Overuse Injuries

Rachel Miller is a highly experienced HCPC-registered podiatrist who treats many patients with overuse injuries.

An overuse injury is produced by a repeated action causing a repetitive trauma over a period of time. They are common among sportspeople and can often occur in children and adolescents. There can be multiple factors causing injury and a thorough diagnosis with a treatment plan may help speed recovery and lessen the recurrence of overuse injuries.

Please see below if you want more detailed explanation of overuse injuries, their symptoms, causes and treatment.

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Overuse Injuries

Runners, especially distance runners, tennis players and other high impact athletes are at risk of metatarsalgia and many other overuse conditions primarily because the front of the foot absorbs significant force when a person runs or jumps.  See the Metatarsalgia page for more information.

Some overuse injuries are more common in children especially during the period of rapid pubescent growth when they can be taking part in intense sports activities.  See the Children’s foot care page for more information.

Injuries can occur in:

  • bones
  • tendons
  • muscles
  • cartilage
  • bursas
  • nerves

Symptoms of overuse injuries

Symptoms can include:

  • pain can begin gradually
  • aching pain
  • stiffness, often in the morning
  • a “pinpoint pain” at the site of the injury
  • swelling
  • heat
  • redness
  • reduced function
  • pain that does not go away

Heel pain is a common overuse injury symptom. With young sportspeople new bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress.  Intense training or activity can also cause the injuries which lead to inflammation in the metatarsal heads, the ball of the foot and nearby joints. 

Causes of overuse injuries

Exercising or engaging in a physical activity intensely with repetitive actions can mean that tissue breaks down faster than it can rebuild and overuse injuries can occur.

An overuse injuries can happen at any age and you can overuse your muscles, bones, joints, ligaments and tendons when you participate in many sports.  You can also suffer from an overuse injuries from repeated activities such as gardening or jobs that involve repeated actions such as typing.

Risk factors for overuse injuries include:

  • previous injury
  • muscle imbalance
  • biomechanical problems
  • technical errors and training errors such as increasing an exercise regime or its intensity too rapidly
  • changing training routines, shoes, surfaces that you are training or competing on
  • training on hard surfaces
  • poor footwear
  • age; adolescents and older people

Your foot structure can be a predisposing factor to your susceptibility to injury. You may overpronate, where your foot rolls in during gait or you may supinate, where your foot rolls out during gait both of which can put excess forces and stress the foot and ankle that may lead to injury. Athletes with high arches should pay extra attention to their lower limbs as pes cavus is not the most efficient foot structure for absorbing shock and feet with a raised midfoot may be more prone to injuries.

Treatment of overuse injuries

Early assessment and an appropriate treatment plan can help promote recovery and reduce the risk of an overuse injury becoming a persistent or recurrent problem.

Your treatment plan will depend on several factors, including:

  • the specific tissue involved, a tendon, bone or muscle
  • the severity and duration of your symptoms
  • your age, activity level and overall medical history
  • the activities that may have contributed to the injury

The PEACE & LOVE framework provides a useful approach to managing some soft-tissue injuries, combining early management with a gradual return to activity and rehabilitation.

The Initial Phase: PEACE

When symptoms first develop or flare up, the aim is to protect the affected area and manage symptoms:

  • P – Protect: Temporarily reduce or modify activities that aggravate your symptoms.
  • E – Elevate: Elevate the affected limb if swelling is present.
  • A – Avoid anti-inflammatory modalities: The routine use of anti-inflammatory medication or other anti-inflammatory measures may not always be appropriate during the early stages of tissue healing. Seek medical advice about medication if required.
  • C – Compress: Compression may help manage swelling and discomfort where appropriate.
  • E – Educate: Understanding the possible causes of your injury can help you make informed decisions about your recovery and reduce the risk of recurrence.

The Rehabilitation Phase: LOVE

As symptoms improve, a gradual return to activity and appropriate rehabilitation can help the affected tissues adapt to normal demands:

  • L – Load: Gradually reintroduce activity and loading in a controlled way, guided by your symptoms and the specific injury.
  • O – Optimism: Maintaining a positive and realistic approach can support your recovery.
  • V – Vascularisation: Where appropriate, pain-free cardiovascular activity can help maintain general fitness and promote blood flow.
  • E – Exercise: Targeted exercises can help improve strength, flexibility and the ability of the affected tissues to tolerate activity.

Diagnosis and Long-Term Recovery

If you have an overuse injury, a consultation with an experienced podiatrist can help assess your symptoms, identify possible contributing factors and develop a structured recovery plan.

Your management plan may include:

  • footwear advice
  • activity modification
  • rehabilitation exercises
  • targeted stretching programmes
  • An orthotic insole

A biomechanical assessment can help identify mechanical factors that may be contributing to an injury.Where appropriate, bespoke orthotic insoles may be prescribed as part of your treatment plan. Custom-made orthotics may help support the foot, redistribute pressure and influence the way forces are transferred through the foot and lower limb during walking and running. 

 Call the Clinic for an appointment 

Rachel Miller is a highly experienced podiatrist specialising in biomechanics and orthotic insoles who sees many patients with overuse injuries. Her clinic, Highgate Podiatry, is in Highgate Village, 14 Pond Square, N6 6BA, London. Clinics are held every Wednesday, Thursday, Friday and Sunday. Please contact the clinic for an appointment on 020 8348 5553. For the clinic’s address, map and directions see the Contact page and for information about orthotic insoles and biomechanics see the Biomechanics page..

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