Thursday, January 13, 2011

Stress Fractures- the Runner's Bane

How do you end up with a fractured bone without knowing you "broke" it? STRESS FRACTURES are common injuries, especially in athletes (not necessarily professional athletes, mind you, but anyone jumping into serious exercise programs...often as part of New Year's resolutions!) The stress fractures show up as a persistent tender spot or swelling, most commonly in the shin (tibia), foot bones, and upper leg; rarely they also occur in the arms, spine and pelvis.

The typical story is someone who recently had a marked increase in their activity level, or very repetitive activity (running every day) without significant rest. This is why I am a huge fan of CROSS TRAINING! If you are going to start jogging, for example, run on Mondays, Wednesdays and Saturday, and try biking or swimming on the other days.

Stress fractures are OFTEN NOT found on initial xrays (up to 90% of the time). If your symptoms persist, however, a follow up xray a few weeks later has a much higher likelihood of detecting a fracture. Sometimes additional imaging, such as an MRI, may be needed to identify the fracture.

Risk factors include having > 10 alcoholic drinks per week, being female (can't change that!), smoking, low Vitamin D levels, and excessive or repetitive physical activity.

Treatment? REST- stop the activity that causes pain. This sounds simple, but is the most difficult part to enforce, especially in committed runners. Pain medicine is usually just acetaminophen (Tylenol) or possibly ibuprofen, though there is debate whether the ibuprofen may delay healing.

BOTTOM LINE: CROSS TRAIN to PREVENT stress fractures, and see your doctor if you have a persistent tender spot (especially your shins or feet) after starting a new exercise program.</span>

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