An in-depth study of lesions of muscle insertion sites on bone (enthesopathies) in recent and fossilised human skeletons. The work contributes to the field of anthropology in three ways. The author presents a new method of scoring enthesopathies that takes into account variation in muscle attachment site histology and morphology with a system that may well become the new standard for studying enthesopathies in prehistoric and recent populations. Second, the author provides an exhaustive analysis of enthesopathies in three large skeletal series (from Portugal, England and Italy) of individuals of known occupation. This section provides the first controlled comparative documentation of the relationship between activity and enthesopathies, and contributes greatly to the understanding of which muscle attachment sites best reflect activity levels and patterns in individuals, and which types of activity are most likely to contribute to variation in the severity of enthesopathies. Finally, the study describes the results when the new methods are applied to European Late Pleistocene and Early Holocene fossil humans. French text.