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Shannon Ritchey
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Overuse in exercise: what is it and how to avoid it

Overuse injuries are among the most common reasons for joint pain that I see in my clients who are exercise enthusiasts.

The great part is that overuse injuries are entirely avoidable, and with the proper regression, most can fully recover from these injuries. So don’t fret if you think overuse may be an issue in your body. 

This post will review what overuse injuries are, how to know if you’re at risk, and how to avoid them. 

What are overuse injuries? 

Overuse injuries affect the tendons and are generally referred to as tendinopathies. Muscles attach to the bone via a tendon, and a when a muscle contracts, it pulls on the tendon to ultimately move the joint. 

When muscles are contracted under a certain amount of load or repetition during exercise, they pull on the tendon and cause microdamage in the tendon. In the right dose, this is a good thing. It stimulates regeneration of the collagen in the tendon, allowing it to increase in thickness and resilience. 

When we have thicker, stronger tendons, we are more capable of tolerating force and load through our joints, improving our joint health and reducing the risk of injury. 

However, there is a window of tolerance that is unique to each individual, based on their genetics, structure, nutrition, age, and history. Ideally, you stimulate the tendon (via muscle contraction) enough to create an optimal level of stress that stimulates re-growth, without overloading the tissue and causing inflammation/injury. 

When the stimulus exceeds the threshold that your body can handle, your immune cells become overwhelmed, and this is where injury and pain occur. Repetitive low-magnitude forces often cause this to happen, and inflammation, edema (swelling), and pain are the end result (Kannus). Inflammation and edema can block necessary neurologic signals, which can decrease muscle function and lead to compensations, spiraling the injuries and pain.

This is where many of my clients get confused. Let’s say they work their glutes frequently, so they assume they are strong. Overuse from their glutes can trigger this inflammatory process, causing the above cascade, which will result in weakness of the muscle (which I see all the time in many of my Cross Fit clients who squat and lunge all the time). If their glutes are weak due to inflammation, but they are still doing exercises that require glute strength, they will probably compensate and injure themselves further. 

Overuse injuries can occur gradually due to chronic low-level stimulus, or more acutely due to a sudden increase in duration or intensity of exercise. 

A good example of an acute overuse injury is shin splints. If you’ve ever decided to start a running program without the proper training, you’ve probably experienced extremely uncomfortable sensations in the front side of your shin, due to an overload of the tendons of your ankle and foot, causing inflammation and pain on your shin. 

This can happen more gradually, especially when the same muscle groups are worked without proper rest and recovery. Essentially, your immune system can’t keep up with the microdamage, and inflammation stacks up.

How do I know if I’m at risk of an overuse injury? 

I put together an overuse assessment you can take here.

Here are some tools to ask yourself about your exercise program:

1. Does my body hurt after exercise? 

Notice if you’re feeling “achy,” stiff, or sluggish after exercise. These could be signs of inflammation and overuse. 

2. Is there noticeable swelling around my knees, ankles, wrists, elbows? 

You can feel for “puffiness” around joint lines like where your wrist, elbow, ankle, and knees bend. This can be a sign of edema, which indicates an immune response to that area. 

3. Is there tenderness on the tendon? 

Self-palpating is a great tool, as tenderness can be a sign of inflammation in the area and an indication you might be overusing that muscle. With your fingers, gently sink down through your tissue until you feel bone. Lightly palpate the area for a second or two to check for tenderness. If you’re feeling very tender in that spot, it could be time to switch up your routine. See the picture below for some common areas to check.

Remember: this tool is not to “fix” your inflammation. It is to simply identify it. So don’t go to town and rub the heck out of it – you don’t want to increase the inflammation. Get in, and get out. 


What movements often cause overuse? 

I see overuse the most in 5 areas:

Shoulder overuse due to repetitive overhead lifting/movements

  • Swimming, tennis, or other overhead sports or exercise programs

Hip and trunk flexion overuse

  • Running, cycling, lunging, squatting

Wrist extension overuse

  • Planking/pushups/power lifts like cleans 

Knee flexion/extension overuse

  • Running, biking, lunging, squatting

Ankle overuse 

  • Running, biking 

How can I avoid overuse injuries? 

1. Don’t selectively strengthen.

Strengthen ALL your muscles, not just the sexy ones. This will help create muscular balance, and you won’t spend so much time hammering away at the same muscle. Muscle groups that tend to get neglected are: 

  • Calves
  • Upper traps and scapular muscles
  • Low back 
  • Inner thighs 
  • Deep core muscles 

2. If you’re sore, skip working that muscle. 

Soreness is a sign that you could have induced micro-damage in that area. Remember that a small amount of micro-damage is productive (so light soreness is acceptable), but you don’t want to overwhelm your system while it’s healing. Intense soreness could mean you over-did it, so take it easy for a couple days. 

3. Vary repetition 

Low-level, high repetition often causes chronic overuse, so integrate days where you do higher weight and fewer reps. 

4. Only choose biomechanically safe exercises.

Many common exercises in the fitness industry will challenge a muscle at the end range of motion when it is the weakest, which often leads to increased tissue damage. 

Some examples of common exercises that can cause this damage are:

  • Lateral and front raises (for shoulders)
  • Tricep kickbacks 
  • Many band exercises (I prefer to use cables or machines) 

The goal is to choose exercises that load the muscle and tendon when they are in the middle range, where they can tolerate stress. Putting yourself in situations where your muscles and tissues can perform optimally is key. 

I created a basics to biomechanics training, click here.

5. Avoid working the same muscle group two consecutive days.

As we mentioned above, it’s important to give your tissues time to heal and regenerate. 

If you’re wondering if you might be overusing a muscle, I put together an assessment you can take here.