s3/e38 Bone Health & Bone Stress Injuries with Dr. Stephanie Mundt, PT, DPT, OCS, CSCS
Oct 12, 2023
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Dr. Stephanie Mundt, PT, DPT, OCS, CSCS discusses bone health, stress injuries, and more. Topics include bone composition, risk factors for stress injuries, DEXA scan interpretations, considerations for osteoporosis, types of stress injuries, return to run guidelines, the impact of running on bone health, and nutrition for healing and remodeling.
Factors like weight gain, strength training, and proper nutrition can help improve bone density.
Returning to running after a bone stress injury requires a gradual and cautious approach to protect against re-injury and account for the bone's adaptation abilities.
Running-related injuries occur when runners reach their tolerance threshold or are exposed to a level of running that increases their risk profile for injury, highlighting the importance of managing multiple risk factors.
Deep dives
The importance of bone health and bone stress injuries in runners
Bone stress injuries can be confusing and frustrating for runners. The guest, Dr. Stephanie Munt, discusses bone health, bone stress injuries, and the importance of bone density. Bones undergo a remodeling process, constantly breaking down and building new bone. Mechanical loading, such as weight-bearing exercise and muscle contractions, stimulate this process. Low bone mineral density and energy deficiency increase the risk of bone stress injuries. Factors like weight gain, strength training, and proper nutrition can help improve bone density.
Measures of bone health and risk factors for bone stress injuries
Bone mineral density (BMD) is often measured to assess bone health, and a Z-score between -2 and 0 is considered normal. Females and those with low energy availability or a history of eating disorders are at higher risk for fractures. Adolescents and puberty are critical periods for developing strong bones. Risk for bone stress injuries varies based on bone type and site. Trabecular sites, like the sacrum and pelvis, are more sensitive to hormonal changes and energy deficiency. Ball sports and weight-bearing activities can improve bone health.
Considerations for runners recovering from bone stress injuries
Returning to running after a bone stress injury requires a gradual and cautious approach. Return to run programs may initially seem conservative, but they protect against re-injury and account for the bone's adaptation abilities. Bone remodeling is a metabolically intensive process and requires adequate energy availability. Consistency in training and avoiding extreme training fluctuations reduce the risk of bone stress injuries. Furthermore, building bone density requires more than just running, as running alone may not provide sufficient stimulus. Heavy strength training and high-impact activities like plyometrics complement running to strengthen bones.
Factors contributing to running-related injuries
Running-related injuries are not solely caused by factors such as poor mechanics, high or low BMI, or footwear choices. These injuries occur when runners reach their tolerance threshold or are exposed to a level of running that increases their risk profile for injury. The combination of multiple factors, rather than one single factor, contributes to the occurrence of running-related injuries. Coaches can play a crucial role in helping runners understand and manage these risk factors.
Understanding bone stress injuries and risk sites
Bone stress injuries (BSIs) typically occur three to eight weeks after a change in training. They often seem to sneak up on runners, but they are a result of cumulative factors and gradual progression of stress over time. The risk sites for BSI differ based on blood flow and potential for healing without surgical intervention. Areas like the femoral neck, sacrum pelvis, and calcaneous have higher risk due to lower blood flow, while areas like fibula, metatarsal shafts, and posterior medial tibia have better blood flow and lower risk. Understanding these risk sites and the timeline for healing is crucial for appropriate management and prevention of BSIs.
BONES! Literally what holds us upright. So what do we runners need to know about our bones, bone health, and bone stress injuries? Dr. Steph Mundt, PT, DPT, OCS, CSCS (@stephmundt.dpt) joins the show today to teach us about...
What are our bones made of and how do they get stronger?
Who is at higher risk of bone stress injuries?
What is "good bone health" and how can we work towards it?
Understanding bone mineralization and bone density
How to read a DEXA scan for runners
Considerations for runners with osteopenia or osteoporosis
Bone stress injuries: what you need to know
Different types of bone stress injuries
Diagnosing bone stress injuries
Why the timeline for return to run from bone stress injuries is what it is
Why running alone isn't enough to improve bone health
AND MORE!
This episode is sponsored by Previnex! Save 15% off your first order of clinically effective supplements with code RUNEXP on previnex.com
Dr. Steph Mundt is a physical therapist and running coach in Tempe, AZ. Her business Volante PT & Performance specializes in the rehabilitation & coaching of runners with a particular emphasis on bone stress injuries, hip labral tears, and eating disorders. Steph struggled with an eating disorder in high school and college resulting in recurrent bone stress injuries throughout her running career. These experiences led to a strong desire to learn more about bone stress injuries and eating disorders and elevate care for individuals recovering from them. She is a Board-Certified Orthopedic Clinical Specialist, Certified Strength & Conditioning Specialist and is currently working towards becoming a Certified Eating Disorder Specialist. Steph is passionate about helping runners regain trust in their bodies and establish a fulfilling and sustainable relationship with movement.
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