Imagine working so hard that you collapse; this phrase conveys that level of tiredness. She worked herself into the ground and couldn't even enjoy her weekend.
Pro Tip 2/3
Negative Connotation
The phrase often implies working hard isn't good when it's excessive and harmful. After months of driving himself into the ground, Mark finally realized he needed rest.
Pro Tip 3/3
Metaphorical Use
Taken figuratively, not literally; nobody ends up in the ground from exhaustion. You're running yourself into the ground with these back-to-back marathons.