Variations in Definition and Usage of the Term Overuse Injury in Non-contact Sports: A Systematic Review

Introduction: Repetitive microtrauma resulting in subclinical injuries represents a significant proportion of injuries in non-contact sports. The identification of overuse injuries within this context poses a considerable challenge due to their gradual onset, non-specific nature, and often misleading symptomatology. Accurately quantifying the type and frequency of such injuries is crucial for comprehending the overall burden they impose, evaluating whether sufficient resources are allocated for their management, and determining the necessity for targeted preventive measures. Materials and Methods: The review aimed to describe variation between studies in the definition and usage of the term “overuse injury” in non-contact sports. PubMed, Scopus, and Embase were searched using words related to overuse and injury. Non-contact sports players from recreational to international level who play in all formats of the game were included in the study. There was no restriction on the age or sex of the players. The injury data comprised details on the exposure definition, outcome definition, definition provided for overuse injuries, overuse used as a mechanism or diagnosis, and injury identification method. Results: Following a thorough screening based on established inclusion and exclusion criteria, 24 studies were incorporated into the review. Overuse is used as a mechanism of injury in one of the articles, and “overuse” is a category of injury diagnosis in two articles and is used as both a mechanism of injury and a category of injuries in 14 articles. The use of the term “overuse” is unclear in seven articles. Goh et al . provided the clearest definition among all the articles reviewed. They define overuse injuries as “any musculoskeletal pain with insidious onset and without any known trauma or disease that might have given previous symptoms.” Conclusion: The authors posit that the universal application of overuse as a mechanism of injury would significantly reduce instances of confusion and misclassification in diagnosis. Furthermore, to facilitate accurate and thorough investigations of overuse injuries among non-contact sportspersons, a working standard definition of overuse should be agreed upon and implemented.