Overuse Injuries and Chronic Aches and Pains

physical therapist working on athlete
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Most injuries can be categorized as either traumatic (acute) injuries or overuse (chronic) injuries. Acute pain and injury is usually the result of a specific impact or traumatic event. Chronic aches and pain, on the other hand, often have subtle or vague symptoms that develop slowly and are long-lasting. What begins as a small, nagging ache or pain can grow into a debilitating injury if it isn't recognized and treated early.

Chronic pain is often caused by repetitive trauma and overuse. Overuse injuries are common in athletes who play sports and perform repetitive movements. The stress and trauma to soft tissues can become irritated if not allowed enough time to heal fully. These injuries are also called sometimes called cumulative trauma or repetitive stress injuries.

Examples of chronic pain and injuries include:

Many sports injuries that cause subtle pain are overuse injuries. They often occur at the start of a new exercise routine (too much, too soon), or in long-time exercisers who don't allow for enough rest and recovery.


The main factors in the development of overuse pain and injury include:

  • Doing Too Much, Too Soon: It’s important to start slow and increase your training time and intensity over time. Following the Ten Percent Rule may help you in avoiding overuse injuries.
  • Overtraining Syndrome: Some athletes mistakenly think more exercise is better, and they fail to get adequate rest. This can lead to a chronic, overuse injury. This is also common in advanced exercisers who suddenly increase their time or intensity in an abrupt manner (often while training for an event).
  • Returning from Injury Too Soon: Many athletes try to come back from an injury too quickly. They frequently develop a secondary overuse injury while trying to make up for lost time.
  • Using Poor Technique: Most people need some professional coaching at the beginning of a new sport to learn the fundamentals and develop good habits. Keep in mind that we are all unique and some movements may be better-suited to your abilities or biomechanics. An instructor can help you modify exercises to fit your unique needs. For example, Golfers tend to have overuse injuries due to poor golf swing mechanics. Working with a coach, personal trainer or therapist can help you avoid these errors.
  • Doing Only One Type of Exercise: Doing the same exercise day after day is another way to end up with an overuse injury. Stressing the same muscle groups and performing the same movement patterns repeatedly can put a tremendous amount of strain on muscles, tendons, and ligaments, causing irritation, inflammation, and even stress fractures. Even if you successfully avoid an overuse injury, you may end up with muscle imbalance, weakness, tightness and alignment problems. To avoid these problems, vary your exercise training routine. Do a variety of different types of exercise and cross-train.
  • Wearing the Wrong Shoes: Wearing the right shoe is important, especially for runners. shoe inserts or insoles are sometimes helpful as is knowing when to replace your running shoes.
  • Running Surface: The terrain you run on can also set you up for injuries.
  • Using the Wrong Equipment: Poorly fitting bicycles, golf clubs, tennis rackets, etc. can lead to stress on the muscles and joints and increase injury risk.


Treating overuse injuries requires resting the stressed tissues. Reducing the intensity, duration or frequency of the exercise will sometimes be all the treatment required for fast relief.

Icing the injury can also help reduce inflammation and pain. For more serious overuse injuries, physical therapy, over-the-counter medications, and complete rest may be necessary.

Preventing Overuse Injuries

To prevent the return of overuse injuries, athletes should maintain a training schedule that includes varied intensity and duration as well as the type of activity. Getting a proper warm-up and cross training is also helpful.

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Article Sources

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  • 2008 American Council on Exercise, Exercise Safety Guidelines
  • ACSM's Guidelines for Exercise Testing and Prescription, 7th Edition 2005.