Life after a stress fracture: the journey back to fitness:
Stress fractures are one of the most feared and frustrating injuries for runners as they can derail running for a lot longer than the average soft tissue injury. This month, the team at Apex Clinic advises on what you can do and things to avoid on the journey back to full fitness from a stress fracture.
Understanding the enemy: what is a stress fracture?
A stress fracture is a crack that does not go completely through a bone. The injury has two main causes: too much repetitive stress on a bone and/or weakness of the bone (poor bone density). These causes can result from a number of different factors, such as age, gender, high impact running surfaces, poor training regimes, mileage increases too rapidly, dietary factors, poor footwear, biomechanical disorders and a history of overuse injuries.
Now you know what you’re dealing with, what can you do to get better? Rest up or regret it…
It is essential to avoid weight-bearing exercise for usually around 12 weeks following a stress fracture. This is a very long time to wait for most runners, but you must avoid the temptation to take short cuts on this one. If you resume training too early you will almost certainly make the situation worse by delaying bone healing and making the overall recovery time longer.
Why me? Take action to prevent recurrence..
With the emphasis usually on returning to running, people often forget to find out exactly why they developed a stress fracture in the first place. Every injury has a cause and by understanding your injury you can take steps to prevent a recurrence in the future. We recommend you consult an experienced physio and ask them to examine your body’s entire kinetic chain, from your mid back down to your feet to better understand why this has happened to you. If the problem is found to be biomechanical – ie in the feet, hips or legs – then, you may be advised to get insoles (orthoses). Specific stretches of tight leg muscles may need to be started along with strengthening or activating weak muscle groups. If the cause is not biomechanical, then the injury will most certainly be the result of overuse or a low bone density, which is more common in women.
Aqua jog to take the load off:
A great way to maintain cardiovascular fitness and tone when recovering from a stress fracture is by aqua jogging in a pool which is deep enough. Get equipped with an aqua jogging belt and head off to your local diving pool. The real advantage of aqua jogging is that you can continue to train for all types of running; you can do your long runs, intervals and tempo sessions in the pool with minimal load on your body.
You are what you eat:
Some people may be predisposed to stress fractures because of their diet, especially those with a calcium-poor diet or those with osteoporosis (thinning of the bones with a reduction of bone mass). Eating a calcium rich diet can play an important role in preventing future stress fractures. If you are not getting enough calcium in your diet, you should take a daily calcium supplement and try boosting your vitamin D intake also to help your body absorb the calcium.
Don’t fall into the ‘too much too soon’ trap:
Although factors such as your age, the number of fractures, their location and severity may all impact on your recovery, with the correct diagnosis and treatment the good news is that you should be able to make a full return to running.
Our final word of advice, once you are given the green light to run again, is not to overdo it. Build up slowly and make sure to do the majority of your running in the future on softer surfaces such as sand, grass and bark trails. For most runners, stress fractures are not the end of the road.