By Jacqueline Armendinger, PT, DPT, OCS
From golfers and tennis players to runners and baseball pitchers, athletes of all sorts are at risk for injuries that can hinder their performance and leave them sitting on the sidelines.
Often these injuries are caused by overuse or repetitive stress on the same muscle groups or joints.
In many cases, these injuries can be treated — and prevented — with rehabilitation. Penn Medicine Princeton Medical Center (PMC) Princeton Rehabilitation offers sports-specific rehabilitation programs to treat and prevent sports injuries and improve game performance.
Causes of Overuse Injuries
Overuse injuries are a result of repetitive motions and stresses on the body that exceed the body’s ability to repair itself. These injuries cause damage to the bones, muscles, ligaments, or tendons.
Some of the most common causes of overuse injuries include:
- Overtraining. Athletes who push themselves too hard without adequate rest can
experience overuse injuries.
- Poor technique. Athletes who use improper techniques are at greater risk for overuse
- Muscle imbalances. Muscle imbalances can occur when an athlete’s muscles are not
evenly developed or used.
- Overuse injuries can occur in a wide range of sports — from golf and tennis to baseball, softball and running. Research shows that approximately 25 to 50% of all sports injuries are a result of overuse.
Types of Overuse Injuries
Overuse injuries can occur in any part of the body that experiences repetitive stress. Some of the most common types of overuse injuries include:
- Tendinitis. Tendinitis is the inflammation of the tendons, which connect muscles to
bones. It is most common in the shoulder, elbow, knee, and ankle. Tennis elbow, for
example, is a type of tendinitis that affects the elbow and is caused by repetitive motion of the forearm and wrist.
- Bursitis. Bursae are small jelly-like sacs that are positioned between bones and soft tissues to help reduce friction. Bursitis is inflammation of a bursa, which can be caused by repeated small stresses and overuse. Many people experience bursitis along with tendinitis.
- Stress fractures. Stress fractures are small cracks in the bones caused by repetitive stress. They are common in the feet, legs, wrists, and spine.
- Tibial stress syndrome or shin splints. Characterized by pain and inflammation along the shins, shin splints are most common in dancers, military members, runners, and other athletes who run on hard surfaces. Shin splints can be caused by foot and ankle abnormalities, and/or improper footwear.
- Patellofemoral syndrome, also known as runner’s knee. Runner’s knee is a common overuse injury that affects the function of the kneecap.
Signs and Symptoms
Overuse injuries typically occur over time and symptoms usually develop gradually. Pain that cannot be tied to an acute injury, such as from a fall, twist, or blow to the body is a common sign of an overuse injury. The pain often increases with activity and improves with rest.
Swelling and changes in form or technique are also commonly associated with overuse injuries.
If you suffer from an overuse injury or other sports injury, your doctor will likely recommend rehabilitation as part of your treatment plan. At Princeton Rehabilitation, sports rehabilitation programs are designed to improve and optimize physical performance by addressing flexibility, stability, endurance and conditioning.
Physical therapists also focus on correcting faulty mechanics during play. Princeton Rehabilitation provides care for all types of athletes and offers specific rehabilitation programs for golfers, runners, tennis players, dancers, and musicians.
Treatment includes an individualized evaluation and plan of care along with home exercises, self-care techniques, and prevention education.
To help prevent overuse injuries, follow these tips from the American Academy of Orthopaedic Surgeons and American College of Sports Medicine.
- Use proper equipment. Replace your athletic shoes as they wear out. Wear comfortable,
loose-fitting clothes that let you move freely and are light enough to release body heat.
- Aim for balanced fitness. Develop a balanced fitness program that incorporates cardiovascular exercise, strength training, balance, agility, and flexibility. Add activities and new exercises cautiously. It is best to add no more than one or two new activities per workout. Be sure to check with your primary care physician before you begin a new exercise regimen.
- Warm up. Before stretching, jog in place or stationary cycle for a few minutes to prepare
for exercise. Breathe slowly and deeply, or gently rehearse the motions of the exercise
- Drink water. Drink enough water to prevent dehydration, heat exhaustion, and heat stroke. Drink one pint of water 15 minutes before you start exercising and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise.
- Cool down. Make cooling down the final phase of your exercise routine. It should take twice as long as your warm-up. Slow your motions and lessen the intensity of your movements for at least 10 minutes before you stop completely.
- Stretch. Begin stretches slowly and carefully until the point of muscle tension. Hold each stretch for 20 to 30 seconds, then slowly and carefully release it. Inhale before each stretch and exhale as you release. Repeat each stretch two to three times. Never stretch to the point of pain, always maintain control, and avoid bounce on a muscle that is fully stretched.
- Rest. Schedule regular days off from vigorous exercise and rest when tired. Fatigue and pain are good reasons not to exercise.
- Avoid the “weekend warrior” syndrome. Try to get at least 30 minutes of moderate physical activity at least five days per week. If you are pressed for time, you can break it up into 10-minute periods.
Physical therapy can help athletes stay at the top of their game. If you suffer from symptoms of an overuse injury, talk with your doctor about rehabilitation.
To find a physical therapist with Princeton Rehabilitation, call 609-853-7840 or visit
Jacqueline Armendinger, PT, DPT, OCS is a licensed physical therapist and certified orthopaedic specialist with Penn Medicine Princeton Medical Center Princeton Rehabilitation.