Episode 61: A Practical Guide to Bone Stress Injuries
Oct 27, 2023
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The podcast covers how the hosts got into teaching continuing education and the need for seasonality in training. They also discuss common questions about bone stress injuries, differentiating between fatigue and insufficiency fractures, and managing bone stress injuries. The importance of avoiding judgment as a healthcare provider and understanding the volatility of the rehab process for runners with bone stress injuries are also emphasized. Additionally, optimizing bone health through exercise prescription and the approach to rehab for bone stress injuries are discussed.
Early diagnosis of bone stress injuries is crucial to prevent misdiagnosis and delays in treatment.
Tailored rehab programs, considering nutrition and overall health, are essential in recovering from bone stress injuries.
Physical performance tests can help in identifying bone stress injuries, and addressing lifestyle and psychosocial factors is important in their management and prevention.
Deep dives
The diagnostic challenges of bone stress injuries
One of the main challenges in diagnosing bone stress injuries is distinguishing them from other common running injuries. This can lead to misdiagnosis and delays in proper treatment.
The importance of individualized rehab programs
Rehab programs for bone stress injuries should be tailored to each individual's specific needs and capabilities. This includes addressing factors such as nutrition and overall health, as well as gradually reintroducing running and intensity.
The role of physical performance tests
Physical performance tests, such as single leg hopping and single leg stance, can be helpful in identifying bone stress injuries. Symptoms, such as pain and coordination issues, during these tests may indicate the presence of a bone stress injury.
The impact of lifestyle and psychosocial factors
Various lifestyle and psychosocial factors, such as increased stress and training load, can contribute to the development of bone stress injuries. Understanding and addressing these factors is crucial in the management and prevention of these injuries.
Managing Bone Stress Injuries
When dealing with bone stress injuries, it is important to prioritize imaging to accurately diagnose the problem. Palpation and tenderness can provide valuable information. Medial tibial pain greater than five centimeters along the medial tibia indicates medial tibial stress syndrome or shin splints, while a smaller area of tenderness suggests a bone stress injury. Subjective history and the individual's perception of the pain are crucial in determining the severity of the injury. Bone stress injuries consistently worsen and do not show improvement with rest or changing environments, distinguishing them from other conditions. Understanding the nuances of the injury and listening to the patient's perception helps in developing an effective treatment plan.
Optimizing Bone Health through Exercise
To optimize bone health, it is not enough to simply engage in high-impact exercises. The bone needs to be in a receptive state, and the stimulus should be sufficient to prompt adaptation. Specific exercises should be adapted to the individual's situation, gradually increasing strain magnitude and strain rate. Studies have shown that perimenopausal women with low bone mineral density and osteoporosis can improve bone density through heavy resistance training. However, exercise prescriptions should be personalized, considering the person's training plan, subjective feedback, and specific concerns. Rather than solely focusing on running, it is crucial to make sensible training decisions and incorporate other activities that promote bone health.
In today’s episode, Chris and Nathan discuss how we got into teaching continuing education and the need for seasonality in training and life. Then Chris puts Nathan on the hot seat to answer common questions about BSIs. Be sure to check out the studies they site below.
