Pathophysiology of overuse injuries in the hand and wrist.

Injury from overuse is an important and increasingly common problem in athletes and health-conscious people. The unaccustomed application of repetitive stress to any tissue may cause sufficient structural disruption to overcome that tissue's adaptive ability and thus cause injury without necessarily causing complete loss of function. The events leading to injury, as well as the level of stress required to incite them, may vary depending on the tissue and the individual. The pathway common to all tissues most likely involves microdamage to tissue collagen, combined with a direct or indirect effect on the microvasculature, with subsequent oxygen deprivation. The inflammation and repair process common to all tissues is well described. An understanding of this process is critical in the optimal treatment of these injuries. The modification of factors, both intrinsic and extrinsic, is important in the prevention of injury and in a rehabilitation program aimed at return to sports.