Don't Stress Out!
Are you planning a Marathon this year? Perhaps a new sport, or an event you have set as a goal? GREAT – but be careful with your training loads. Our bodies need time to adapt to new or increased loads, and we’re NOT just talking about your fitness level!
This month, we will discuss some general concepts of stress fractures, the main training injury you definitely don’t want to get!!
When a bone is gradually exposed to repeated load (eg the foot bones when slowly building up running volume), it adapts, by producing and laying down more bone in the lines of direct stress. If the increase in repetitive load is too rapid to allow the bone to respond by strengthening itself, the bone can overload and develop a stress fracture. This is a tiny microfracture in the bone, that often won’t show up on xray.
Stress fractures can occur in nearly every bone in the body, via direct impact, or by a muscle repeatedly pulling on a bone. Pain is normally very localized and can generally be easily felt on the bone. This, paired with a history of a recent change in training or taking up a new activity, would make a Health Professional very suspicious of stress fracture. If further confirmation is required, the investigation of choice is then a bone scan or an MRI.
For most stress fractures, the main treatment is complete rest from the type of activity that caused it, and this can be required for 6 to 8 weeks. This would be incredibly inconvenient if you were training for a Marathon! Soft tissue injuries can sometimes be managed with a reduction in training, but stress fractures need complete rest to heal. Perhaps a movie marathon instead??!!
Here is a summary of more common stress fractures and their causes:
Metatarsal (ie the long bones in your feet that lead into your toes) – This is commonly called a ‘March fracture’, as it can be common in Army populations with large volumes of pack marching. Also very common in runners and ballet dancers! Sometimes crutches are required for 2 to 4 weeks.
Tibia (ie the main bone in your lower leg) – Another common running one, and again this can require crutches to heal.
Navicular (ie a bone in the middle of your foot on the inside) – Often this is more from sprinting and jumping sports. A baddie, as you would have to wear a cast for 6 weeks to heal it!
Ribs (ie bones you breathe with!) – I have seen this in rowers a few times, as the trunk muscles pull on the ribcage and cause overload. Very painful, but fortunately no plaster cast required, as that would make it rather hard to breathe…
Vertebra (ie bones in your spine) – This is a nasty one for fast bowlers and gymnasts. Fortunately Dili has neither of these, so at least you can cross this one of the list!
Anyway EARLY INTERVENTION for stress fractures is the key (gosh I sound like a broken record sometimes). So if you have a tender spot on your bone that wont go away, consult your friendly Physiotherapist.
Happy and safe training!
If you have any further questions about this article, email me:
karen@physios-online.com
Karen Finnin
Musculoskeletal Physiotherapist
BAppSc(Physio),MMuscPhys