Overuse injuries are among the most common musculoskeletal problems in athletes, particularly in sports involving repetitive jumping, running, or landing activities. These injuries typically develop gradually as a result of cumulative microtrauma and inadequate recovery, often affecting structures such as tendons, muscles, and joints of the lower limbs.

A recent systematic review published in The Journal of Sports Medicine and Physical Fitness (Hameed et al., 2024) examined the role of strengthening exercises in both the management and prevention of overuse sports injuries affecting the lower extremity. The authors aimed to synthesise the current evidence on how structured strengthening interventions influence pain, muscle performance, return-to-sport outcomes, and recurrence rates in athletic populations.

Methodology Overview

The review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework and evaluated the methodological quality of included trials using the PEDro scale. Relevant databases such as MEDLINE, PubMed Central, Cochrane Library, and PEDro were systematically searched to identify randomised and controlled clinical trials investigating strengthening-based interventions for lower limb overuse injuries.

Key Findings

• The included studies ranged from fair to excellent methodological quality, with a focus on athletic participants experiencing conditions such as tendinopathies, stress injuries, and muscle overuse syndromes.
• Three studies primarily investigated the therapeutic effects of strengthening exercises on existing overuse injuries.
• Four studies explored their role in preventing recurrence or new injury episodes among athletes.

Across the studies, strengthening interventions were consistently associated with:

• Improved muscle strength and performance
• Enhanced speed, power, and agility relevant to sport-specific demands
• Reduction in pain intensity and functional limitation
• Earlier return to sport
• Decreased incidence of injury recurrence

Clinical Implications

The findings reinforce the importance of incorporating progressive resistance training into both rehabilitation and preventive conditioning programs for athletes. Strengthening exercises not only target the affected musculature but also enhance load tolerance of surrounding structures, reducing mechanical stress and improving kinetic chain efficiency.

From a physiotherapy perspective, a well-designed strength program should consider:

• The specific demands of the sport, including movement patterns and loading cycles
• Individual biomechanical factors, such as muscle imbalance or joint alignment
• Gradual progression in intensity to promote tissue adaptation without overload

Conclusion

The systematic review by Hameed et al. (2024) provides strong support for the inclusion of strengthening exercises in evidence-based management and prevention of overuse sports injuries of the lower extremities. Strength training contributes not only to improved recovery outcomes but also to long-term injury resilience and athletic performance.

Integrating structured, progressive strength programs into rehabilitation and training frameworks is therefore recommended as a standard approach for athletes and active individuals exposed to repetitive loading patterns.