Understanding Bone Stress Injuries (Stress Fractures) and How To Identify If You Have One

bone stress injuries phyxyou port macquarie
bone stress injuries phyxyou port macquarie

What is a Bone Stress Injury? 

Bony stress injuries (stress fractures) are a painful and common injury seen in athletic populations, often preventing participation in sport and decreased performance. It is natural and healthy for our bones to be loaded throughout the day through sport and exercise. When bones are subjected to loading, they remodel, laying down more mass and density to be stronger and more capable of handling future loading. 

Stress injuries occur when this bone is overloaded to the point where it cannot recover and remodel quick enough, leading to  micro/macro fractures  and pain. Bony stress injuries can affect a multitude of different bones in the body, and this is often related to the activity being performed. For example, runners and impact athletes more commonly develop lower limb bony stress injuries of the metatarsals and tibia. 


What are the symptoms of a stress fracture? 

Bony stress injuries have different levels of severity. In the early stages of its development, you may notice subtle pain which worsens with activity and subsides with rest. For runners, this may be located across the shin bone or across the foot. As the condition worsens, pain is noticed with even subtle loading or exercise, may last long after ceasing activity, and bony tenderness across the painful area can also develop. 


What are the risk factors for developing a bony stress injury? 

  • Training overload
  • Insufficient recovery following exercise
  • Sudden change in exercise routine 
  • Energy deficiency (lower energy intake than the amount expended) 
  • Poor bone health 
  • Female gender (due to hormonal influences, bone density, muscle strength etc)


How can we help treat them? 

The most important step to managing bony stress injuries is optimal load management. This means balancing the amount of stress/force exposed to your stress injury with sufficient rest and recovery. For some, this might require a period with a walking or mobility aid (crutches or a boot), and modifying your training. If you also have other modifiable  risk factors for developing stress injuries, these must also be addressed and could require input from other health professionals (i.e. Dieticians, Sports Physicians). 

It is very important that bony stress injuries be taken seriously and should always be managed by a trained health professional, ideally a Physiotherapist and Sports Physician. 

Alasdair Thomson


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