A fatigue or stress fracture is an injury that strikes fear in the heart of every runner, because it can leave running for a long time, and in neglected cases, forever. What is this injury, and how can it be treated or avoided? Everything you need to know about it, we will tell you in this material.
What is Fatigue Fracture
Let’s say you run a lot and don’t recover well. Over time, tired muscles will no longer be able to absorb the shock load and transfer it to the bones. Repetitive load causes micro-damage to the bone, and if you add to this neglect of recovery, ignoring the symptoms of injury, then gradually these damage will become more and more noticeable. What happens next is called a stress fracture.
According to orthopedic surgeons, the second and third metatarsal bones of the foot are more susceptible to stress fractures than other bones. The area where they are located is most involved in running. She is responsible for repulsion.
Stress fractures can affect the heel, the ankle, and the midfoot, and even the pelvis, the sacrum: in general, all those areas that are subject to impacts, and the muscles cannot absorb them due to fatigue. But in runners, the bones of the lower leg or foot are most often affected, because they are the most working ones for this sport. These are the supporting bones – the tibia and metatarsal.
Stress fractures of the shin and foot are successfully treated, and if the fracture occurs in very strong bones of the pelvis or hip, this indicates health problems that are much more serious than a sharp increase in load and insufficient recovery.
Symptoms and Diagnosis
The most common symptoms of a fatigue fracture are:
- Pain while running, walking, and even at rest. If you experience pain while running that forces you to land on your foot differently than usual to avoid pain, see your doctor.
- Sharp pain when pressing on the area where discomfort is felt.
- Swelling in the affected area, but most often the swelling occurs in the top of the foot. So, for example, you may have a more visible outline of the veins on your injured leg compared to the other foot.
To diagnose an injury, there is also a jump test: you need to jump several times on a leg that hurts, and if pain is felt when landing, this may indicate a fracture.
The good news: the bone has a certain margin of safety. This means that pain, hinting at a stress fracture, appears long before it. The measures taken in time will allow not to fall out of the running program for one and a half to two months.
What leads to a stress fracture
In simple terms, insufficient recovery leads to this injury. Everyone has heard about the golden rule of 10% increase in training loads? All this is not easy, since both muscles and bones must get used to the load in order to be able to digest it. And it’s not just the mileage on your watch.
Fatigue fractures, as a rule, are the result of not only unusually large volume, but also a sharp increase in intensity, when the body does not have enough time to adapt. In this case, the bone will simply exhaust all its resources for recovery.
Winter is the time when the risk of developing a stress fracture is greatest. Reason: Lack of vitamin D. So remember that you, as an active person, need higher levels of vitamin D than everyone else.
What else could put a runner at risk? Low calcium levels, coupled with high caffeine consumption, flushing it out of the body. In addition, studies show that women with low body mass index and older runners are at a particular risk group and tend to lose bone density over the years.
Influence of running technique
Running on the heel is more likely to lead to a stress fracture, according to world statistics. This positioning of the foot puts more stress on the thigh, increasing the likelihood of injury to the tibia. However, running from the forefoot is “not without sin.” For untrained feet, it carries the risk of a fatigue fracture of the foot and ankle bones.
You should also pay attention to the surface. Suppose you have been running along unpaved paths all the time and in the winter you have moved to the arena, keeping the same volumes. A sudden change of surface is fraught with danger, especially considering that the track in the arena involves bends, and the asphalt, for example, is much harder than natural soil.
Influence of sneakers
Shoes that are out of size, not your pronation, or general discomfort contribute to the likelihood of injury. And if the sneakers are perfectly matched to you, but have already lost their shock-absorbing ability from old age, this will also negatively affect the legs. Most manufacturers set the lifespan of their shoes at 800 km.
- Increase the load slowly and gradually make changes to the program. Experts recommend increasing the volume by no more than 10 percent from week to week.
- Work your cadence upward: 80-90 strides per minute for one leg reduces the risk of injury.
- Don’t do too much speed and tempo work. Run really light on light days;
- Include exercises to strengthen weak areas in the program. The key muscles are the calf and tibialis anterior.
- If possible, see a professional who will appreciate your running technique.
- Vary your running surface.
- Eat a healthy diet with enough calcium and vitamin D in your diet. Take vitamin and mineral supplements for bone health.
- Give yourself some recovery days after a tough session. Yes, you may feel full of energy, but the musculoskeletal system takes much longer to recover than the cardiovascular system.
Treatment and rehabilitation
It is most reasonable to make an appointment with an orthopedist after the first pains. If it is impossible to do this right away, help yourself: stop running, apply ice 3-4 times a day for 10 minutes, take painkillers.
At the doctor’s appointment, you will be prescribed an examination. This is likely to be a CT scan or magnetic resonance imaging scan, since X-rays cannot detect a fracture at an early stage.
Upon confirmation of injury, you will be banned from activity, and a plaster cast will be applied to the damaged area to support the bone while it heals. During this period, your main remedy is rest. Within 6-8 weeks, you should completely abandon the activity that caused the injury and replace it with an activity that does not have a negative effect on the injury. For example, you can spin your bike or go skiing, roller skiing or rollerblading. Talk to your doctor for advice on safe exercise.
If you resume running before it is completely healed, it can lead to a much larger fracture, which will make the bone problems chronic. Do not bring your injury to surgery or, even worse, to a complete bone fracture. Just imagine that treatment and rehabilitation in this case will take at least six months.
It should also be borne in mind that once a stress fracture occurs, there is an additional risk for re-injury. This is a hint to take care of your body in the future.
Stress fractures are not only treated with complete rest and bone plaster support. You may be assigned:
- remedial gymnastics;
- manual therapy;
How to get back to running and training
So, after 8 weeks off your running shock, your muscles and bones have recovered. How to train? Of course, forget about the previous volumes and do not try to update all your personal records. Exercise should be resumed gradually and stopped if you feel pain. Ignoring these simple guidelines increases the likelihood of re-fracture.
During the gradual return to training, wear compression gaiters, a brace, or an ankle boot, depending on the location of the injury. They will take stress off the weakened area. Buy special inserts or orthopedic insoles for your shoes for better shock absorption.