The term “overuse injury” is a term used chronically and ambiguously in the medical community.  Many times, providers will refer to specific injuries as an overuse injury and will recommend resting or taking a break from sport or hobby.  However, how many times have you stopped running for weeks and your plantar fascial pain or your achilles pain did not get better?  Or better yet, it just came right back when you returned to higher level activities.  If these injuries were truly secondary to overuse then your pain would go away and the injury would heal simply with rest. When you rest you are not performing the sport that uses that joint over and over.

Conditions such as plantar fasciitis, carpal tunnel, achilles tendonitis, bursitis, shin splints, hamstring tendinopathy, and Iliotibial band syndrome are often considered overuse injuries.  And yes, they commonly are painful after doing something that is repetitive in nature i.e. running, jumping, typing, walking, shoveling, or lifting. If it was truly an overuse injury then everyone who runs all the time, or bikes all the time, or lifts all the time would all have the same injuries.  

Usually by the time we as Physical Therapists see these clients they have been resting for several weeks to several months, been modifying activities in conjunction, rolling/stretching, and icing.  If at this point the rest and modification of activity has not changed or alleviated the pain, we can confidently say this is not an overuse injury.  

Another way to look at this is if one person can run lots and lots of miles and not get pain but the next person does the same training and is plagued with chronic heel pain–then wouldn’t all runners have heel pain?  You would think if it was simply from overuse then we would all get carpal tunnel from working at a desk or doing computer work for 20 years.  

So what should we call this….we as PTs call this injury a “misuse” injury. To treat a misuse injury,  the PT must reteach the client how to move better and not use the injured muscle, tendon, or joint incorrectly.  Retraining the brain the correct neuromuscular movement patterns helps to create change, decrease stress and load, and revert bad habits.  These poor movements patterns, if performed incorrectly over and over again, can lead to injury.  Efficient movement patterns allow us to perform at a higher level, train smarter, and decrease risk of injury.  This is why an olympic lifter can deadlift >400lbs because they train their body how to move a heavy object off the ground correctly.

Can you have an overuse injury with misuse? Absolutely!  First, we do a movement that is repeated over and over again incorrectly and this pattern becomes a learned movement pattern.  The compensation or change in movement goes unnoticed by the individual and is subconscious.  By the time the pain is set in, the movement pattern has become habitual and the body has self corrected through weakness, tightness, or dysfunction.  

So, what can you do? Relearn good movement patterns again.  If you are a runner and you have chronically been an overstrider for 10+ years and your heel pain won’t go away, teach your body to not overstride to decrease load to your heel.  Physical Therapists are the leaders of movement in the industry.  We have an eye for correct biomechanics and we are able to identify, instruct, and begin to teach the individual how to train the nervous system to move better. Continued, correct movement patterns lead to happy health tissue that can withstand repetitive load.