Stress fractures can occur in two ways:
- The redistribution of impact forces resulting in increased stress at focal points in bone.
- The action of muscle pull(s) across bone.
The tibia, which is the larger and stronger bone of the lower leg, is the site of approximately 50% of all stress fractures in athletes. - Running & FitnewsSymptoms of a stress fracture:
- Localized bone pain
- Pain is aggravated with physical activity and relieved with rest
- Area may be tender to the touch, with occasional swelling and redness
One of the biggest mistakes athletes make after being diagnosed with a stress fracture is returning to training too quickly. It's important to let the body heal and if it's rushed, there is a greater risk that the injury will reoccur. Depending on the severity of an injury, the healing process can be anywhere from eight to seventeen weeks. Clinicians recommend that training begin slowly with a low intensity and be pain free. Cross training is a great option for recovery and may include deep water running, cycling and gym work.
Stress fractures are managed best by taking preventative measures. Stress fractures are directly related to training loads and how fast an athlete increases the frequency, intensity, and duration of their activity. Bones can adapt to repetitive stress but extreme stress, if it occurs too often, can overwhelm the body's ability to adapt. Having a varied training schedule is essential for prevention as well as having the proper athletic gear. Distance runners are particularly susceptible to this type of injury and it's recommended that athletes replace athletic shoes as they wear out, approximately 700-1,000 kilometres or 6-12 months.
Other risk factors beyond training schedules and loads are nutrition and gender. Calcium and vitamin D deficiency decreases bone density which can increase the chance of injury. For female athletes, amenorrhea (infrequent menstrual cycle), osteoporosis and/or an improper diet can all contribute to the occurrence of stress fractures.
Coaches and athletes should be aware of the effects of overtraining and the importance of taking rest days. If you think you may have a stress fracture, keep in mind that this type of injury should not be self treated. Proper diagnosis should come from a physician and depending on the location and severity, recommendations for treatment will differ.
References from the SIRC Collection:
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