Stress fracture

The term stress fractures include a wide spectrum of conditions, ranging from periostitis (inflammation of the periosteum, membranous tissue that surrounds the bone itself) to a complete fracture of the bone. As the term indicates, stress fractures occur when an excessive amount of repetitive load exceeds the structural capacity of a bone. This imbalance between load and regenerative capacity of the bone leads to a progressive inability of the bone to restore its homeostasis, leading to its fracture. These types of injuries are common in the athletic population, especially in sports where high volumes of repetitive impacts are present, such as running and jumping sports (e.g.: distance runners, volleyball, basketball, etc). Due to the nature of these injuries, the majority part of this condition is reported to the lower limb, especially at the tibia and foot. As for the other fractures, these types of injuries are more common in populations that present weaker bones, likely due to multiple factors such as underlying medical conditions (e.g.: osteoporosis), eating disorders, nutritional deficiencies, etc. The typical symptoms reported by patients affected by these injuries are pain located on the site of the injury that tends to get worse when performing impactful activities, tenderness at palpation, and swelling. Aside from collecting data from the injury mechanisms and performing a physical assessment of the patient, an imaging examination (e.g.: x-ray or computed tomography) is required to optimally visualise the fracture specifics.

Management

The management of these injuries has to be extremely personalised on the individual and based on the root causes of the conditions. Due to their nature, these injuries are often caused by extended periods of overload of the bone that result in the injury. Based on this, the first important intervention to be implemented is a reduction of the training load to support the healing process of the bone. Depending on the severity of the injury and its location, the implementation of a boot or crutches can be considered to offload the area. Rehabilitation should be commenced immediately to address the other contributing factors to the development of the injury itself, such as weakness, poor movement quality, etc. In Isokinetic, after being visited by a specialised doctor, you will be prescribed a rehabilitation programme based on your condition and needs. Your recovery process will be structured in different stages and take place in four different environments, the pool, the gym, the movement analysis and retraining room and the pitch to address the root causes of your condition. In the early stages, the main goals are to restore homeostasis by reducing pain and swelling, recover the potentially impacted mobility, and gradually restore lower limb functioning. In mid-stage rehabilitation, lower limb strength and endurance recovery become the priority, together with the optimisation of the general movement quality to learn how to effectively distribute the load among different joints. Finally, to complete the recovery process, on-field rehabilitation plays a fundamental role in improving your load tolerance and supporting your return to participation in all your favourite activities and sports, maximising your rehabilitation outcomes and reducing the likelihood of complications.

Stress fracture

Management

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