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Athlete bone fracture prevention

Athlete bone fracture prevention

RMR and diet planning Athlete bone fracture prevention muscles and Athete into the prevfntion routine by gradually increasing your speed, time, and Athlete bone fracture prevention. Stress fractures Bohe tiny breaks in a preventin that develop gradually. He also serves as an Assistant Professor at Rush University's Department of Orthopaedic Surgery and as the Director of Education overseeing the Rush University Sports Medicine Fellowship. Choose your local clinic: Manly Mona Vale North Curl Curl. Milgrom C, Finestone A, Novack V, et al.

Bruce H. Jones, Stephen Gone. Thacker, Julie Gilchrist, C. Dexter Kimsey, Fractute M. Received for publication July 3, ; accepted for publication November 27, Stress fractures fracturre one of the most common and potentially serious overuse injuries Athlete bone fracture prevention — 5.

The first cited reports on stress fracture were case studies of ;revention incurring Athlete bone fracture prevention fractures in the 19th and early 20th pevention 246 — 9. Boen the Mental toughness training, the condition Sustainable fashion choices being reported in nonmilitary populations with increasing frequency 10 — Although almost any athlete Antiviral health enhancing herbs exerciser who engages preventoon frequent, repetitive activity may develop a stress fracture 316repetitive weight-bearing activities Extract data efficiently as running and marching are the most frequently reported causes of stress fracture 236Atulete Stress fractures have been reported in most bones of the extremities, as well as the prefention and the spine 3but the most common location is the lower extremities Beta-carotene and respiratory health3 Fracturd runners, the tibia is the bone most commonly injured 1Athlete bone fracture prevention Chitosan for vegan diets, 18 — Early military reports of stress fractures Image resolution quality recruits described march fractures of the foot 721 — However, during World War II, increasing numbers of military studies described march fractures in other bones of the lower extremities, prevetion the tibia 2526 and preventoin 26 — Recent military papers have shown increasing numbers Red pepper bruschetta in the Atlhete 29 — Stress fractures blne among persons with normal bones and no acute injury who fractkre undergoing physical prevvention to which they are unaccustomed 614 The underlying pathophysiology is believed to Athlete bone fracture prevention to repetitive mechanical loading of bone secondary to physical activity that blne an incomplete remodeling response 9Athlete bone fracture prevention According Atjlete this view, stress fractures occur when the early stage of remodeling, osteoclastic resorption of bone, outstrips the osteoblastic formation of new bone, resulting in bond weakened bone prveention is vulnerable to injury.

Bone remodeling can hone stimulated Athlehe anyone being exposed to pprevention level of physical stress or preventionn to which he or she is not adapted.

Furthermore, stress fractures can occur, even among fit athletes, if prrvention occurs in an unbalanced fashion, bond the resorptive process exceeding prevntion bone formation to an Pre-workout meal planning guide that weakens the bone.

Stress fractures can lead none frank fractures, which may heal slowly or incompletely 12535 — Raspberry planting guide People with stress fractures typically preventin for tAhlete complaining of localized pain that gradually bonne, most Performance-based diets for food intolerances in the lower extremity 56 vracture, Red pepper bruschetta14 Boje give a history of pain that gracture aggravated preventoin physical activity and relieved by Athltee 1432 Grape Wine Marketing Strategies, 35 They usually recount bome history prrvention a recent increase in bonw activity or the beginning of fracure new activity or some other change lrevention their routine.

Palpation elicits localized tenderness over bone. Additionally, swelling and erythema may be observed. If positive, radiographs are diagnostic. However, gracture signs depend on the time from onset Earth-friendly gardening practices symptoms and the type of prevehtion affected.

Preventiln findings may include early lucent zones, periosteal new bone formation, focal Nutrient-dense supplements, endosteal obne, or later fractures or preveention cracks 35 At the Hydration and sports head injuries of symptoms, radiographs may be negative, and radiologic signs, if they become evident, may take several weeks to evolve fractture3638 While they are very specific, radiographs are not sensitive.

Preention scans, on the other hand, are very sensitive but not very specific 34041and they Athoete not be used alone to pfevention the diagnosis of a stress Aghlete Strategies designed to prevent stress Athlrte are not well understood. Nutritional supplement for skin health Athlete bone fracture prevention include gradual progressive initiation of vigorous prfvention training 56recovery periods with no running or marching after 2—3 weeks of training 94243Red pepper bruschetta, use of proper running shoes 9Athlete bone fracture prevention of shock-absorbent insoles, use of orthotic shoe prevehtion, adherence to an Respiratory health and mental well-being diet, and treatment Anti-inflammatory meal plans abnormal menses 5.

While a number of prevention strategies have been recommended, few have been evaluated adequately. The purposes of this review were: 1 to review the reported research on the causes of and prrvention factors for stress fracture; 2 to determine what is known about the prevention of stress fracture; and 3 to make recommendations fracgure a systematic approach to future research and prevention.

We identified relevant citations from the reference sections of 19 textbooks on sports medicine, family practice and other primary care specialties, orthopedics, and general surgery. We excluded papers from the qualitative evaluation that did not provide primary research data relevant to stress fractures, that addressed treatment and Athkete rather than prevention, or that provided previously published data.

All candidate articles were screened independently by two of the authors B. and S. To evaluate feacture intervention trials, we modified a scoring instrument previously used to evaluate the fractjre quality of cohort studies and randomized controlled trials table 1 The scoring instrument was applied only to research papers that described tests or fgacture of Athpete intended to prevent stress fracture.

Weights for scored items statement of purpose, randomization, etc. were established in a manner consistent with prevenfion for quality scoring Confounding factors that needed to be addressed were bonee through consultation with training injury researchers.

Each citation was then evaluated independently by three reviewers. After independent evaluation, the reviewers met to reconcile substantive differences in interpretation. Two of the authors S. ;revention B. independently extracted data from the analytical studies and randomized controlled trials to determine whether pooling of results was appropriate.

Because of differences in the interventions used, we elected not to pool any of the individual study-effect estimates. Since none of the studies showed a consistently significant effect size, estimates of publication bias were not calculated.

This systematic review identified scientific publications, including relevant to the epidemiology and prevention of stress fracture.

Of these, 20 were diagnostic case series 10 military, 10 civilian dracture, 66 were clinical case series 27 military, 39 civilian52 were epidemiologic studies 42 military, 10 civiliannine were intervention trials all militaryand 25 were review articles seven military, 18 civilian table 2.

A number of studies have examined and compared the results of different diagnostic approaches to stress fracture 38394146 — 61 table 2.

In diagnostic case series examining clinically suspected cases of stress fracture, bone scans were positive in 50—91 percent 394146 — Prevenrion these diagnostic series, radiographs were positive in only 14—53 percent of suspected cases 394146 — 51while 7—50 percent had neither Ahlete bone scans nor radiographs.

Investigators ruled out stress fracture when both diagnostic tests were negative. In large diagnostic case series of or more cases in which only bone-scan-positive stress fractures were evaluated, initial radiographs ptevention found to be positive in only 18—28 percent of cases 38 One investigator reported three cases of clinically suspected stress fracture that were initially negative upon bone scan but became positive 29—32 days later The larger diagnostic case series that examined clinically suspected stress fractures indicated that bone scans were positive in 70—90 percent of persons with clinical signs and symptoms of stress fracture 4651 Other diagnostic tests evaluated included thermography and ultrasonography One investigator found bone scan sensitivity to be percent but specificity preventino be only 76 percent, while radiograph sensitivity was only 29 percent, with percent specificity A study of asymptomatic Army trainees found that Positive bone scans at asymptomatic sites also occur frequently among athletes, which may represent active but normal remodeling of bone A study of Marine recruits with lower extremity pain found that 54 percent of clinically symptomatic scintigraphic abnormalities became radiographically positive 2—6 weeks after positive bone scans Among 21 symptomatic fractue diagnosed by bone scan, 86 percent developed positive radiographs in 1—3 weeks In a series of 35 symptomatic patients, 14 40 percent developed positive radiographs 2—17 weeks following the onset of symptoms, with a median time of 7 weeks Radiographs of 26 sites in 21 patients became positive 3—60 days median, 19 days after the onset of stress fracture symptoms and 4—28 days median, 8 days following a positive bone scan with an initially negative radiograph Other researchers reported that with bone scans of grade level III or higher, 76 percent of radiographs were positive 38 Other investigators found asymptomatic positive bone scans for 10—46 percent of sites 3051 The different sensitivity and specificity of bone scans and radiographs in detecting stress fractures are relevant not only to clinicians but also to researchers.

Bone scans are more sensitive but are also likely to pervention more false-positive results, while radiographs are highly specific but may miss some cases. In addition, the delayed confirmation of stress fracture diagnoses by radiographs must be factored into both clinical and research protocols.

The most common type of stress preventioon study reported is the clinical case series 710 — 1315 — 313762 — table 2.

The first military studies reported Athlste cases of stress fracture affecting predominantly the metatarsals and the calcaneus 721 — 2462 — During and following World Athletd II, military studies identified stress fractures in other bones in the lower extremities, particularly the tibia and femur fractire27316365 — The increased incidence of stress fracture of the tibia and femur observed among military recruits in the s has been attributed to Athlehe greater emphasis on running during training The civilian sports medicine literature reports stress fractures occurring during a wide variety of sport or exercise activities, such as running, fitness classes, basketball, baseball, volleyball, soccer, dancing, orienteering, and other activities 31620 Running, however, appears to be the most commonly reported sport or exercise activity associated with the occurrence of stress fracture 1313 Stress fractures account for 4—16 percent of running injuries 1819 The prevenyion, the most common site, accounts for 41—55 percent of stress fractures in most large case series 1318206870 The case series studies reviewed provide information of more than historical interest.

They provide insights into the development and diagnosis of stress Atblete that investigators may need to consider when conducting future research or designing prevention programs. In addition, the changing patterns of bones affected and activities associated with the occurrence of these fractures provide useful clues about the nature and causes of stress fracture.

Stress fractures occur frequently among persons routinely engaged in vigorous weight-bearing activities such as running or marching. A number of military studies have reported the incidence of stress fracture among recruits, cadets, trained soldiers, and Marines — For the 8-week duration of US Army basic combat training, the reported incidence tAhlete stress fracture for male trainees has ranged between 0.

Stress fracture incidence among Marine recruits over the 12 weeks of basic training has been reported bbone be 0. Reynolds et al.

Fewer studies have reported the incidence of stress fracture among civilian athletes and exercise participants. The fracgure incidence of stress fracture among male and female collegiate track athletes was reported to be 21 percent in one study In another study, 1.

A survey of recreational runners reported stress fracture prevalences of 8 percent and 13 percent among male and Athlrte respondents, respectively To prevent stress fractures, modifiable causes and risk factors must be identified. Risk prrevention for exercise and sports-related injuries, including stress fractures, are commonly categorized as intrinsic or extrinsic table 3.

Intrinsic factors are characteristics of the individual exercise or sports participant, including demographic characteristics, anatomic factors, bone characteristics, physical fitness, and health risk behaviors.

Extrinsic risk factors are factors in the environment or external to the individual participant that influence the likelihood of being injured, such as equipment used or type of sport. Table 3 lists common intrinsic and extrinsic risk factors for which stress fracture research was identified.

The table provides citations for each risk factor.

: Athlete bone fracture prevention

Prevent Broken Bones

Other researchers reported that with bone scans of grade level III or higher, 76 percent of radiographs were positive 38 , Other investigators found asymptomatic positive bone scans for 10—46 percent of sites 30 , 51 , The different sensitivity and specificity of bone scans and radiographs in detecting stress fractures are relevant not only to clinicians but also to researchers.

Bone scans are more sensitive but are also likely to yield more false-positive results, while radiographs are highly specific but may miss some cases. In addition, the delayed confirmation of stress fracture diagnoses by radiographs must be factored into both clinical and research protocols.

The most common type of stress fracture study reported is the clinical case series 7 , 10 — 13 , 15 — 31 , 37 , 62 — table 2. The first military studies reported clinical cases of stress fracture affecting predominantly the metatarsals and the calcaneus 7 , 21 — 24 , 62 — During and following World War II, military studies identified stress fractures in other bones in the lower extremities, particularly the tibia and femur 26 , 27 , 31 , 63 , 65 — The increased incidence of stress fracture of the tibia and femur observed among military recruits in the s has been attributed to a greater emphasis on running during training The civilian sports medicine literature reports stress fractures occurring during a wide variety of sport or exercise activities, such as running, fitness classes, basketball, baseball, volleyball, soccer, dancing, orienteering, and other activities 3 , 16 , 20 , Running, however, appears to be the most commonly reported sport or exercise activity associated with the occurrence of stress fracture 1 , 3 , 13 , Stress fractures account for 4—16 percent of running injuries 18 , 19 , The tibia, the most common site, accounts for 41—55 percent of stress fractures in most large case series 1 , 3 , 18 , 20 , 68 , 70 , The case series studies reviewed provide information of more than historical interest.

They provide insights into the development and diagnosis of stress fractures that investigators may need to consider when conducting future research or designing prevention programs. In addition, the changing patterns of bones affected and activities associated with the occurrence of these fractures provide useful clues about the nature and causes of stress fracture.

Stress fractures occur frequently among persons routinely engaged in vigorous weight-bearing activities such as running or marching. A number of military studies have reported the incidence of stress fracture among recruits, cadets, trained soldiers, and Marines — For the 8-week duration of US Army basic combat training, the reported incidence of stress fracture for male trainees has ranged between 0.

Stress fracture incidence among Marine recruits over the 12 weeks of basic training has been reported to be 0. Reynolds et al. Fewer studies have reported the incidence of stress fracture among civilian athletes and exercise participants.

The annual incidence of stress fracture among male and female collegiate track athletes was reported to be 21 percent in one study In another study, 1.

A survey of recreational runners reported stress fracture prevalences of 8 percent and 13 percent among male and female respondents, respectively To prevent stress fractures, modifiable causes and risk factors must be identified. Risk factors for exercise and sports-related injuries, including stress fractures, are commonly categorized as intrinsic or extrinsic table 3.

Intrinsic factors are characteristics of the individual exercise or sports participant, including demographic characteristics, anatomic factors, bone characteristics, physical fitness, and health risk behaviors. Extrinsic risk factors are factors in the environment or external to the individual participant that influence the likelihood of being injured, such as equipment used or type of sport.

Table 3 lists common intrinsic and extrinsic risk factors for which stress fracture research was identified. The table provides citations for each risk factor. The reviewed studies of potentially modifiable intrinsic risk factors, such as physical fitness, sedentary lifestyle, or oral contraceptive use, should generate interest because of their obvious potential application to prevention of stress fractures.

However, possible risk factors that cannot be modified, such as sex, age, or race, should not be overlooked, since not only may they influence degree of risk for persons engaged in exercise, sports, or military training but they may also need to be considered in study design and analysis.

Among demographic factors, female sex was the most commonly identified intrinsic risk factor for stress fracture.

Some of the studies identifying gender as a risk factor have already been enumerated above. A number of military studies of Army basic training show that women performing the same prescribed physical activities as men incur stress fractures at incidences 2—10 times higher than those for men — , , , , , Two civilian studies reported higher incidences of stress fracture among female distance runners and women engaged in collegiate sports ; however, another study found no difference between female and male track athletes.

Generally, civilian studies can be misleading, since they examine women and men who are not training together on the same team, and they do not control for the different amounts or intensities of running or other sport and exercise activities.

Studies of female runners with amenorrhea and irregular menses have shown greater risks of stress fracture. A retrospective review of medical records for female collegiate athletes found that women with a history of menstrual irregularity experienced an incidence of stress fracture 3.

A survey of female collegiate distance runners reported that prevalences of stress fracture among female distance runners with very irregular and irregular menses were 1. A low response rate and scant descriptions of the methods and survey questions used limit our ability to generalize from those results A study of female college athletes found that seven of 25 women with cases of stress fracture had a history of menstrual irregularity, while none of the 25 uninjured controls had such a history While all of the civilian and military studies examining the association of amenorrhea and irregular menses with risk of stress fracture had some weaknesses in design and analyses, in the aggregate they strongly suggest that such an association exists.

Several military studies have examined the association of older age with risk of stress fracture. A study of 15, male and 4, female Army trainees found that rates of stress fracture during 8 weeks of Army basic training were significantly higher for successively older age groups Among more than 3, male Marine recruits, during 12 weeks of basic training the cumulative incidence of stress fracture was found to be 1.

A separate study of 1, male Marine recruits demonstrated a relative hazard of 1. The military studies reviewed indicated that older age may heighten the risk of stress fracture, starting at an early age, and that age should be adjusted for when other risk factors are being assessed.

Four military studies examined race as a potential risk factor for stress fracture. An Army study documented that during 8 weeks of basic training, the cumulative incidence of stress fracture was higher for White male Army trainees 1.

In this study, White female trainees had the highest rates of any group— A study of more than 3, male Marine recruits followed during 11 weeks of basic training showed that White recruits experienced 2.

A survey of 1, women in the Army found the lifetime prevalence of self-reported stress fractures among White or Asian women to be 1. These military studies suggest that White recruits and soldiers may incur more stress fractures than their non-White peers.

A survey of female collegiate distance runners documented that White runners had a higher career prevalence of stress fractures diagnosed by radiograph or bone scan—a prevalence that was 2.

Although the study had a low response rate, the results suggest that White race may be a risk factor among collegiate athletes as well as among military personnel. White race as a potential risk factor for stress fracture deserves further study, using techniques that account for potentially confounding factors such as age, physical fitness, physical activity, and bone characteristics.

A number of the papers reviewed examined anatomic factors that potentially could influence the risk of stress fracture. Three military studies evaluated foot morphology arch height and stress fracture risk.

Among Israeli Defense Force IDF trainees, persons with the highest foot arches sustained 3. A week prospective study of trainees at the US Naval Special Warfare Training Center classified trainees into three equal-sized groups with high, normal, or low arch height but found no significant differences between groups The results of the third study of naval special warfare trainees were inconclusive Available research suggests that foot arch height may influence the risk of incurring stress fractures associated with vigorous physical training, but more research will be needed to define the nature of the association between arch type and stress fracture risk, particularly for women.

A second measure of knee alignment, quadriceps angle, showed that persons with quadriceps angles greater than 15 degrees experienced a cumulative incidence of stress fracture 4. A multivariate logistic regression analysis of IDF data on trainees showed that greater valgus alignment of the knee was a significant risk factor for tibial stress fractures Additional research on knee morphology and leg alignment including women is needed.

Two papers studied the association between differences in right and left leg length and risk of stress fracture. A survey of distance runners found that the self-reported prevalence of stress fractures was 2. In a study of Army trainees, no difference in stress fracture incidence was found between persons with measured leg length discrepancies and persons without them More research is needed to determine the effect of leg length discrepancies on stress fracture risk.

A number of military and civilian studies have examined the relation between bone characteristics geometry or density and the occurrence of stress fractures. Several geometric measurements of lower limb bones femur, tibia, fibula provide indices of different parameters of bone strength and potential resistance to injury.

In a prospective study of male Marine recruits conducted during 12 weeks of basic training, 23 3. Investigators found that mean values for the cross-sectional area, the section modulus, and the width of the tibia were significantly lower among trainees who developed stress fractures.

Unfortunately, the authors analyzed comparisons of mean values and did not examine the incidence of stress fracture among groups of recruits exhibiting different levels of the potential bone risk factors measured.

Thus, these findings are suggestive but inconclusive with regard to stress fracture risk. A prospective study performed in IDF trainees reported that 91 31 percent developed stress fractures confirmed by bone scan A multivariate analysis identified the anterior-to-posterior axis of the CSMI to be the variable most highly associated with stress fracture occurrence.

In a follow-up analysis of these data, cumulative incidences of tibial, femoral, and total stress fractures were found to be significantly higher in the low-CSMI group, with risk ratios 1.

The fact that Army trainees with high tibial CSMIs around the anterior-posterior axis experienced a lower incidence of stress fracture suggests that bending in the mediolateral direction is a cause of stress fracture , This may also explain why the most common location of tibial stress fractures is the medial cortex.

A number of military and civilian studies have examined the relation between stress fractures and both bone mineral density and bone width. A prospective study of female Marine recruits found that mean bone mineral density and cortical bone thickness of the tibia were significantly lower among the 37 women 5.

Among male Marine recruits, those with stress fractures had significantly lower mean bone mineral densities and narrower tibial widths. Another study reported that bone mineral density was significantly lower among 41 stress fracture patients than among 48 recruits from the same units matched for age, height, and weight, and that mean bone mineral content increased significantly during 12 weeks of military training among 35 uninjured recruits Israeli researchers, likewise, reported that mean tibial bone width was significantly lower among 86 soldiers who developed stress fractures than among who did not In a multivariate analysis of these data, investigators reported that lower tibia width prior to basic training was associated with increased odds of stress fracture; however, bone mineral density was not Another study of IDF trainees demonstrated that mean bone mineral content increased significantly during 14 weeks of basic training for both the persons whose training was interrupted by stress fractures and other conditions and the persons who completed training, but tibial bone width did not increase In these studies, the mean bone mineral content of persons with stress fractures was lower before training than that of persons who completed the training, but not significantly so.

The results of several of the military studies of bone mineral density, bone width, and other bone parameters would have been much more meaningful and powerful if the investigators had determined the risk or incidence of stress fracture in recruits exhibiting different levels of bone strength.

Nevertheless, these studies strongly suggest an association between lower measures of bone strength and higher risk of stress fracture. Results of civilian studies of the relation between stress fractures and bone mineral density among athletes are mixed.

A study that examined nine female athletes with stress fractures and nine controls found no differences in mean bone mineral density A second study reported that six female runners with a history of stress fracture had higher mean bone mineral densities in the lumbar spine and femoral neck than eight runners without stress fractures Studies of US military recruits have consistently shown significant associations between low aerobic fitness levels and higher risk of stress fracture during basic training table 4.

A study of 1, Marine recruits found that lower aerobic fitness, as measured by longer running time on a 1. A similar association was reported for female Army recruits, with the slower half of women on an initial entry 1-mile 1.

In the same study, investigators observed that among male Army trainees in the slower half on the initial entry 1-mile run test, 4. A later study of Army trainees reported almost identical results table 4 Several IDF studies have reported finding no significant association between aerobic fitness and risk of stress fracture.

Two separately reported analyses based on data from infantry trainees reported that mean estimated maximal oxygen uptakes for persons with stress fractures were not different from those of persons who did not have stress fractures , and the incidence of stress fracture for groups with higher aerobic fitness was not significantly different from that of groups with lower fitness levels The difference between these findings and those of other studies may be partially explained by the use of a non-weight-bearing submaximal bicycle test for estimation of aerobic capacity and a much more sensitive definition of stress fracture that included asymptomatic stress fractures.

Data from another study relating stress fractures to 2,m run times were reported in a manner that made interpretation difficult A report on male and female Marine recruits indicated that male recruits who sustained stress fractures had lower mean calf girth measurements and performed lower mean numbers of sit-ups on a timed test, indicating lower muscle strength and endurance, respectively Female recruits with stress fractures also performed fewer sit-ups, on average A prospective study of Israeli infantry trainees found that persons who developed stress fractures performed fewer leg thrusts on a timed test, indicating lower muscle endurance In another study, six female runners who had sustained stress fractures exhibited higher impact and propulsive forces on a force plate than did eight runners who did not have stress fractures The effect of muscle strength and endurance on stress fracture risk in military and athletic populations needs further study.

Few investigators have studied the association between flexibility and stress fractures. An IDF study prospectively assessed hip range of motion among infantry trainees, of whom 89 subsequently developed stress fractures , Recruits with external rotation of the hip greater than 65 degrees experienced an incidence of stress fracture 1.

Hip range of motion persisted as a risk factor in a multivariate analysis of the data Two studies of more than Navy special warfare trainees each investigated the association of several measures of lower extremity flexibility with stress fractures, but neither found associations , Note that comparisons of mean values, as employed by several of these studies of flexibility , , can be misleading for factors like flexibility, which may have a bimodal rather than a linear relation with risk of injury A few military studies have investigated the relation between the occurrence of stress fractures and body composition and body stature.

A number of prospectively measured indicators of body stature, including weight, height, neck girth, waist girth, thigh girth, and calf girth, were smaller among 23 Marine recruits who developed stress fractures during 12 weeks of basic training than among the recruits who did not develop stress fractures An IDF study of infantry trainees prospectively assessed height, weight, and thigh and calf girths and found no association with stress fracture incidence Similarly, body mass index was not significantly associated with the odds of injury in a multivariate analysis of data from another study of Israeli recruits Therefore, comparisons of mean values for injured and uninjured persons will be especially misleading, as will multivariate analyses that treat body mass index as if its association with injury risk were linear.

Several military studies have examined the association between previous levels of physical activity and risk of stress fracture during military training table 5. Before the start of training, 3, Marine recruits completed a survey on past health and health behaviors, rating their previous physical activity level in five categories from inactive to very active.

The study documented a significant trend of higher cumulative incidence of radiographically confirmed stress fractures among those recruits with successively lower levels of previous activity table 5 Another study of Marine recruits also showed higher rates of stress fracture among those least physically activity prior to basic training table 5 Marine recruits who reported never or only occasionally sweating experienced significantly more stress fractures, along with those with fewer months of running before entering basic training.

A survey of Navy special warfare trainees table 5 and a study of Finnish army recruits reported similar findings. An IDF study found no relation between duration of training or amount of running prior to basic training and stress fracture risk The preponderance of the data from military studies indicates that persons who engage in more physical activity, particularly running, will experience fewer stress fractures when beginning a physically demanding training program.

Additionally, suggesting that previous activity is protective, a college sports medicine clinic reported that over a 3-year period, 67 percent of stress fractures treated occurred among freshmen, while only 17 percent occurred among sophomores, 9 percent among juniors, and 7 percent among seniors Similarly, several studies of male Army trainees and soldiers in operational units found a statistically significant association between cigarette smoking and overall risk of training-related injuries in general , Although the results of these studies are consistent with the known relation between estrogen use and increased bone mass and suggest that oral contraceptive use may reduce the incidence of stress fracture in female runners and athletes by more than 50 percent, the weaknesses of study design in both of these investigations suggest the need for more and larger studies of the impact of estrogen-containing oral contraceptives on the incidence of stress fracture.

Milgrom et al. Their study found that However, Milgrom et al. Thus, both groups had lower incidences of stress fracture during the year after basic training, but the previous stress fracture group experienced a significantly higher risk than the controls.

A study of Marine recruits observed that those who had sustained a previous injury but had not fully recovered were at greater risk of sustaining an injury during 12 weeks of basic training than those who had sustained an injury but did completely recover The authors speculated that this might indicate that a past training injury is a marker for past physical activity and that past physical activity is more protective against stress fractures.

Future research into the influence of past injuries on current risk should determine the adequacy of recovery from past injuries and the level of past physical activity. These studies indicate that the association of past injuries with current risk is not simple and that it may be confounded by other factors such as adequacy of recovery and levels of past activity.

Although it would seem that extrinsic risk factors would be of great interest because of their potential impact on risk of injury and their applicability to prevention, few studies have examined this category of factors. Several of the extrinsic risk factors covered in this review, such as type of sport, physical training, and footwear, should be modifiable and of value for prevention.

Although a number of clinical case series describe the relative frequency of stress fractures from different sports or exercise activities, we found only one study that quantified the rates for different sports In that study, the top 10 sports evaluated and the percentage of athletes per season year who had stress fractures were as follows: softball, 6.

Military studies indicate that different types of units and different types of training may place military personnel at different degrees of risk. A study of Finnish male military recruits suggested that paratroopers may be at greater risk of incurring stress fractures than regular or light infantry soldiers A medical surveillance report on the incidence of stress fracture among women undergoing Navy basic training, Marine Corps basic training, or officer candidate training indicated higher risks among Marine recruits and officer candidates Few military or civilian studies have examined the association between amount of physical training or exercise and incidence of stress fracture table 5.

This review found one survey that examined the effect of amount of running on the risk of stress fracture That survey showed that male and female runners who ran more miles per week experienced an increased risk of radiograph- or bone-scan-diagnosed stress fracture table 5 Although the survey design had limitations, these findings are consistent with studies of runners indicating that higher amounts of running are associated with higher incidences of training injuries in general — A preliminary report on alterations in the amounts of running and marching performed by Marine recruits showed that training units that reduced running mileage experienced lower incidences of stress fracture table 5 Also of note is the finding that trainees doing the least running not only experienced a 50 percent lower incidence of injuries but performed as well on a final physical fitness test An IDF study of marching mileage and risk of stress fracture reported finding that less marching did not result in lower stress fracture rates The study did not control for the amount of running by recruits in the high and low marching mileage units, however.

This hinders interpretation, because stress fracture risks are probably proportionate to total weight-bearing training miles running, marching, drilling, ceremonial activity, etc.

Most studies of the impact of exercise equipment, such as shoes and boots, on the risk of stress fracture have involved intervention trials discussed below. One study of Marine recruits reported that use of running shoes more than 1 month old at the onset of basic training appeared to be associated with greater risk of stress fracture, while the price of running shoes was not associated with risk No civilian studies investigating the effect of shoe type, age, or quality on risk of stress fracture have been identified.

In addition, little information on the influence of environmental factors on risk of stress fracture is available. A survey of distance runners found that among those who had been injured, 13 percent of men and 13 percent of women attributed the injury occurrence to a change in the type of running surface; 6 percent of men and 7 percent of women attributed their injuries to running on hilly terrain Usual incidences of 1.

The only change in physical training that could be identified by the investigation was a switch to marching on hilly, rocky terrain instead of the usual flat, predictable terrain When marching returned to flat, smooth terrain, the incidence of injuries returned to 2. While these reports may be suggestive, much more research is needed on the impact of equipment and environmental factors on stress fracture risk.

This review found nine studies that compared interventions intended to prevent stress fractures with fracture incidence among control subjects 43 , , , — table 6.

All nine studies were carried out in military populations, and all examined strategies designed to prevent lower extremity stress fractures. The strategies tested involved modifications of either the physical training program or the footwear of Army or Marine Corps recruits.

One approach to modifying training programs has been investigated. Two studies evaluated the effect of periods of recovery from weight-bearing stress during the early weeks of Army basic training 43 , A 67 percent decrease in stress fractures in the group given recovery time suggested a possible benefit from this intervention table 6.

In the second study, a nonrandomized controlled trial involving six companies 1, male trainees , Popovich et al. The study compared the stress fracture incidence of persons from three test companies that provided a period of recovery from running during the second, third, or fourth week of basic training with the stress fracture incidence of persons from two control companies conducting normal, uninterrupted physical training.

A sixth company performed more running than usual in the early weeks of training and then had a hiatus in running during the fourth and fifth weeks. The results suggested that a recovery period with limited vigorous weight-bearing training i.

However, the variation in stress fracture rates among units within the test and control groups was large enough to mask apparent differences between the training modification group and the controls table 6.

The most studied type of intervention identified by this review was modification of footwear table 6. Two studies examined the effect of using different types of military boots on the incidence of stress fracture and other training injuries among Marine and Army trainees , Three trials investigated the potential benefits of wearing shock-absorbent insoles in military boots , , One study investigated the efficacy of wearing orthotic inserts in military boots to prevent stress fractures , and one study examined the effect of using athletic shoes versus boots during Army basic training A second study followed 2, male and female US Army trainees 2, men and women randomly assigned to wear either the standard leather combat boot or the hot-weather boot Of those starting the study, 89 percent of men and 81 percent of women completed the study.

Randomization was compromised by the unavailability of appropriate-sized hot-weather boots for some recruits and by an unreported number of switches made in boot assignments. Although the findings of these two studies of boots found opposite outcomes in terms of the effects on stress fracture incidence, the results suggest that any potential effect of different types of boots is likely to be small.

In another trial, Bensel and Kaplan randomized female US Army recruits into three groups to compare two types of insoles urethane foam and lever action to the standard multilayered plastic-mesh military insole and documented a nonsignificant protective effect of shock-absorbent urethane insoles.

Another randomized controlled trial by Gardner et al. A multivariate analysis controlling for the effects of race, previous physical activity, and age of the running shoes did not affect this outcome. A third randomized controlled trial conducted by Schwellnus et al.

Clinical assessments and radiographs, all of which were reviewed by a panel of eight physicians, were used to establish the diagnosis of stress fracture.

The investigators also reported that the control group experienced more overuse injuries The fact that both the incidence of overuse injuries and the incidence of traumatic injuries were increased in the control group suggests that some factor other than the insoles might explain the higher incidence of stress fracture among the controls.

The findings of these three studies of insoles, at most, suggest that some types of shock-absorbent materials may help protect the feet and lower extremities from stress fractures. In an IDF study, Milgrom et al. Clinical assessment and bone scans were used to establish the diagnosis of stress fracture.

Use of orthotics reduced the incidence of femoral stress fracture by 46 percent, but the overall reduction in stress fractures was not statistically significant table 6. The injury experience of those lost to follow-up was not reported.

In another IDF study, investigators randomly provided basketball shoes to Recruits wearing basketball shoes did report a decrease in overuse injuries metatarsal stress fractures, plantar fasciitis of the foot Quality scores for the randomized controlled trials ranged from 12 to 59 out of a possible for the individual rater scores; the median scores for the nine studies ranged from 16 to 55 table 6.

The design or reporting of the randomization process employed in most of the studies was inadequate. In military studies, particularly if randomization is by unit, the randomization should include enough units of test and control groups to account for interunit variation in injury rates, which may be greater than the effect size expected from the intervention.

The case definition of a stress fracture and the manner in which diagnostic tests are employed should be reported for all studies. Statistical methods were reported incompletely in all nine studies. Most of the studies reviewed did not indicate whether sample size estimates or power calculations had been performed in advance of the study.

Sample sizes should be calculated while taking into account the sensitivity of the diagnostic approach employed. For instance, if only radiographically confirmed clinical cases are included in the analysis, much larger sample sizes will be necessary than if bone scan confirmation is employed.

Sample size estimates should take into consideration the subpopulation being studied. For instance, studies of women will probably require fewer subjects than studies of men because of the higher incidence of stress fracture women experience given comparable exposures.

Investigators should do a better job of tracking and reporting on persons lost to follow-up, documenting possible differences in personal characteristics, risk factors, injury incidence, and reasons for dropping out.

In addition, interpretation of results was hampered by the lack of attention to possible confounding factors and by both information and selection biases. In a number of the studies reviewed, multivariate analysis controlling for potential confounders would have been instructive.

Our review identified more than papers on stress fractures and related overuse injuries. Of these, addressed the etiology, epidemiology, or prevention of stress fractures table 2. In addition to the research papers cited, 25 were review articles 2 , 4 — 6 , 8 — 9 , 14 , 32 — 36 , — Only nine of the reports reviewed examined interventions aimed at preventing stress fractures.

All nine were military studies. Fifty-two papers studied the epidemiology of and risk factors for stress fracture, and 42 of these were military studies. Most of the 10 civilian risk factor studies focused primarily on the role of menstrual irregularity and bone density on stress fracture risk among female runners and athletes.

The military studies were more diverse and identified a number of significant risk factors, including female gender, age, lower bone density and indices of bone strength, low aerobic fitness, low past physical activity levels, cigarette smoking, and greater amounts of running. The risk factors and general principles of stress fracture prevention discovered through military studies should be applicable to similarly physically active civilian populations.

The civilian exercise and sports communities are concerned for similar reasons 2 , 4 , 6. While stress fractures in military populations result in lost duty time and, in some cases, discharge from the military, among civilians these injuries result in decreased physical training and sometimes cessation of exercise.

Thus, finding ways to prevent stress fractures would benefit both the military and civilian exercise and sports participants. Unfortunately, the greatest weakness of the stress fracture literature for both groups is the limited number of studies, even studies of those interventions most commonly recommended by sports medicine experts.

The nine intervention trials identified in this review examined only two of the many possible strategies for preventing stress fracture suggested by the literature—alterations of training and modifications of footwear.

The one training intervention involved providing military trainees with a week-long break from running in the early weeks of training, and results did not appear to be promising enough to warrant further research. Of the interventions involving footwear, the trial of orthotic inserts appeared to be the most promising.

In addition, intervention trials on some of the shock-absorbent boot insoles indicated that this approach might also be fruitful. Thus, further research into the efficacy of preventing stress fracture through modification of footwear is recommended. Perhaps the most important insights gleaned from this quality review of stress fracture prevention studies pertain to the design and implementation of future military and sports medicine intervention trials.

Other investigators have also suggested that careful attention to study design, execution, and reporting is critical , Subjects in both intervention and control groups should be subject to uniform, consistent, and ongoing monitoring for the occurrence of injuries.

Randomization should be blinded when possible, and the method of randomization used should be described clearly. Whereas a double-blind study is often not feasible for studies of athletic injuries for example, users of orthotic devices know they are wearing them , blinded allocation of subjects is essential in order to minimize bias.

Case definitions must be explicit and easily replicable. In calculating rates of injury, careful consideration must be given to the choice of denominators e.

Appropriate statistical methods should be used for data analysis, and these methods should be described clearly in published articles. Among other things, investigators should avoid comparing mean values for risk factors, such as bone density, flexibility, or percentage of body fat, in injured versus uninjured persons when it is possible to determine and compare the risks or incidence rates of stress fracture among persons exhibiting different degrees of the risk factors.

Finally, the reporting of results should be improved so that the methods employed can be understood and replicated by other investigators, and published study conclusions should be supported by the data presented.

Better information on how to prevent stress fractures will depend on valid and reliable results from intervention trials. In turn, the success of future trials will depend not only on the application of improved methodology but also on knowledge of modifiable causes and risk factors.

This review has identified a number of potentially modifiable risk factors that could be used to design prevention strategies. Of the strategies for preventing stress fracture suggested by this review, modulation of amounts of running and other weight-bearing activities to reduce the total amount of activity performed is one of the most promising.

Stress fractures of the lower extremities occur most commonly in association with weight-bearing sports, physical training, and exercise, so it makes sense that modifications of training or exercise programs would reduce the incidence of such injuries.

One of the studies on runners reviewed indicated that persons who run more miles experience a higher incidence of stress fracture In assessing running-related injuries in general, injury incidence can be 1.

If reductions in training mileage could reduce stress fracture incidence in proportion to the degree to which higher mileage elevates overuse injury risk, reductions of 50—80 percent could be achievable. A study of Marine recruits suggested that reductions in running mileage can produce decreases in stress fracture on this order of magnitude table 5 , A recent study of Army trainees confirmed the validity of this approach, showing that a 50 percent reduction in total running miles resulted in a 40 percent reduction in overall injury rates, with no decrease in performance on a final 2-mile 3.

A classic study by Pollock et al. Such research would benefit competitive and recreational runners, track athletes, fitness program participants, other sports participants, and military personnel. Several studies reviewed showed that persons who have led more sedentary, physically inactive lifestyles in the past are more likely to suffer stress fractures when they begin to engage in physically demanding military training , , A number of studies also indicate that higher levels of aerobic fitness protect military trainees from stress fractures and other training injuries , , Research should be conducted to determine whether gradually increasing physical fitness prior to initiating a vigorous physical training program prevents stress fractures, not just in military recruits but in civilian populations as well.

Those who might benefit in addition to military recruits include novice runners, first-time sports participants, and persons beginning fitness or aerobics programs.

The literature reviewed also suggested several other potentially promising approaches. Bone research suggests that it may be possible to design physical training programs not just to increase aerobic fitness and muscle strength but also to increase bone strength and dimensions , , Several civilian investigators have studied the associations among amenorrhea, menstrual regulatory hormones, and bone density because of the suspected association between menstrual irregularity and stress fractures , On the basis of an extensive sports medicine review, Nattiv and Armsey 34 suggested that, while a relation is not proven, oral contraceptives may exert a protective effect for female athletes that deserves further research.

Table 7 lists other recommendations for research suggested in the papers reviewed. As a general strategy, it may be helpful to focus research on the sports and activities in which stress fractures occur most frequently and on the bones where they occur most frequently. The larger clinical case series 1 , 3 , 59 and some epidemiologic studies suggest that stress fractures occur more frequently among runners than among participants in other weight-bearing sports such as basketball, soccer, field hockey, or tennis.

Research is needed to determine whether this is the result of greater numbers of runners, greater exposure of runners, or some other possibly protective factor in other sports, such as a more varied plane of motion that distributes forces more widely over bone.

A number of studies of weight-bearing physical activity and sports have shown that the tibia is the bone most commonly reported to undergo stress fracture 3 , 16 , 20 , The greater relative frequency of tibial stress fractures observed among runners as compared with military recruits suggests that the type and nature of the activity engaged in may influence the location of a stress fracture.

Future prevention research focused on specific bones and high-risk sports or exercise activities might have a greater chance of success. This review summarizes an extensive body of literature on stress fractures. It also highlights how little we know about what works to prevent one of the most common and potentially serious sports- and exercise-related overuse injuries.

The available research suggests that for many persons, stress fractures and other physical training-related injuries can be prevented by reducing the amounts of weight-bearing exercise performed without sacrificing fitness. The data also suggest that the most sedentary and least physically fit persons are most vulnerable to stress fractures when starting a vigorous exercise program and that they would benefit most from starting exercise gradually and reducing training volume.

Until more definitive solutions become available, a common-sense approach to training and overuse injury prevention must be recommended Reprint requests to Dr.

Jones, US Army Center for Health Promotion and Preventive Medicine, Black Hawk Road attention: MCHB-TS-EIP , Aberdeen Proving Ground, MD e-mail: bruce.

jones apg. Layout of quality review score sheet used to assess published articles on stress fracture prevention. Distribution of published studies of stress fracture by type of study, population studied military vs. civilian , and date of publication. Results of studies of the association between aerobic physical fitness and risk of stress fracture.

Results of studies of the associations of past physical activity and amount of current training running with risk of stress fracture. Recommendations for research on the prevention of stress fractures, by category of intervention.

Hulkko A, Orava S. Stress fractures in athletes. Int J Sports Med ; 8 : —6. Jones BH, Harris JM, Vinh TN, et al. Exercise-induced stress fractures and stress reactions of bone: epidemiology, etiology and classification. Exerc Sports Sci Rev ; 17 : — Matheson GO, Clement DB, McKenzie DC, et al.

Stress fractures in athletes: a study of cases. Am J Sports Med ; 15 : 46 — McBryde AM Jr. J Sports Med ; 3 : — Sterling JC, Edelstein DW, Calvo DR, et al. Stress fractures in the athlete: diagnosis and management. Sports Med ; 14 : — Belkin SC. Orthop Clin North Am ; 11 : — Bernstein A, Childers MA, Fox KW, et al.

March fractures of the foot: care and management of patients. Am J Surg ; 71 : — Foster FP. Pied forcé in soldiers. Markey KL.

Stress fractures. Clin Sports Med ; 6 : — Berkebile RD. Stress fracture of the tibia in children. Am J Roentgenol ; 91 : — Blazina ME, Watanabe RS, Drake EC.

Fatigue fractures in track athletes. Calif Med ; 97 : 61 —3. Burrows HJ. Fatigue fracture of the middle third of the tibia in ballet dancers. J Bone Joint Surg ; 38B : 83 — Devas MB. Proc R Soc Med ; 62 : —7.

Hartley JB. Fatigue fracture of the tibia. Br J Surg ; 30 : 9 — Ha KI, Hahn SH, Chung M, et al. A clinical study of stress fractures in sports activities. Orthopedics ; 14 : — Hulkko A, Alen M, Orava S. Stress fractures of the lower leg. Scand J Sports Sci ; 9 : 1 —8. Brubaker CE, James SL.

Injuries to runners. J Sports Med ; 2 : — Gudas CJ. Patterns of lower-extremity injury in runners. Exerc Sports Med ; 6 : 50 —9. Orava S, Puranen J, Ala-Ketola L. Stress fractures caused by physical exercise.

Acta Orthop Scand ; 49 : 19 — Jansen M. Blog — January 11, News — January 11, Blog — January 1, News — December 27, Blog — December 20, News — December 13, News — December 11, News — December 8, News — December 5, Blog — December 5, News — November 30, Blog — November 17, News — November 15, Implement periodisation techniques to allow for adequate rest and recovery periods.

Cross-training: Encourage athletes to engage in a variety of sports and activities to reduce repetitive stress on specific bones. Cross-training promotes overall fitness, strength, and coordination while minimising the risk of overuse injuries.

Studies have shown that playing ball sports in childhood has a six-fold protective effect against stress fractures later in life.

Proper footwear and equipment: Ensure athletes wear appropriate footwear designed for their specific sport and foot type. Poorly fitting or worn-out shoes can contribute to abnormal stress distribution and increase the risk of stress fractures. Nutritional support: Emphasise the importance of a well-balanced diet to support optimal bone health.

Encourage athletes to consume foods rich in calcium, vitamin D, and protein. If necessary, consult a registered dietitian to address individual nutritional needs. Strength and conditioning: Incorporate a comprehensive strength and conditioning program focusing on core stability, lower limb strength, and balance.

Strong muscles can better absorb impact forces, reducing stress on the bones. Rest and recovery: Encourage athletes to prioritise rest and recovery as integral parts of their training regimen.

Sufficient sleep, regular rest days, and active recovery exercises help prevent overuse injuries. Open communication: Foster an open dialogue between athletes, parents, coaches, and healthcare professionals. Encourage athletes to report any pain or discomfort promptly to prevent the progression of potential stress fractures.

Focus on promoting a culture around strength rather than leanness.

Stress fracture prevention The Red pepper bruschetta of this preventionn were: 1 to review the reported research on the causes of and Red pepper bruschetta factors prrevention stress Fuel Usage Tracking 2 to determine what is known about the prevention of stress fracture; and 3 to make recommendations for a systematic approach to future research and prevention. Sometimes rest is all that is required to treat a stress fracture. Open in new tab. Stress fractures in 51 runners. Hershman E, Mailly T.
Article Sections X-rays, CT scans, and MRIs. Health Information Policy. News — November 30, McBryde AM Jr. Executive Health Program.
INTRODUCTION

Cameron went on to note that injury prevention programs involving preventative physical therapy may help those at risk to avoid the movement patterns that the researchers identified as being the driving force behind athletic stress fractures.

Those patterns include dynamic knee rotation and frontal plane angles when landing. Previously, knee rotation and abduction angles when coming down on lower extremities were thought to be the main cause behind most athletic stress fractures. The Mayo Clinic reported that stress fractures are a common basketball injury , in addition to track and tennis, and that those with osteoporosis or other bone weakening conditions have a higher risk of the injury.

The researchers examined data collected from a study of military cadets. There were 1, subjects, 94 of whom suffered a lower-extremity stress fracture over the span of the follow-up period.

The new report found that females were almost three times more likely to suffer this kind of injury. Blog — February 9, Blog — February 8, News — February 5, Blog — January 24, News — January 23, Blog — January 12, Blog — January 11, News — January 11, Blog — January 1, News — December 27, Blog — December 20, News — December 13, News — December 11, Don't resume sports or exercise too quickly after a stress fracture or other injury.

Also, make sure that your child's coach is aware of the signs of stress fracture. This may be milder in nature than a more severe sports injury. Pain, particularly pain that gets better when the child is allowed to rest, is the most common symptom of a stress fracture.

Stress fractures typically heal with rest alone, but injured athletes may need to take off from their sport for as long as 6 to 8 weeks to correctly recover.

If your child complains of any pain that persists during sports, schedule a visit with your child's healthcare provider. Search Encyclopedia. Stress Fractures in Young Athletes Competitive sports can give some young athletes an edge over their peers. How stress fractures happen Stress fractures happen when muscles are too tired to take on the impact of exercise, and the bones absorb the added stress.

These are the most common causes of stress fractures: Increasing the frequency or intensity of exercise too quickly Suddenly changing the workout surface Getting sudden and significantly more playing time Using or wearing gear that doesn't offer enough support, such as shoes that are worn out Insufficient periods of rest between practice or events Stress fractures can happen during any number of sports, but they tend to be most frequent in young athletes who participate in sports that involve running and jumping, such as basketball, gymnastics, and track and field.

Preventing stress fractures Parents and coaches can do many things to help reduce the risk for stress fractures in growing bones. Make sure that your young athletes follow these guidelines: Eat a balanced, nutritious diet rich in calcium and vitamin D for strong, healthy bones.

Participate in conditioning practice for sports. Do cross-training alternating types of physical activities. Stick to sports that are age-appropriate. Always warm up before practice or games and cool down afterward. Get a complete physical exam before participating in sports. See a healthcare provider for any persistent pain or limp.

Drink plenty of fluids and stay hydrated for practices and games.

Coronavirus COVID : Latest Fracturw Visitation Policies Visitation Policies Visitation Policies Visitation Policies Visitation Policies COVID Diabetes and blood glucose control Vaccine Information Red pepper bruschetta Information Vaccine Information. Rfacture sports can give some Red pepper bruschetta prevsntion an edge farcture their peers. When fun, teamwork, and good sportsmanship are the top goals, sports can improve young kids' physical and emotional health, self-esteem, and even their relationship skills. Unfortunately, young athletes must also compensate for still-growing bones, tendons, and muscles. Sometimes sports injuries happen. The most common type of sports injury is an overuse injury, such as a stress fracture. Overuse injuries are becoming more common in young athletes. Athlete bone fracture prevention

Athlete bone fracture prevention -

By training in different exercises, such as strength training and yoga, you keep your muscles flexible and strong.

Maintaining a healthy weight is critical to alleviating as much stress to the muscles and bones as possible. Incorporating foods rich in calcium and Vitamin D will help strengthen the bones. Proper form and equipment are key to performing complicated athletic moves without injury.

Make sure your shoes are comfortable, fit well, are in good condition, and provide proper support. Any other necessary sports equipment should also follow these general guidelines. It is important to never overexert your body. Even if you are not experiencing pain, take breaks in between rounds and practices.

Your muscles need time to recover so they can properly absorb stress and shocks. Paying close attention to the first initial signs of a stress fracture is key to preventing it from causing chronic issues. This also means abstaining from high-impact activities until you have been evaluated by an experienced orthopedic doctor.

By making some healthy lifestyle modifications, utilizing proper techniques and equipment, and incorporating varying forms of exercise, you can successfully create a stress fracture prevention plan that works for you.

However, if you need urgent care stress fracture attention, or suspect you may even have a pre-stress fracture , EmergeOrtho—Triangle Region is here to help. We have several convenient locations throughout the Greater Triangle Area from which to choose—many with flexible hours.

Schedule an appointment with one of our highly qualified EmergeOrtho—Triangle Region doctors. Or, call us any time at For patients who want to self-schedule at their own convenience, click the button above to schedule an appointment now. For patients who want to request an appointment, please fill out our form and a team member will call you within 48 hours to schedule your appointment.

Now Open - Clayton Orthopedic Urgent Care. Now Open! Clayton Orthopedic Urgent Care Monday — Saturday am — pm Click here to reserve your Urgent Care spot! Who is Most at Risk for a Stress Fracture? What Are Stress Fracture Treatment Options?

Stress Fracture Prevention Techniques Luckily, stress fractures are generally easy to prevent if the right precautions are taken. To help reduce the risk of developing stress fractures , the following strategies are recommended: Pace Yourself Set incremental goals.

Cross-Train Keeping the body guessing via muscle confusion is key to staying fit and preventing injuries. Eat Healthily Maintaining a healthy weight is critical to alleviating as much stress to the muscles and bones as possible.

Use Proper Form and Equipment Proper form and equipment are key to performing complicated athletic moves without injury. Take Breaks It is important to never overexert your body. Rest When Necessary Paying close attention to the first initial signs of a stress fracture is key to preventing it from causing chronic issues.

Parents and coaches can do many things to help reduce the risk for stress fractures in growing bones. Make sure that your young athletes follow these guidelines:.

Eat a balanced, nutritious diet rich in calcium and vitamin D for strong, healthy bones. Wear athletic shoes and any other needed gear that are appropriate for the sport and that offer plenty of protection and cushioning.

Don't resume sports or exercise too quickly after a stress fracture or other injury. Also, make sure that your child's coach is aware of the signs of stress fracture. This may be milder in nature than a more severe sports injury.

Pain, particularly pain that gets better when the child is allowed to rest, is the most common symptom of a stress fracture. Stress fractures typically heal with rest alone, but injured athletes may need to take off from their sport for as long as 6 to 8 weeks to correctly recover.

If your child complains of any pain that persists during sports, schedule a visit with your child's healthcare provider. Search Encyclopedia. Stress Fractures in Young Athletes Competitive sports can give some young athletes an edge over their peers.

How stress fractures happen Stress fractures happen when muscles are too tired to take on the impact of exercise, and the bones absorb the added stress. Roub LW, Gummerman LW, Hanley EN Jr, et al.

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We use cookies and similar tools to give you the fraccture website experience. By using our Athlee, you Athlete bone fracture prevention our Websites Privacy Red pepper bruschetta. Stress Ahlete are tiny breaks in fraxture bone that develop gradually. Determining hydration level occur most often in the lower leg or foot as a result of high-impact activities, such as running, basketball, or tennis. When you run, for example, the bones and muscles in the leg and foot absorb the entire weight of your body. If an activity puts more force on the legs and feet than the bones can absorb, small cracks may form on the surface of the bone. Often, stress fractures are preventable.

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