Stress Fracture? What are they?

06 Nov Stress Fracture? What are they?

Don’t train faster than your bones can rebuild

Bones seem very strong and sturdy, and we tend to think of them as robust pillars that make up the scaffolding of our bodies.  People are often surprised to learn that healthy bones are continually breaking down and being reabsorbed.  This is a normal process for bones. The good news is that bones are also continually rebuilding.  As long as the breaking down and rebuilding processes are balanced with each other, we are not even aware it is taking place.

When we place stress on bones by performing activities as running, this stress contributes to the breaking down of the bones in our legs and feet. Our bodies are resilient, so they rebuild the bone, as long as we give them enough rest between sessions of exercise.  If we suddenly increase the distance, frequency, or intensity of running however, we run the risk of causing too much bone to be broken down at one time.  If we fail to give our bodies enough time to rest after such activity, the bone is not able to rebuild as fast as it has broken down.

When bones break down faster than they can repair, they can sustain stress fractures.  Stress fractures are microfractures which combine to create a fracture in the outer surface of the bone.

Stress fractures usually cause pain in a specific area on a bone, and most people report a pain that came on during training without any real injury or obvious cause.  When people continue the activity that they were doing when they first noticed the pain, they usually have increased pain over time. Eventually they can even experience pain when at rest. Stress fractures can happen in bones in several areas of the body, but we most commonly see them in the shins and feet. Impact activities such as running and jumping are common causes of these stress fractures.

Treatment for stress fractures includes taking strain off the bone in the initial phases.  This does not mean the individual will not be able to continue exercising.  What it does mean is that they will likely need to adjust their exercise to cause less impact on the legs.  Depending on the severity of the stress fractures, runners can often switch to performing cycling or swimming in the short term to keep their cardiovascular fitness levels intact while their bones have a chance to repair.

Aside from relative rest from impact activities such as running or jumping, it is equally important to understand what caused the stress fractures to develop in the first place. Often there are several factors such as flat feet, poor muscle development, or worn out or unsupportive shoes.

When a patient sees a physiotherapist for their stress fractures, they are given exercise advice, told which muscles they need to stretch or strengthen, and advised what footwear they may need to wear to take the strain off their legs. Making changes like these give the bones a fighting chance. The goal is not only to allow the stress fractures to fully heal, but also to prevent them from returning in the future.