PREVENTION OF STRESS FRACTURES

Stress fractures are a common overuse injury which can occur in any sport but are more common in impact sports such as running. They can occur in any bone in the body but the most common sites are the tibia, metatarsal and fibula.  They occur due to microdamage in the bone that occurs every time we exercise. Bone resorption occurs to repair the damage and replace with new bone. If there is unaccustomed activity the deposition of new bone lags behind the faster resorptive process and eventually a stress fracture will occur. Here is a brief checklist of the risk factors and preventive strategies to avoid stress fractures.

THE RISK FACTORS FOR STRESS FRACTURE

Training factors- Too much volume and intensity. Sudden change in training. Inadequate recovery between sessions
Muscle fatigue/Flexibility- Leads to loss of attenuation of ground forces
Terrain- Too hard a surface or uneven surface
Alignment- e.g high arched cavus foot, hyperpronation, knee alignment, difference in leg lengths
Shoes – Not suitable for foot or worn
Female- Are more at risk
Bone geometry/size- smaller circumference of bone in cross section has a greater risk
Bone density- Low bone density
Hormonal factors- Menstrual abnormalities
Nutritional factors- inadequate calorie or calcium intake

PREVENTION OF STRESS FACTORS

Muscle strength and endurance- Strengthening of weak areas e.g calf raises
Suitable footwear and orthotics if necessary
Correct other biomechanical abnormalities e.g leg length difference, pelvic tilt/weakness
Training surfaces should be varied
Training factors- avoid rapid increase in training, too much intensity or volume
Ensure adequate calcium intake
Maintain a normal hormone status