

  • Pain immediately after or within 12 hours of exercising or activity 
  • Pain during and after exercise or activity that does not prevent movement and eventually gets better 
  • Pain during and after exercise or activity that prevents movement and eventually gets better
  • Constant or chronic pain that prevents movement and does not get better

When microtraumas aren't given time to heal, they can cause major injuries such as ruptured tendons and ligaments, fractures, broken bones, partial or complete loss of joint function, and even infection.

What causes overuse injuries?

Exercise and activity can strengthen muscles, tendons, bones, and ligaments through a process known as remodeling — the break down and growth of new tissue. But when tissue breaks down faster than it can rebuild, injuries occur,. 

Exercising or engaging in a physical activity too intensely, too long, and too often does not allow enough time for remodeling. For example, if you run 3 miles 3 times a week at a moderate pace and then suddenly increase the number of days you run, run farther, and run faster, your muscles, tendons, ligaments, bones, and joints are unlikely to have the time they need to rebuild. 

You also can get an overuse injury from changing equipment such as shoes if you are a walker, runner, or dancer. Running on pavement instead using a treadmill or cushioned track also can contribute to overuse injuries. Improper technique when strength training, throwing a ball, and swinging a tennis racquet or golf club can strain certain muscles and joints and result in overuse injury. Some people even get overuse injuries from favoring injured parts of the body. For example, having a sprained ankle can cause you to improperly or too frequently use your healthy ankle and leg and cause an overuse injury of the healthy leg.

Certain medical conditions, including previous injuries, flat feet, excessively arched feet, bowlegs, unequal leg length, and poor alignment of the spine, hips, and legs also can increase the likelihood of overuse injuries.

As you age, you are more likely to experience overuse injuries. But overuse injuries are becoming more common in children and adolescents, especially when they repeat the same activity such as pitching for a baseball team in the spring, summer, and fall leagues.

The good news is that you can
prevent most overuse injuries!

To prevent overuse injuries:

  • Rest when you feel pain or are overly sore
  • Get instruction from a certified personal trainer who can teach you proper form and how to use equipment correctly
  • Vary your exercise routine and activities (cross train) to build overall strength and fitness
  • Vary the intensity and duration of your workout or activity
  • Gradually increase the duration, intensity (pace, amount of weight/resistance), and distance of your activity
  • See a sports medicine expert before beginning or when returning to an exercise program or activity, especially if you have previously had an overuse injury
  • Schedule at least 2 rest days per week so your musculoskeletal tissues have time to rebuild
  • Use the right-sized equipment (bicycle, tennis racquet, golf club, shoes)

Treatment for overuse injuries includes:

  • Not using the injured muscle, tendon, ligament, or bone until it has time to heal and your pain goes away
  • Reducing the intensity, duration, and frequency of workouts and activities
  • Icing the injury 
  • Gently stretching the injured muscle, tendon, or ligament when advised by your doctor
  • Using over-the-counter anti-inflammatory medications to help relieve symptoms
  • Warming up before your workout or activity
  • Varying your workouts and activities

Learn helpful exercise tips!

To schedule an appointment
with a sports medicine expert,
call Summit Medical Group Sports Medicine
at 908-277-8936.



1. Micheli LJ. Common painful sports injuries: assessment and treatment. Clin J Pain. 1989; 5 Suppl 2:S51-9; S59-60.