Stress fractures are one of the more common sporting injuries, affecting runners more than any other. They develop from an increase in repetitive load on a bone that come from a significant increase or change to training. The most common areas affects are our weight bearing bones of the lower limb. The best treatment usually is a period of initial rest followed by a slow gradual return to sport while reducing the risk factors for re-aggravation.
One of the more common and frustrating injuries commonly associated with athletes is the stress fracture. These injuries are caused by a repetitive (an abnormal) load placed on the bone over a short period of time (weeks). Under ‘normal’ circumstances bone goes through micro trauma (meaning micro fractures), though the body very happily repairs the bone. Over time the muscles surrounding a particular bone become fatigued and unable to absorb the load they normally would. Consequently this increases the load placed upon the bone, which creates an accumulation of micro fractures which eventually lead to what is known as stress fractures.
So why do these fractures occur in the first place? The most common scenario is a rapid change in either the way athletes train or an increase how much they are training. Specifically, a substantial increase in the amount of running, change in running surfaces, change of equipment or change in the type of training sessions can all be examples of how changes in training can lead to an increase load on a bone. Inadequate rest and recovery between sessions, especially high intensity sessions, poor diet and lack of sleep can be other contributing factors which increase the chance of developing stress fractures.
The most common areas for developing a stress fracture are the weight bearing bones of the body, our lower limbs bones. Common areas include:
- Metatarsals – mainly the 2nd and 3rd toes
- Navicular
- Tibia – one of the most common
- Femur
- Pelvis
- Lumbar spine and sacrum
Symptomatically each different area of stress fractures behaves differently but ultimately they are painful with activity while resting usually alleviates the pain. Symptoms can vary between areas that stress fractures are likely to develop so getting a professional screening is important when diagnosing a stress fracture correctly.
The recovery process for a stress fracture can potentially be lengthy, which can cause a large amount of frustration for the highly active athletes. Initially rest in indicated, potentially requiring moonboot, to allow for bone healing. Once able, training can be resumed at a slow gradual pace to reduce the risk of recreating the stress fracture. Addressing any biomechanical issues or equipment problems (running shoes) is also highly recommended during the early stages of a return to training to lessen the risk of re-aggravating the stress fracture.
Here at PhysioHealth we offer comprehensive screening and strengthening programs specific to stress fractures. Screenings allow us to highlight any potential areas that may need addressing to reduce the risk of re-aggravating a stress fracture. We can then develop a specific rehabilitation programs that will aid your recovery and have you back to training and competing sooner than later.
