Doc Ma­cLean

Stress frac­tures can be ma­jor source of stress for ath­letes

Evening Times - - SPORT - In­jury clinic

FOR those of us who en­joy ex­er­cise, whether elite ath­lete or recre­ational run­ner, sus­tain­ing an in­jury leads to a frus­trat­ing time out of our nor­mally ac­tive life.

The on­set of most in­juries is usu­ally ob­vi­ous – the twist­ing of a knee or the sud­den tight­ness in a ham­string. As a re­sult we seek pro­fes­sional help quickly or at least re­duce our ac­tiv­ity to al­low heal­ing and a con­trolled re­turn to sport. How­ever some in­juries have a more in­sid­i­ous on­set and are not recog­nised un­til sig­nif­i­cant dam­age has oc­curred. One such in­jury is a stress frac­ture.

A stress frac­ture is an in­jury now well­recog­nised in high-im­pact sports like longdis­tance run­ning or gym­nas­tics, as well as in other dis­ci­plines like bal­let or army re­cruits who un­der­take a very ac­tive train­ing regime. Women are more at risk es­pe­cially those with ab­nor­mal or ab­sent men­strual cy­cles.

Stress frac­tures are usu­ally the re­sult of an in­crease in high-im­pact ac­tiv­ity such as when you in­crease the fre­quency, in­ten­sity or du­ra­tion of this ac­tiv­ity for ex­am­ple in the weeks prior to a 10K or half marathon es­pe­cially if you have fallen be­hind in your train­ing plan. Most oc­cur in the weight­bear­ing bones of the leg or foot. Poor con­di­tion­ing, more eas­ily fa­tigued mus­cles and poor footwear can all con­trib­ute, as does a change in run­ning sur­face, such as in­door to out­door track, or poor tech­nique.

The main symp­tom of a stress frac­ture is pain which de­vel­ops grad­u­ally, in­creases with the weight-bear­ing ac­tiv­ity and which de­creases with rest. Even­tu­ally the pain will be present even on nor­mal daily ac­tiv­ity and the site may be­come swollen and ten­der to touch. Di­ag­no­sis is of­ten dif­fi­cult.

Treat­ment re­quires a re­duc­tion in ac­tiv­ity – dif­fi­cult to achieve if you are train­ing for a ma­jor com­pe­ti­tion like the Olympics. A visit to a sports po­di­a­trist can as­sist with footwear and non-weight bear­ing ac­tiv­ity such as swim­ming and cy­cling to main­tain fit­ness. Once heal­ing has taken place you can grad­u­ally re­turn to ac­tiv­ity, tak­ing care to slowly build up the fre­quency, du­ra­tion and in­ten­sity with ad­e­quate rest.

Preven­tion is al­ways bet­ter than cure. A healthy diet to build and main­tain bone strength and proper footwear are vi­tal. Main­tain mus­cle strength and de­lay fa­tigue with a ba­sic strength­en­ing pro­gramme. You should al­ways try to in­crease ac­tiv­ity grad­u­ally, es­pe­cially in a new sport or when you in­crease your train­ing. Try to al­ter­nate ac­tiv­ity – for ex­am­ple try adding swim­ming or cy­cling to your jog­ging pro­gramme – you will get the same ben­e­fit on fit­ness and stamina.

■ To con­tact the Ham­p­den Sports Clinic call 0141 616 6161 or visit www.ham­p­den­sports

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