Kannus P
Accident and Trauma Research Center, UKK Institute, Tampere, Finland.
Scand J Med Sci Sports. 1997 Apr;7(2):78-85. doi: 10.1111/j.1600-0838.1997.tb00123.x.
In sports medicine, a chronic overuse injury is defined as a long-standing or recurring orthopedic problem and pain in the musculoskeletal system, which started during exertion due to repetitive tissue microtrauma (1). Repetitive microtrauma, which is basically repeated exposure of the musculoskeletal tissue to low-magnitude forces, results in injury at the microscopic level, and no single acute trauma is normally involved in the pathogenesis of an overuse injury. In chronic tendon disorders, 'overuse' implies that the tendon has been strained repeatedly to 4-8% strain until unable to endure further tension, whereupon injury occurs (2). The structure of the tendon is disrupted micro- or macroscopically by this repetitive strain, i.e. collagen fibrers begin to slide past one another, causing break-age of their cross-linked structure, and denaturate; inflammation, edema and pain result. Thus, tendinitis, peritendinitis, tenosynovitis, insertion tendinitis, tendinous bursitis or apophysitis is the earliest clinically recognizable manifestation of overuse tendon injury (3).
在运动医学中，慢性过度使用损伤被定义为肌肉骨骼系统中长期存在或反复出现的骨科问题和疼痛，其起因于重复性组织微创伤导致的劳累过程（1）。重复性微创伤，本质上是肌肉骨骼组织反复暴露于低强度力，会在微观层面造成损伤，过度使用损伤的发病机制通常不涉及单一急性创伤。在慢性肌腱疾病中，“过度使用”意味着肌腱反复受到4%至8%的拉伸，直至无法承受进一步的张力，进而发生损伤（2）。这种重复性拉伸会在微观或宏观层面破坏肌腱结构，即胶原纤维开始相互滑动，导致其交联结构断裂并变性；引发炎症、水肿和疼痛。因此，肌腱炎、腱鞘炎、腱鞘滑膜炎、附着点肌腱炎、肌腱滑囊炎或骨突炎是过度使用肌腱损伤最早在临床上可识别的表现（3）。
