The decision to operate is usually based on persistence of pain and loss of athletic performance. Often, surgery is performed to remove aberrant tissue, alter tissue structure, relieve extrinsic pressure, or stimulate a renewed healing response. The common denominator is excessive frequency, intensity, and duration of the training regimen. The most common site of overuse injury is the muscle-tendon unit. Physicians must take care not to confuse overuse injury with delayed-onset muscle soreness.
Effective treatment depends on an accurate diagnosis.
Modification of the training regimen, cryotherapy, stretching and strengthening of the injured extremity, and correction of obvious training errors and biomechanical abnormalities should then be undertaken. Nonsteroidal anti-inflammatory drugs relieve pain but may have no effect on outcome. Surgery is the last resort. Introduction to overuse injuries. Cell-matrix response in tendon injury.