Stress fractures are very common to female athletes,
especially runners. They are essentially
an overuse injury that worsens over time.
Bone structure, running mechanics, and the Female Athlete Triad all make
women more susceptible to stress fractures than men.
especially runners. They are essentially
an overuse injury that worsens over time.
Bone structure, running mechanics, and the Female Athlete Triad all make
women more susceptible to stress fractures than men.
What is a stress fracture?
According to the American Academy of Orthopaedic Surgeons, a
stress fracture occurs “when
muscles become fatigued and are unable to absorb added shock. Eventually, the
fatigued muscle transfers the overload of stress to the bone causing a tiny
crack called a stress fracture.”
stress fracture occurs “when
muscles become fatigued and are unable to absorb added shock. Eventually, the
fatigued muscle transfers the overload of stress to the bone causing a tiny
crack called a stress fracture.”
Typically a stress fracture begins with pain that occurs
toward the end of a physical activity or after the activity is through. It can progress to a constant pain while
walking or standing. In most cases, pain
can be pinpointed and there is also some local swelling or tenderness.
toward the end of a physical activity or after the activity is through. It can progress to a constant pain while
walking or standing. In most cases, pain
can be pinpointed and there is also some local swelling or tenderness.
Return to play time is typically 12 weeks,
depending on the risk classification. If
an athlete begins activity before the stress fracture is fully healed, they are
at a higher risk of re-fracturing that bone.
depending on the risk classification. If
an athlete begins activity before the stress fracture is fully healed, they are
at a higher risk of re-fracturing that bone.
Factors that can contribute to a stress fracture: previous stress fractures, the Female Athlete Triad and the FIIT (frequency, intensity, time, and type of physical activity).
The Female Athlete Triad
The Female Athlete Triad is made up of 3 health problems
common to female athletes:
common to female athletes:
- Energy
Deficiency/Eating Disorders - Low
Bone Mass/Osteoporosis - Menstrual
Irregularity/Amenorrhea
Energy deficiency is another term for “under-fueling.” We get our energy though our diets and if
your body is not getting enough nutrients, it will not be able to perform and you
will feel tired and weak. It can lead to
injury, illness, menstrual changes, and changes in energy levels.
your body is not getting enough nutrients, it will not be able to perform and you
will feel tired and weak. It can lead to
injury, illness, menstrual changes, and changes in energy levels.
Low bone mass can be a result of many risk factors: not enough
calcium and vitamin D, cigarette smoking and alcohol consumption, a sedentary
lifestyle, gender, and genetic predisposition.
Osteopenia and osteoporosis are advanced cases of bone loss and can be
diagnosed through dual energy x-ray absorptiometry (DXA).
calcium and vitamin D, cigarette smoking and alcohol consumption, a sedentary
lifestyle, gender, and genetic predisposition.
Osteopenia and osteoporosis are advanced cases of bone loss and can be
diagnosed through dual energy x-ray absorptiometry (DXA).
Energy deficiency can also lead to menstrual
irregularity. A cessation of the
menstrual cycle is termed amenorrhea. Low
body weight, hormonal imbalances, stress, eating disorders, or over-exercising
can cause amenorrhea. When periods are
missed, the female body produces less estrogen, a hormone essential to building
strong bones.
irregularity. A cessation of the
menstrual cycle is termed amenorrhea. Low
body weight, hormonal imbalances, stress, eating disorders, or over-exercising
can cause amenorrhea. When periods are
missed, the female body produces less estrogen, a hormone essential to building
strong bones.
The Female Athlete Triad is not something to be taken
lightly. Stress fractures are just one
of the potential side effects of the Female Athlete Triad.
lightly. Stress fractures are just one
of the potential side effects of the Female Athlete Triad.
How can stress fractures be prevented?
There is no way to completely prevent stress fractures but
here are some tips to help keep those bones strong and decrease the probability
of injury:
here are some tips to help keep those bones strong and decrease the probability
of injury:
- Drink
your milk! Calcium and vitamin D
are essential bone building nutrients.
They work together as vitamin D helps the body absorb calcium. The latest guidelines recommend
1,000-1,200mg per day of calcium and 600IU per day (800IU for 70+ years
old) of vitamin D. Peak bone mass
is reached in your 20s but consuming enough calcium and vitamin D can help
slow down bone mass loss as you age.
- If you
are just beginning an exercise program or just getting back into it, start
slow. Increase your mileage
gradually to avoid injuries. Impact
and weight bearing activities help to preserve bone mass but if you get
too ambitious too quickly, it can add extra stress to your body.
- It’s
important to incorporate a good strength training program into your
routine. Functional training, the
Burdenko Method (on land), free weights, and resistance tubing are all great
ways to maintain your bone mass and gain muscle strength and
endurance. Fatigue and weakness can
lead to a change in your running form, which can then lead to
injuries. Build strong bones and muscles
to keep from losing your stride.
- Get
screened! The Functional Movement Screen (FMS) is a good tool to discover any physical limitations or
asymmetries in different patterns of movement. Finding these areas of weakness and
working to correct them will help to help to keep you injury free.
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- Change
your shoes often. A good pair of
running will typically last 300-400 miles.
Pay attention to the wear patterns on your shoes. Over-pronators or over-supinators may go
through shoes quicker than someone with a more neutral stride. If you start to see the bottoms of your
soles wear off, its time for new shoes!
Running shoes will cost you around $90-110 but new shoes are cheaper
than Physical Therapy and your feet, knees, and hips will thank you in the
long run!
Blog post by Jen Skiba.
