Understanding Overuse Injuries

Written by: Jacob Esarco, OMS-II

Overuse injuries are caused by microtraumas, microscopic tears within the bones, muscles, tendons, or ligaments triggered by repetitive motion of a joint or muscle. These microtraumas can lead to discomfort, swelling, and pain in the area. 

Overuse injuries are often associated with young athletes, but these injuries may affect anyone who repeats the same motions over and over in their daily lives. Gardeners, assembly line workers, carpenters, and even musicians are types of professions that could be susceptible to overuse injuries.

If you believe you have an overuse injury, contact our specialists at OrthoNeuro. We have the experience needed to give you a proper diagnosis and treatment. Schedule your visit today!

What Are the Symptoms of Overuse Injuries?

Overuse injuries can be associated with pain, tenderness, and swelling of the affected areas. Usually, when injuries are mild, the pain and discomfort are only felt when participating in an activity that uses the affected area. This can be confused with just normal tiredness and fatigue. 

A man with an overuse elbow injury from playing tennis.

When the damage becomes more moderate, the pain may be felt even in times of rest. Severe overuse injuries may even result in compromised use of the area due to continuous trauma being applied to the soft tissue, muscles, and tendons.

How Overuse Injuries Are Diagnosed

Overuse injuries can be diagnosed most often by utilizing a physical exam and patient history. Physical examination tests like the “empty can test” can be used to localize the specific muscle or tendon that is damaged. 

Less commonly, different types of imaging studies, such as X-rays and MRIs, can be applied to understand the extent of the injury. X-rays have a difficult time visualizing the soft tissues within the body. Still, they can be exceptionally useful in ruling out other musculoskeletal conditions that may present similarly to overuse injuries, such as broken bones. 

MRIs are outstanding at visualizing the soft tissues within the body and can help recognize the extent of the damage within the area. MRIs can help physicians discuss the next steps and treatment plans with the patient. 

How Can Overuse Injuries Be Prevented?

Warm up and stretch before participating in the repetitive activity. Warming up allows for the muscles and tendons to be ready to take on more intense loads during more strenuous activity.

Allow children to play multiple sports. Playing different sports can give certain muscle groups time to recover while a different one is being activated. This can help strengthen all major muscle groups within the body and not allow one to take over and be susceptible to trauma.

How Can Overuse Injuries Be Treated?

Rest is crucial to allow the microtraumas to heal and return to full activity. Rest should be included in a child’s schedule, and at least one day of rest is recommended for a child actively participating in sports.

Braces and compression wraps can be used to add support and take the load off the affected joint while participating in an activity. Braces can give the injury time to rest and prevent further microtears and damage from forming.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen (Advil) can help reduce any inflammation and swelling that may be a result of the microtraumas. Swelling and inflammation are the body’s way of saying that something is wrong. Ibuprofen helps “calm the joint down”. 

Other medications, such as acetaminophen (Tylenol), help block the sensation of pain and can help alleviate any discomfort.

Common Overuse Injuries

Below, you will find some of the most common overuse injuries. They include the following:

  • De Quervain’s Tenosynovitis: Named for the surgeon who first described it, this condition manifests as pain and tenderness localized to the base of the thumb. Repetitive thumb and wrist movements can aggravate the tendons that connect to the thumb. Patients may also describe a loss of grip strength and a “catching” feeling as they try to move their thumb.
  • Lateral Epicondylitis: Pain and tenderness on the lateral (outside) aspect of the elbow due to excessive extension of the wrist and forearm. This is also known as “Tennis Elbow” because the extension of the wrist and forearm is needed to perform backhand shots.
  • Medial Epicondylitis: Pain and tenderness on the Medial (inside) aspect of the elbow due to excessive flexion of the wrist and forearm. This is also known as “Golfers Elbow” because flexion of the wrist and forearm is needed to perform forehand shots.
  • Prepatellar Bursitis: Also called “housemaid’s knee” or “carpet layer’s knee” because it is often associated with occupations or activities that require repetitive kneeling. It is an irritation of the bursa (fluid-filled sack) located within the knee to help lubricate and act as a shock absorber.
  • Osgood-Schlatters: Caused by repetitive contraction of the quadriceps (thigh) muscles in very active children. The pulling of the quads will cause pain in the front of the knee or tibia (shin bone).
  • Shin Splints: Caused by excessive running or beginning a high-intensity running regimen without proper build-up training. Pain can be localized along the anterior (front) or lateral (outside) aspects of the shins.
  • Sever’s disease: Caused by inflammation where the Achilles tendon connects to the calcaneus (heel bone). Microtears form from repetitive use. Sever’s disease is the most common cause of heel pain in children.

Schedule an Appointment Today

If you believe you or your children are experiencing an overuse injury and symptoms have not subsided, please schedule a consultation with one of our expert physicians at OrthoNeuro today! Our highly trained orthopedic surgeons have a multitude of experience treating injuries like these. 

Our goal is to help you return to the activities you need to do daily. Contact us at one of our offices in Columbus, OH now!

Resources

  1. Wu, Mark BS; Fallon, Ryan BS; Heyworth, Benton E. MD. Overuse Injuries in the Pediatric Population. Sports Medicine and Arthroscopy Review 24(4):p 150-158, December 2016. | DOI: 10.1097/JSA.0000000000000129
  2. Aicale, R., Tarantino, D. & Maffulli, N. Overuse injuries in sport: a comprehensive overview. J Orthop Surg Res 13, 309 (2018). https://doi.org/10.1186/s13018-018-1017-5
  3. Bilić R, Kolundzić R, Jelić M. Sindromi prenaprezanja u saci, podlaktici i laktu [Overuse injury syndromes of the hand, forearm and elbow]. Arh Hig Rada Toksikol. 2001 Dec;52(4):403-14. Croatian. PMID: 11831123.
  4. Verdon ME. Overuse syndromes of the hand and wrist. Prim Care. 1996 Jun;23(2):305-19. doi: 10.1016/s0095-4543(05)70278-5. PMID: 8784932.

Medically Reviewed by Mark Gittins, DO

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