What are the risk factors of picking up a stress fracture?

& How to Avoid it

While exercise is beneficial to our health it is important that when starting a new exercise program that we try not to cause any injuries. Running is a very good form of exercise especially for improving bone health and keeping you active as you age. One possible type of injury that runners can pick up is a running stress fracture.

If you have a bone stress injury or a stress fracture generally you will have pain that is very localized to one area. If it is a superficial bone you will be able to recreate your pain by touching the area and the injured area itself may be bruised, swollen, or both.

How to know if you have a Stress Fractor

Generally, with bone stress problems you will get pain when you start to run, as you run the pain will get worse and then will go away once you stop. This is kind of the opposite of what we would expect in tendon injuries where once you warm up you are able to go for a run but once you’re finished the pain will come back. Another marker of a bone stress injury is having pain at night that doesn’t go away. This is a sign of the inflammatory process working within the bone.

The load on the bone during the ‘bending moment’ as we as therapists would term it is key to bone stress injuries. You don’t need to understand what a bending moment is, but instead what influences the bending moment is more important to you if you want to reduce the chances of picking up a bone stress injury.

The bending moment is influenced by:

  1. Changes in your training. This is why it is important to plan your training as changes in speed, duration, frequency or even the surface you are training on can increase your risk of injury. And not just bone stress injuries/stress fracture, these are also risk factors for common running injuries such as ‘shin splints’, Achilles tendinopathy or even various causes of knee pain.
  2. Reduced strength. This is why weight training with your running is key. Stronger muscles gives a protective effect for bony injuries.
  3. Fatigue. Fatigued running is seen as a big risk factor for bone stress injuries.
  4. Lack of recovery. As well as helping you to not be fatigued, proper recovery helps with the adaptation of bone and muscle tissue to training. The key component of recovery that effects bone stress injuries most is a lack of sleep.

A study last year compared hundreds of athletes to see what differences there were between the athletes who had bone stress injuries/stress fractures and those who didn’t.

In the group of athletes who had bone stress injuries/stress fractures, researchers found that these athletes had lower body mass indexes (BMI), were more stressed/anxious, got less sleep, did no weight training, and ate less dairy.

Good Nutrition

Good nutrition is essential for preventing bone stress injuries/stress fractures. Getting enough food into you so that you are recovering well after exercising. Also, the right amounts of Vitamin D and calcium are necessary in order to keep your bones healthy and prevent injury.

As well as good nutrition, good sleeping habits are essential for recovery and also bone recovery specifically. A study looked at the Israeli army because they had a high level of bone stress injuries and stress fractures with up to 38% of the infantry suffering from them. The researchers changed the training intensity of the infantry division and also enforced a minimum of 6 hours of sleep a night and were able to reduce the incidence of stress fractures to less than 10%.

Recap: Top tips for bone stress injuries and stress fractures.

To sum up, if you want to have good bone health then weight-bearing exercises like running are brilliant for both your overall health and your bone health. Too much running though could cause injury. If you want to make sure you don’t overdo it follow a plan so that you gradually increase your exercising.

To augment the benefits of your weight-bearing exercise make sure you also use strength training so that the muscles on the bones provide a protective effect on your bone health. On top of this, eat healthily and make sure you get plenty of calcium and vitamin D to keep your bones healthy.

Finally, make sure you are getting somewhere between 7 and 9 hours of sleep every night. Sleep is the best recovery tool we have especially when it comes to preventing bone stress injuries/stress fractures.

If you have any more questions on bone stress injuries, bone health, or running please don’t hesitate to contact us.

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Tommy Brennan

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