Overuse Injuries: Unlocking the Secrets to Injury Prevention

Author: Ruben Salinas, PT, DPT, OCS, CSCS

Author: Ruben Salinas, PT, DPT, OCS, CSCS

Ruben Salinas is the founder and president of Salinas PT.

What are Overuse Injuries?

Overuse injuries are among the most common causes of injury in adult and youth sports. A good example is the current epidemic of Tommy John surgeries in baseball pitchers, which is skyrocketing. What used to be a rare procedure in the 80’s has drastically increased over the years and now affects younger athletes. It has been determined that one of the main factors is youth early specialization and pitching year-round in baseball. But don’t be confused; overuse injuries are not limited to just athletes. Any repetitive movement can lead to an injury if the warning signs are ignored. 

Understand the warning signs

Before discussing the causes of overuse injuries, we need to understand the term pain as it relates to injury. Merriam-Webster defines pain as:

  • Pain – (n): A localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress and typically results from bodily disorder (such as injury or disease). 

The term pain represents a broad spectrum of sensations. Consider pain as a signal your body sends to your brain to protect you from harm. That being said, not all pain should be treated equally. Here are some examples:

Touching a hot stove

Example 1

When you touch a hot stove, your body instinctively pulls away by sending a “pain” signal to your brain to prevent further injury. 

Back Pain From Sitting

Example 2

Sitting at a desk for an extended period makes it familiar for your back and neck to hurt. Your body is sending a signal of “pain” that lets your brain know the skeletal system is being strained, and you need to adjust your position to prevent further injury. 

What to look for in overuse injuries

Overuse injuries are gradual by nature. They start with slight discomfort, aching, or tingling sensations after activity. When the warning signs are ignored, any level of exercise can aggravate the symptoms or limit activity altogether.  Here are some of the warning signs to pay attention to:

  • Pain – Gradual pain or soreness that lingers, especially after heavy activity is a warning signal from your body. The pain typically increases the longer you remain active on the damaged tissue.
  • Stiffness – Increased stiffness to a muscle or joint is an early indicator of injury. Your body attempts to repair the injured site by providing inflammation responsible for the stiff feeling.
  • Swelling and Tenderness – Swelling and tenderness to the touch is a sign that your injury has advanced. The injury site may become immobilized due to swelling or too painful to continue use.
  • Gradual Onset – Pain, stiffness and swelling signal that an injury is present. If they do not correlate with direct trauma or tissue damage, you may be experiencing an overuse injury.

How do you know if the pain is serious?

Well, that depends on a variety of situations that a physical therapist can help identify for you. Here are some signals that you shouldn’t ignore:

  • Pain that is localized to a joint
  • Pain that does not go away with time
  • Localized swelling or discoloration
  • Pain as a result of trauma

* When to call a doctor

If you’ve suffered from an injury and have pain, swelling and loss of mobility or difficulty walking, you should be evaluated by a licensed professional. Pain that lingers for longer than a week may indicate that your body is not healing properly, and further action may be required to improve your condition. If you’re experiencing pain during the night and you are unable to sleep comfortably, this can be another indicator of a serious problem.

Tennis Elbow

The Main Causes of Overuse

As mentioned before, overuse injuries are common with repetitive movements. Now that we understand how pain signals are delivered and the warning signs, we need to discuss the leading causes of overuse injuries and how to prevent them. 

1. Repetitive Motions:

Repetitive motion disorders (RDM’s) are muscular conditions resulting from repetitive motions or repeated daily activities. These disorders are caused by overuse, unnatural or unsupported movements like twisting, incorrect sitting posture, improper lifting, and unbalanced muscle use. Even tasks that may seem harmless like playing the violin, sitting at a desk, or scanning items as a grocery clerk, can lead to injury if the warning signs are ignored.

2. Early Specialization:

Youth sports have evolved from child-driven, recreational free play for enjoyment to adult-driven, highly structured, deliberate practice devoted to skill development. While intense training can be beneficial for skill development, most will suggest delaying early specialization until late adolescence to minimize injury, psychological stress, and burnout. One of best examples of this concept takes place in youth baseball. Some coaches and parents believe the more you train in a sport-specific skill, the better you will become. While that may be true for skill development, this is a perfect recipe for overuse injuries.

3. General Overuse:

Overuse injuries can occur with any repetitive movement. Excessive loading, incomplete recovery and under-preparedness can increase the risk. Overuse injuries can affect bones, muscles, tendons, and ligaments. Most overuse injuries appear in the form of general stress, inflammation, and tendonitis. As the condition progresses, symptoms can present with any activity level, and eventually, the symptoms limit or restrict activity. 

Tired Athlete

4. Inadequate Rest:

Inadequate rest can be considered one of the leading causes of overuse injuries. From long innings on the pitching mound to repetitive tasks such as typing, your muscles, tendons, and ligaments require time to recover from stress.  Adequate rest allows your body to rebuild tissue creating a greater tolerance to load in the future. Conditions like golfers elbow, tennis elbow, and stress fractures in runners are all examples of overuse injuries.

5. Improper Form / Technique:

Another contributor to overuse injuries is the need for proper form. The body is an amazing structure that performs best how it is designed. Over time fatigue can alter movement patterns that lead to compensation and injury. Poor lifting mechanics with your back instead of your legs or twisting with your spine instead of your hips are examples of how not to move. Poor pitching and improper running mechanics are common causes of pain and can lead to injury over time. 

6. Inexperience & Coaching

Overuse injuries among novice athletes are also common. The muscle structure and neurological pathways for sports take time to develop. Youth athletes are especially prone to overuse injuries due to the lack of fitness required to perform the skill. Because youth athletes are still growing, the consequences of overdoing a sport can lead to damage. Coaches and parents alike may be putting pressure on athletes to over-train.

Healthy Exercise


Understanding the causes of overuse injuries is the key to learning strategies to prevent them. The following steps are an excellent way to be sure you do not become a victim of these types of injuries. 
  1. Warmup: A proper warmup primes the neuromuscular system and increases muscle blood flow.  A dynamic warm up that may include simple movement like skipping, backpedaling, and jumping jacks is an excellent way to prepare for an activity. 
  2. Progress Gradually: When starting a new activity, it is essential that you start slowly. Too often, people start too fast before their body is conditioned and can over-stress muscles, tendons, and joints. 
  3. Improve Your Strength: Healthy muscles can help protect your joints and reduce the risk of injury. 
  4. Avoid Year-round Sports: There is a reason most professional sports have an off-season. Adequate rest and recovery help the body mend itself. Cross-training can also help by working different muscles and varying the stress on the body. 
  5. Learn Proper Technique: Take the time to learn how to correctly perform the activity you enjoy. Good form will evenly distribute the forces across your joints and spine to prevent injury. 
  6. Rest & Recover: Recovery is equally as important at the activity or exercise you perform. Overtraining can be harmful to the body. Make sure you incorporate rest days into your routine. 


Pain is a warning signal that should not ignored. The adage “no pain, no gain” doesn’t apply to overuse injuries. Some of the keys to preventing overuse injuries is ensuring that you warm up your body correctly before participation. Your fitness level must be adequate to handle your sport’s demands or activity level. Learning the proper mechanics – pitching, swinging a golf club or hitting a backhand in tennis – should be understood. The most important lesson is to allow your body adequate time to recover. The recovery part of an exercise or sports participation is just as important as the exercise. 

If you have pain and believe you might have an overuse injury, don’t hesitate to contact our office. We can help evaluate your condition, analyze your movement, offer suggestions, and develop a plan to keep you participating in your desired activity without limitations from pain.  

In good health,
Ruben Salinas  PT, DPT, OCS, CSCS