Overuse

Overuse injury

In fact, overuse is present in every injury. The load has then been too great relative to the load capacity (the load that the body can handle without problems). Usually, overuse refers to an injury that has developed gradually.

In addition to the diagnosis, identifying the cause of the overuse is especially important in order to treat it effectively.

Causes of overuse

With overuse injuries, there are two categories of causes: extrinsic and intrinsic. Extrinsic factors are the (external) circumstances that mainly influence the load. Intrinsic factors are the personal characteristics that determine how load-tolerant someone is. Extrinsic factors are usually easy to identify; intrinsic factors are more difficult.

Extrinsic factors  
Training
  • Too frequent training
  • Training sessions that are too long
  • Training that is too intense
  • Progressed too quickly
  • Insufficient recovery
  • Poor technique
Footwear
  • Worn-out shoes
  • Too little support
  • Too much support
  • Shoes too small
  • Shoes too large
  • Wrong type of shoes
Surface
  • Too hard
  • Too soft
  • Sloping
  • Downhill
  • Uneven
(Sports) equipment
  • Poorly fitting clothing
  • Grip too thick or too thin in tennis, hockey, badminton, etc.
  • Racket string tension
  • Protective equipment (shin and knee guards, helmet, etc.)
  • Wrong size or adjustment of, for example, a bicycle or a bow
Environmental factors
  • Too warm
  • Too cold
  • Humid
  • Dry
Stress
  • Exhaustion
  • Poor recovery
'Poor' nutrition
  • Eating too much or too little
  • Insufficient nutrients
Intrinsic factors  
Age
  • Young or old
Sex
  • Male or female
Posture
  • Good or poor posture
Body build
  • Leg length discrepancy
  • Flat feet
  • Skeletal structure
  • Height
  • Weight
Muscle imbalance
  • Poor coordination between different muscles.
Muscle weakness
  • Insufficient muscle strength
Stiffness
  • Muscle tension
  • Joint stiffness
  • Insufficient flexibility
Metabolic disorders
  • Problems with nutrient absorption
Hereditary factors
  • The rate at which someone can build strength, speed, or fitness is largely genetically determined
Medical factors
  • Previous surgeries
  • Heart conditions

Load and load capacity

Load and load capacity play a crucial role in overuse injuries. In an acute injury, the load over a very short time has been too great, causing a (muscle) tear or bone fracture. In overuse injuries, the load has been too high over a long period. This can involve bone, muscle, and tendon tissue as well as cartilage or ligaments.

The load capacity of the tissue depends on all the factors described. Stress factors, in particular, are often underestimated. With a busy workweek and poor sleep, the same training can suddenly cause overuse. At that time, load capacity is lower than when well rested.

Underloading

Long-term underloading (too little loading) is a major problem. Because of long-term underloading, everyday activities can already lead to overuse. It is therefore necessary to continue loading the body even as you get older. As you age, load capacity decreases. However, by loading the body even less, load capacity declines even faster, resulting in overuse more quickly.

Treatment of overuse

The first approach to overuse injuries is (relative) rest to allow the affected area to recover.

At the same time, treatment will address the causal factors, looking at both extrinsic and intrinsic factors. Extrinsic factors are relatively easy to resolve. Intrinsic factors are more difficult because they are usually personal characteristics. Age and medical factors, for example, cannot be changed. The relationship between the risk factors and the overuse injury is especially important.

Every individual has postural deviations or a muscle imbalance. The question is: when do these factors cause overuse? And why, for example, do fallen arches cause symptoms in one person and not in another?

Physical therapy for overuse

Could you use help finding the balance between load and load capacity? Or do you need treatment for your overuse injury? Make an appointment with a physical therapist for detailed advice and/or treatment. Enter your ZIP code below to find the nearest physical therapist in your area.

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