LOWER LIMB
OVERUSE INJURIES

Glute tendinopathy, hip bursitis, ITB syndrome, runner’s knee, Achilles tendinopathy, and plantar fasciitis — the overuse injuries Sydney runners and triathletes accumulate across a big training block. Treated at Five Dock.

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The Overuse Injury Spectrum

Overuse injuries don’t happen in a single moment — they develop over weeks and months of training that exceeds the tissue’s capacity to adapt. The earlier they’re addressed, the faster the recovery.

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Glute Tendinopathy

Degeneration of the gluteus medius or minimus tendons at the greater trochanter — common in female endurance athletes and runners with high adduction patterns. Often misdiagnosed as trochanteric bursitis. Load management and specific glute strengthening are the cornerstones of management.

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Hip Bursitis

Trochanteric bursitis from repetitive compression of the bursa between the ITB and greater trochanter. Closely related to glute tendinopathy and often coexistent. Compression avoidance — not rest — is the key early management strategy.

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ITB Syndrome

Lateral knee pain from compression of the ITB against the lateral femoral condyle — the most common running injury in distance runners. Load management and hip strengthening produce better outcomes than stretching alone.

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Runner’s Knee (PFPS)

Patellofemoral pain syndrome — anterior knee pain from abnormal loading of the patellofemoral joint. Running gait, hip strength, and training load are the primary drivers. Vastly overrated as a “structural” problem — almost always an overload problem.

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Achilles Tendinopathy

Mid-portion or insertional Achilles tendon degeneration from repetitive running load. The most important intervention is a progressive eccentric and heavy slow resistance loading program — not rest, not stretching, not cortisone.

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Plantar Fasciitis

Plantar fasciopathy from repetitive loading of the plantar fascia — characteristic morning heel pain that eases with walking but worsens with running. Load management, calf and foot strengthening, and shockwave therapy for resistant cases.

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The Load Management Framework

Every overuse injury has the same root cause: load exceeded the tissue’s capacity to adapt. Management must address both sides of that equation.

Reduce What’s Irritating the Tissue

Training volume modification, technique assessment, footwear review, and identification of the specific activities driving the overload. We don’t tell you to stop doing everything — we identify what needs to change and what can continue.

Build the Tissue’s Capacity

Progressive loading programs designed for the specific tissue involved. Tendons respond to heavy, slow resistance training. Muscles respond to eccentric loading. Bone responds to graduated impact loading. Each tissue has a specific rehabilitation approach.

Address Contributing Factors

Glute weakness driving knee valgus. Hip drop causing ITB compression. Calf weakness increasing Achilles load. Every overuse injury has biomechanical contributors — identifying and addressing them is what prevents recurrence, not just treating the symptoms.

Return to Full Training

Graduated return to full training volume with ongoing monitoring. We build a load management plan for your training season — not just to get you through this injury, but to prevent the next one. Including race-specific training load recommendations.

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Shockwave for Resistant Tendinopathies

For chronic tendinopathies — particularly Achilles tendinopathy and plantar fasciitis — that haven’t responded to a thorough rehabilitation program, shockwave therapy is available at our Five Dock clinic via Sydney Shockwave. It’s particularly effective for calcific presentations and for cases where previous cortisone injections have failed to provide lasting relief.

Sydney Shockwave

BTL-6000 shockwave therapy for Achilles tendinopathy, plantar fasciitis, and other resistant tendinopathies at Five Dock.

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FAQ

Can I keep training with an overuse injury?

Often yes — with modification. Most overuse injuries in endurance athletes can be managed with load modification rather than complete cessation of training. The specific modifications depend on the injury and its severity. Book a consult and we’ll build a modified training plan that allows you to keep moving while the tissue recovers.

I’ve had this injury before and it keeps coming back. What’s different this time?

Recurrent overuse injuries almost always indicate that a contributing factor wasn’t addressed in previous management. We’ll systematically assess the biomechanical, load, and training factors driving the injury and address all of them — not just the symptomatic tissue.

Do I need a referral?

No referral needed. Book a consult and we’ll assess your injury, understand your training context, and build a management plan from there.

Other Rehab Pages

Stress Fractures

Soft Tissue Strains

Shoulder Impingement

Dealing with a Nagging Overuse Injury?

Book a consult. We’ll identify what’s driving the injury, modify your training appropriately, and build the tissue’s capacity to handle your training load.

Book an Injury Assessment

No referral needed · Five Dock, Inner West Sydney · Health fund rebates available