I prefer the term ‘Misuse Injury’ to ‘Overuse Injury’ but I am sticking with the term ‘Overuse Injury’ because it is more generally used and understood. I think that Misuse Injury is a more accurate term because these injuries are not just caused by overuse but by misuse and the term ‘misuse’ covers the term ‘overuse’ but not vice versa. This is important because when doctors and the public use the term ‘overuse’ they are then inclined to think that the answer is to simply underuse the affected part, rather than learn correct use and undergo very careful rehabilitation where appropriate.
Definition of overuse injury (1)
Overuse injury occurs due to ‘repetitive submaximal loading of the musculoskeletal system when rest is not adequate to allow for structural adaptation to take place’.
Key features (1)
i) repetitive loading (rather than acute traumatic)
ii) exceeds the capacity of the tissues to remodel leading to a damaged structure
iii) there is an imbalance between training loads and recovery.
One of the main problems with overuse injuries is that they can creep up on you without you noticing or just happen very suddenly giving you very little chance to respond effectively. In my case, I have noticed that it has often taken months for the overuse injury to appear. During this time it is easy to become complacent. The other problem is that they can be very difficult to diagnose.
I have also noticed that therapists, whether doctors or physiotherapists, do not draw a distinction between degenerative changes in the body, overuse injuries and acute injuries. I’ve tended to find that they tend to treat all of these things quite similarly e.g. the tear in my knee cartilage is seen as just that, rather than an overuse tear – which I know that it is because of the history of the problem. Obviously there is overlap between degenerative, overuse and acute injuries, for example degenerative change may predispose to an overuse or acute injury.
There is more awareness now that pain and loss of function caused by overuse of the tendons does not necessarily cause tendonitis i.e. inflammation of the tendons. This is why the term tendonosis or tendonopathy is the preferred term now. This is not a simple case of semantics because tendonitis requires a completely different treatment approach to tendonopathy. Read about research here. Overuse injuries do not always involve inflammation, this is something that is more associated with an acute injury, e.g. if you sprain your ankle it will swell because of inflammation. Overuse injuries are caused by repeated microtears.
Unfortunately trying to treat an overuse can lead to further injury, more about this topic on this page.
I am wondering if there is an Overuse Injury syndrome where someone is prone to overuse injuries because I seemed to have picked up so many and it seems unlikely that I am unique. I think that it may be caused by a combination of physical and psychological vulnerabilities and other factors such as deficiencies in the health care system and not resting properly. These factors lead to injuries in a cascade effect because one injury leads to further compensatory behaviour within the body and inappropriate interventions, either from health care professionals or oneself. Essentially physical stress is moving from one part of the body to another without being correctly resolved.
Links and references
These are some good links that I’ve found about Overuse Injury: