Stress Fractures with Beau, the Stress Fracture Physio
Mar 19, 2024
auto_awesome
Physiotherapist Beau shares insights on stress fractures in runners, discussing risk factors, complications, and recovery strategies. He explores bone strengthening activities, correlations with ACL tears, and challenges in managing stress fractures. Beau emphasizes the importance of multidisciplinary approaches and proper bone-strengthening interventions for athletes.
Stress fractures require extensive healing time due to accumulated micro damage, distinct from traumatic fractures.
MRI scans distinguish stress fractures with thicker lines, posing unique challenges in the healing process.
Enhancing bone health through varied exercises and multidisciplinary approaches is vital in stress fracture prevention and management.
Deep dives
Understanding Stress Fractures
Stress fractures are overuse injuries caused by repetitive loading of bones, distinct from traumatic fractures. Unlike traumatic fractures, stress fractures require more healing time due to widespread micro damage accumulating across a larger bone area. The mechanism involves repetitive loading causing micro damage, leading to prolonged return to sports. Factors like bone absorption, healing, and general health influence the recovery process.
Differentiating Stress Fractures
Stress fractures, characterized as bone stress injuries, develop due to prolonged loading causing micro damage and cracks. An early stress reaction signals bone weakening from repeated loading, evolving into a stress fracture with increased pain intensity. Identifying stress fractures involves pinpoint pain locations and understanding the continuum from minor aches to severe fractures. MRI scans show stress fractures as thicker lines compared to acute fractures, highlighting unique healing challenges.
Risk Factors and Management
Risk factors for stress fractures include repetitive activities like running and lack of cross-training, impacting bone health. Factors such as low muscle mass, unbalanced diets, and hormonal imbalances amplify injury risk. Screening for metabolic issues, nutritional deficiencies, and Red S syndrome is crucial. Enhancing bone health involves weight-bearing exercises, varied training, and incorporating change-of-direction sports. Multidisciplinary approaches address bone health, hormonal balance, and overall well-being in stress fracture prevention and management.
Managing Bone Stress Injuries for Effective Healing
Properly addressing metabolic and hormonal health is crucial for the healing of bones after stress fractures, as inadequate improvement in these areas can significantly delay recovery. Prolonged offloading, necessary for healing, can lead to a reduction in bone strength, making individuals more prone to bone stress injuries. Patients should focus on developing strong bones before returning to activities that caused the injuries, as about one-third of individuals may experience reduced bone strength for up to 12 months post-injury. To mitigate these challenges, early loading on the uninjured side and pain-free loading in low-risk stress fractures are recommended.
Gradual Return to Running Post Bone Stress Injury
When considering the return to running or sports post-bone stress injury, ensuring the absence of pain during activities, especially bone pain, is critical. Patients should undergo a structured rehab program focusing on heavy strength training and plyometrics for a minimum of six to eight weeks to ensure bone tolerance. Clinical decision-making should also consider patients' risk factors, such as metabolic conditions, to tailor progressions accordingly. Increasing volume before intensity, monitoring symptoms, and implementing a gradual return to running regimen, emphasizing controlled increases in volume over intensity to safeguard bone health and prevent re-injury.
Beau is a physiotherapist in Sydney, Australia, whose clinical practice revolves around treating runners. As a result, he helps countless people manage stress fractures and has become an expert in the topic through his clinical work, deep dives of the scientific literature, and his experience managing his own stress fracture.