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“Underuse” as a cause for musculoskeletal injuries: is it time that we started reframing our message?
  1. S D Stovitz,
  2. R J Johnson
  1. Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
  1. Correspondence to:
 Dr Stovitz
 Department of Family Medicine and Community Health, University of Minnesota, 2615 E Franklin Ave, Minneapolis, MN 55406, USA; sstovitz{at}umphysicians.umn.edu

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Promoting physical activity

Sports medicine clinicians need to be leaders in the field of physical activity promotion. As such, we must avoid language that inappropriately discourages exercise. Articles on musculoskeletal injuries typically divide the causes into either “acute” or “overuse”. Both of these terms implicate activity as the basis for the musculoskeletal pain. However, as we learn more about the epidemiology, pathophysiology, treatment, and prevention of these injuries, it is clear that, in fact, inactivity may be the underlying cause of many of these conditions. “Underuse injuries” may be a more appropriate term to explain the aetiology of many conditions seen by those in the field of sports medicine.

THE OVERUSE OF THE TERM OVERUSE

A May 2006 Medline search for articles with the keyword “overuse injuries” registered 7649 “hits” over the past 40 years, and 3970 in just the past 10 years. The vast majority clearly suggest that overuse is the reason for the injury. To be fair, a search of “underuse injuries” reveals seven findings. However, none implicate “underuse” as the cause of the injury. For example, one article deals with underuse of imaging, another with the underuse of analgesia, and a third with the …

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