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“Overuse”—an overused term?
  1. P L Gregory
  1. Centre for Sports Medicine, Department of Orthopaedic and Accident Surgery, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH, UK
  1. Correspondence to:
 Dr Gregory;

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Use of the term overuse injury should be avoided until there is definite proof of the cause of the injury

Injuries are often categorised as being due to trauma or overuse. When no moment of trauma is recalled, then an assumption is made that an injury is the result of overuse. In this article, I will argue that there is insufficient evidence to support this extensive use of the term “overuse” and that there are problems associated with using it. Thus, we should avoid the term, which implies the cause of the injury, until we have proof of the cause.


Overuse injury is now categorised in medical subject headings as “cumulative trauma disorder (CTD)”. This is a subcategory of sprains and strains. CTD is defined as a “Harmful and painful condition caused by overuse or overexertion of some part of the musculoskeletal system, often resulting from work-related physical activities. It is characterized by inflammation, pain, or dysfunction of the involved joints, bones, ligaments, and nerves.” The term includes overuse injury, overuse syndrome, repetition strain injury, repetitive strain injury, and repetitive motion disorders. As CTD is defined as being caused by overuse, this definition fails to clarify the meaning of overuse injury. Overuse probably implies there is an amount of use that is excessive, and if use reaches or exceeds that amount then injuries arise.

Consider now this term as used in sports medicine. Traumas, such as a fractured tibia caused by a tackle in soccer, are likely to be most common among players who play or train most. Yet, overuse is not said to be the cause of this injury. Injuries arising from obvious trauma are excluded from the category of overuse injuries. Such a trauma may be witnessed or may be felt as an acute moment of injury. An …

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