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Stress Fracture Rehabilitation

Stress Fracture Rehabilitation
Stress Fracture Rehabilitation

Don’t Rush Stress Fracture Rehabilitation

A stress fracture is a fairly serious injury. The presence of a stress fracture indicates the need to examine training approach, running biomechanics as well as the overall health of the athlete.
A basic rule with stress fracture rehabilitation is that any attempt to rush things can cause re-injury. The positive news is cross training through the stress fracture rehabilitation process by doing activity that doesn’t cause pain during or after is encouraged. Alternative activates that are generally considered safe and appropriate during stages of the healing phase include:

  • Swimming
  • Pool walking or deep water running
  • Cycling / exercise bike
  • Elliptical machine (also referred to as the cross trainer)
  • The more elite athlete may have access to the use of an anti-gravity treadmill that has a harness support system that can support as much as 80 percent can keep the athlete running during the recovery process.

Not all of the above are necessarily safe to start immediately once given the diagnosis of a stress fracture lower load activities like swimming or deep water jogging normally are however cycling or the elliptical trainer may need to hold off for a number of weeks. The golden rule during stress fracture rehabilitation is ‘if it hurts, don’t do it’.

Stress fracture rehabilitation centers on allowing the bone to heal. This bone healing takes around four to six weeks for most stress fractures. The exact time required depends on the fracture site, some bones with poor blood supply will require total immobilization, non weight bearing and extra time to heal completely and some will not. Your physiotherapist and sports medicine specialist will guide you on what is appropriate for your specific situation.

Components Of Stress Fracture Rehabilitation

The goal of stress fracture rehabilitation is that the down time when resting to allow the fracture to heal is used to come back mentally refreshed and having had some time to strengthen all your major muscle groups vital to running and come back stronger than before the injury. Managing mileage is not the only thing to consider in stress fracture rehabilitation and the return to running.

Diet And Stress Fracture Rehabilitation

Making sure you are eating well is important in preventing stress fractures. A diet short on calcium will force your body will steal calcium from your bones, which can make them vulnerable to breaking. Vitamin D in the diet or via sunlight helps your body absorb calcium.
The Female Athlete Triad may make females prone to stress fractures This triad is a combination of osteoporosis, amenorrhea (absent or infrequent menstrual periods which is associated with decreased estrogen in the body, limiting the bodies ability to process calcium) and eating disorders (poor intake of nutrients, including calcium coupled with significant weight loss which itself can bring on amenorrhea).

Footwear And Stress Fractures

Always get professionally fitted for your running shoes, to ensure you purchase the correct shoe for your foot and running demands to start with. It is false economy trying to save money on running shoes by going for a cheap pair or buying a pair because they are on sale if they aren’t the shoe that’s right for you. Equally trying to stretch shoes that are obviously worn out ‘just a few more runs’ may well end up costing your ten fold in medical expenses not to mention the frustration of injury as a result of your shoe penny pinching.

Regularly check for signs of wear in your shoes and even consider rotating your older and newer running shoes during your training week so your feet are experiencing some variation from one run to the next.

Running Form And Stress Fracture Rehabilitation

Factors to consider are the speed at which you train and the strike frequency often referred to as the cadence.

  • Running fast can mean greater forces when your feet hit the ground. Consider slowing down the pace once you begin your comeback.
  • Also look at your running stride rate. Elite runners tend to maintain a stride frequency of around 180 steps per minute or more. This cadence is even maintained at slow paces. Keeping a high cadence will encourage your body to stop over striding, this will reduce the impact in your feet and legs.

Any changes made however with stress fracture rehabilitation to running speed or cadence must be made gradually as with any changes to a running program.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Stress Fracture Rehabilitation should consult his or her general practitioner, physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.


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