Overuse Injuries

Rachel Miller is a highly experienced 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.

Call the Clinic for an appointment

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 diagnosis and a specialist treatment plan are essential for a faster recovery and to prevent an overuse injury from becoming a long-term chronic condition.

Your treatment plan may depend on:

  • The specific tissue involved (tendon, bone, or muscle).

  • The severity and duration of your symptoms.

  • Your age, activity level, and overall medical history.

The PEACE & LOVE protocol provides a clinically recognised framework for managing overuse injuries, focusing on both the initial resting phase and the rehabilitation phase.

The Initial Phase: PEACE When symptoms flare up, the goal is to calm the affected area:

  • P – Protect: Temporarily reduce or modify activities that aggravate the pain.

  • E – Elevate: Elevate the limb if swelling is present.

  • A – Avoid Anti-inflammatories: Excessive use of anti-inflammatories can sometimes mask pain and delay the natural tissue-repair process.

  • C – Compress: Use supportive taping or compression to manage discomfort.

  • E – Educate: Understand the “why” behind your injury to avoid the same training errors in the future.

The Rehabilitation Phase: LOVE Overuse injuries require a gradual return to activity to “re-teach” the tissue to handle stress:

  • L – Load: Guided, gradual re-introduction of activity. Letting pain be your guide is the most important part of treating overuse.

  • O – Optimism: Maintaining a positive outlook throughout the recovery journey.

  • V – Vascularisation: Engaging in pain-free, low-impact aerobic exercise to boost blood flow to the area.

  • E – Exercise: Targeted strengthening to address the biomechanical imbalances that caused the overuse in the first place.

Diagnosis and Long-Term Recovery

If you have sustained an injury, a consultation with an experienced podiatrist is important for an accurate diagnosis and a structured recovery plan.

Your management plan may include professional footwear guidance, rehabilitation exercises and targeted stretching regimes. For many patients, a specialist biomechanical assessment is an effective way to identify the underlying mechanical triggers of an injury.

Where appropriate, bespoke orthotic insoles can be prescribed. These medical devices are custom-made to support and realign the foot, significantly reducing impact forces and improving mechanical efficiency when walking or 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..

Links to Services:

Links to Conditions Treated Include: