September 2017

Stress Fractures in Runners 

A stress fracture is an overuse injury in a bone that results when repeated stress exceeds its ability to recover/remodel. Stress fractures in runners typically occur in the lower extremity to include the tarsal bones, tibia, fibula, and femur due to the repetitive ground reaction forces (GRF) of the heel strike. Although all runners are susceptible to stress fractures, they occur more commonly in females due to their naturally lower bone mass, irregular menstruation, and inadequate caloric intake (Female Athlete Triad). 


Causes:
· Low bone mineral density
· Pronation of the medial arches of the foot
· Muscular fatigue/weakness resulting in an inability to absorb shock/GRF
· Leg length imbalances
· Improper running technique
· Overtraining
· Running on uneven surfaces
· Large increase in running volume, frequency, or intensity
· Improper/worn footwear

Symptoms:
· Early stages: mild pain with activity
· Late stages: severe pain with activity
· General: redness, swelling

Diagnosis:
· Bone scan: most sensitive

Treatment:
·Acute 
  • Rest, Ice, Compression, Elevation
· Chronic
  • Rest: 4 – 12 weeks
  • Strength training to improve muscular stability and reduce GRF
Prevention:
· Progress training slowly
· Replace shoes when needed
· Correct pronation with orthotics
· Plan periods of rest
· Run on even surfaces
· Vary running surfaces (trail, road, track)
· Females: be aware of long-term changes in menstruation 


Active Performance Chiropractic focuses on the diagnosis, treatment, and rehabilitation of athletic-related injuries. Treatment is a unique blend of Active Release Techniques®, traditional chiropractic therapy, and physical rehabilitation designed to match each patient’s goals and lifestyle.