What Are Overuse Injuries and How Can You Avoid Them

By Dominique Groom on September, 22 2021
Safety / Injuries
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Dominique Groom

Dominique Groom is a certified ISSA trainer in personal training, youth fitness and corrective exercise, and adjunct professor for ISSA's College of Exercise Science and stay at home mother of three who strives to stay active as well as get others active. She has a Bachelor's degree in Exercise and Sports science with an emphasis in rehabilitation. Her passion is running and exercising and keeping her family active.

There is literally nothing worse than getting into the groove of an exercise program and suddenly feeling an ache or pain that you distinctly don't remember feeling before. Raise your hand if you’ve been there, done that. What’s to blame for this unexpected and annoyingly inconvenient discomfort? Probably an overuse injury. Not to add salt to the wound, but if it is an overuse injury, it could have been prevented. Read on for ways to identify overuse injuries and prevent them so you can stay active and stay in the game.


What Are the Differences Between Acute, Overuse, and Chronic Injuries?

There are countless injuries athletes run into while training. There are three primary types of injuries that can get in the way of training and daily activities: 

Acute injuries that happen suddenly
Overuse injuries that happen over time
Chronic injuries that persist 


Acute Sports Injury Examples 

Acute sports injuries are common and can happen suddenly due to an accident. Examples of acute injuries include:

  • Broken bones
  • Sprains (injury to the ligament)
  • Strains (injury to the muscle and/or tendon)
  • Muscle tears
  • Dislocations
These types of injuries are not predictable. One wrong step and you can sprain an ankle. Fall wrong and suddenly your shoulder is dislocated. An acute injury can happen anywhere, at any time, and be caused by just about anything. Acute sports injuries are common, especially in contact sports. Athletic trainers are all too familiar with this kind of injury and know exactly how to treat them.

Overuse Injury Examples 

Overuse injuries are caused by repetitive trauma to a muscle or joint. What does an overuse injury look like? It could be a stress fracture in a runner or a shoulder injury in a pitcher. Overuse injuries occur over time. That is to say, they are not acute. They are the result of small stresses over time.

Overuse injuries could also come from participating in a sport that is high impact or repetitive. Think pitching in baseball or softball, serving a tennis ball, or running. We cover specific examples later in this article.


Chronic Injury Examples 

Overuse injuries can evolve into chronic injuries if ignored. A chronic injury is any injury that persists for a long time. When a client complains of an "old [sport] injury," they are describing a chronic injury.

An example of a chronic injury is tennis elbow or lateral epicondylitis. Another example is Achilles tendonitis. This common overuse injury shows up as pain in the heel from an inflamed Achilles tendon. Runner's knee is a common knee injury clients describe as a dull pain at the front of the knee. Chronic injuries come and go and could last for years. 


How Can You Tell the Difference Between an Acute Injury and a Chronic Injury? 

Acute and chronic injuries differ in a few ways; onset, pain quality, and duration of pain. 

Injury Onset Pain Quality Duration
Acute injuries happen suddenly. Pain associated with an acute injury might be described as sharp and/or shooting. Acute injuries cause pain at the onset. How long pain lasts depends upon the severity of the injury and access to care.
Chronic injuries happen over time. The client complains of a dull pain that comes and goes. They may also complain of a constant ache. Chronic injuries can persist for years and be triggered by inadequate rest, extra physical activity, and certain movements.


Acute injuries can be identified by inflammation, bruising, and deformities. Training injuries can be acute injuries. If a client complains of sudden sharp pain and the area they point to is swollen, red, and warm, they may have just injured themselves and should stop exercising. Once recovered and appropriately rehabilitated, as in the case of a broken bone or muscle tear, an acute injury typically won’t come back.

Chronic injuries may also become swollen or inflamed. For example, tennis elbow and runner's knee can become swollen with too much activity. Chronic injuries may cause discomfort and pain even at rest.


Does Poor Technique Cause Overuse Injuries? 

Overuse injuries happen for many reasons. Lifting loads that are too heavy can cause overuse injuries. So can improper progression. Another cause is poor technique. Poor technique includes bad form, performing a movement too fast, or using the wrong equipment. Bad form, practiced over time, can cause trauma and stress to an area causing an overuse injury. 

Joints are the most common site for overuse injuries. Examples include tendon injuries like Achilles tendonitis and tennis elbow. Repetitive motion stresses the connective tissues causing inflammation and pain.

Clients who try to “work through the pain” eventually cause irreparable wear and tear of the tendon or ligament. In some cases, the overuse injury becomes a chronic injury.


Other Causes of Overuse Injuries 

Repetitive stress to a bone can cause a stress fracture. For example, a runner who puts in lots of miles “pounding the pavement” can cause tiny cracks in the tibia, also known as shin splints, which cause pain over time. This particular injury is worsened by wearing improper shoes and not allowing adequate rest. 

Overuse injuries may also be associated with muscle imbalances and a lack of flexibility. When a muscular imbalance occurs it affects agonist-antagonist pairs. One muscle gets weak causing the other muscle to overcompensate. The result is an increased risk of injury in the weak muscle and poor flexibility in the overcompensating muscle. Inflexibility and a limited range of motion affect muscle mechanics and over time, you guessed it, results in an overuse injury.

Finally, if a muscle is fatigued it doesn’t work well and can’t effectively protect the joint. A prime example is the knee joint. If the muscles in the thigh (hamstrings and quadriceps) are imbalanced, the knees get forced out of alignment. Improper tracking of the knee joint while running, walking, climbing stairs, biking, etc. can cause an overuse injury.


Training Techniques To Help Avoid Overuse Injuries 

Overuse injury isn’t synonymous with exercise. A smart workout plan that includes warm-ups and cool-downs, periodization, time off, cross-training, and good form is the best plan of action to stay injury-free.

Let’s dig a little deeper into each of these smart training tips.


Warm-up and Cool-down 

Always include a proper warm-up and cool-down. Sometimes clients are in a pinch for time and want to jump straight into the workout. Don't let them. If they don't have the extra 10-20 minutes at the beginning and end of the workout, it would probably be better just to skip it. Remind them of the benefits of a proper warm-up and cool-down. Make sure they ease into workouts and allow enough time to cool down and stretch after. 


Practice Proper Progression 

We all love a client who wants to jump into a training program with an all-out effort. Who doesn’t want to start out strong? But it’s better to start low and go slow. Proper periodization and gradual progression go hand-in-hand to prevent injury and enhance fitness.

Try not to curb a client's enthusiasm too much. But don't let them jump into a program hard and fast. This is especially true if they haven't engaged in physical activity in a while. If they're excited and ready to get fit, remind them that fitness is a habit that needs to be built. Training injuries will most certainly halt their progress.  



Schedule time to take a break. Exercising often and for long periods without breaks can cause wear and tear on the body. Always include enough rest and recovery time in training programs. Client's may get frustrated when they're making good progress and you tell them to take a day off. Overtraining is unhealthy and leads to preventable injuries. Gently reinforce the idea of proper progression and the role rest has in enhancing fitness.


Try Cross-Training

Cross-training can help prevent overuse injuries. It also makes exercise more fun! If a client is training for a running race, encourage them to schedule some time on the bike, in the pool, or playing frisbee golf with friends. If they're a regular at Zumba, invite them to try a yoga class, or boot camp for variety.

If you're training an athlete, keeping them active during the off-season with cross-training will keep them primed and ready for the pre-season. Give them some suggestions of activities that will enhance their sport-specific fitness measures without leading to an injury.

For example, runners benefit greatly from adding a strength training routine. Weight-bearing exercise strengthens the bones to help prevent stress fractures and can prevent runner's knee and a lifetime of knee pain.


Maintain Proper Alignment and Form 

Before starting a fitness routine, complete a physical assessment. Collect information using a total body assessment protocol. Remember to check for good posture. Why? Posture is affected by weak muscles. And form is affected by poor posture. Exercising with poor form leads to muscle imbalances. Muscle imbalance leads to muscle weakness. It becomes a vicious cycle if not addressed straight away. 

To begin, it’s safest to focus on form. Even if the only weight the client lifts is a broomstick, they should do it with good form and posture.

In addition, dedicate time to teaching clients the proper movements before performing multiple sets and repetitions. Advise them to move slowly and intentionally so that each part of the movement becomes ingrained into their motor learning.

Even world-class athletes break complicated exercises, like the snatch, into individual movements before trying to execute the full movement.


Other Preventive Measures

Here are a few other recommended steps to keeping clients strong, healthy, and injury-free.

  • Wear appropriate footwear.
  • Use the right equipment.
  • Ensure sports equipment is properly fitted and adjusted.
  • Stay hydrated.
  • Eat colorful whole foods.

What Are Overuse Injuries and How Can You Avoid Them?

We've covered the different types of overuse injuries and how to identify them. We've also shared scientifically proven tips for avoiding them. What are the main takeaways to avoid future injuries?

  • Avoid repetitive motion
  • Follow a periodized training plan
  • Use the right equipment
  • Stay physically active

To learn more about injury prevention, proper, progression, and therapeutic modalities check out Lionel University’s degree program options

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Dominique Groom

Dominique Groom is a certified ISSA trainer in personal training, youth fitness and corrective exercise, and adjunct professor for ISSA's College of Exercise Science and stay at home mother of three who strives to stay active as well as get others active. She has a Bachelor's degree in Exercise and Sports science with an emphasis in rehabilitation. Her passion is running and exercising and keeping her family active.

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