PHYSIO COR­NER

Caitlin Miles, clinic di­rec­tor at Six Physio ex­plains how to di­ag­nose and avoid this com­mon com­plaint

Triathlon Plus - - Contents -

Stop those stress frac­tures and avoid putting your train­ing on pause.

What is it?

When we run or do any ex­er­cise that in­volves im­pact load­ing, a force is passed back up through our body called ground re­ac­tion. All of the tis­sues within our bod­ies such as mus­cles, lig­a­ments, ten­dons and bones re­act to firstly ab­sorb this force but also to gen­er­ate en­ergy to push our body for­wards for the next step. If there is a mis­match in the way our tis­sues ab­sorb this force (for ex­am­ple through weak­ness or in­jury), the load is fo­cused to the other struc­tures. If this force ex­ceeds what that struc­ture is ca­pa­ble of ab­sorb­ing then in­jury oc­curs. Stress frac­tures are the re­sult of too much force be­ing put through a bone, caus­ing that bone to swell and even­tu­ally po­ten­tially crack.

How to iden­tify it

Stress frac­tures are not al­ways easy to iden­tify as their symp­toms match many other lower limb in­juries. How­ever pa­tients of­ten de­scribe: - Pain when run­ning that wors­ens with dis­tance; - Fo­cal sharp pain to touch over the rel­e­vant bony area; - Pain at rest, par­tic­u­larly at night; - Pain when hop­ping. If in doubt, you should al­ways seek the ad­vice of a med­i­cal pro­fes­sional. They will as­sess the his­tory of the in­jury and may seek fur­ther imag­ing of the area for con­fir­ma­tion.

How to avoid it

Make changes grad­u­ally Stress frac­tures of­ten oc­cur due to a change in some­one’s train­ing habits. This may be an in­crease in in­ten­sity, speed, or dis­tance. It is ad­vis­able when you are mak­ing these changes that you do it grad­u­ally so your body can adapt to these new de­mands. Va­ri­ety Vary­ing the sur­face that you run on can help pre­vent stress frac­tures. Run­ning on the same hard sur­face will cause re­peated loads on the same struc­tures ev­ery stride you take. If you change up the sur­face with grass, tread­mill, tar­mac or trail, for ex­am­ple, you will be help­ing your body out. Look to low im­pact When your train­ing pro­gramme is look­ing to in­crease your num­ber of long runs, it may be worth sub­sti­tut­ing this with an­other low im­pact car­dio­vas­cu­lar ex­er­cise such as cross train­ing, cy­cling or swim­ming. That way your body still reaps the car­dio­vas­cu­lar ben­e­fits but with­out load­ing our bones and there­fore giv­ing them a rest pe­riod. Mo­bil­ity and con­trol As stated, stress frac­tures oc­cur due to a mis­match in forces be­ing spread through our soft tis­sues when we load our bod­ies. There­fore it is ad­vis­able to en­sure your body is ca­pa­ble of deal­ing with the stress you put it un­der with your train­ing regime. Not only do you need an ap­pro­pri­ate range of move­ment in cer­tain joints, but you also need the strength to ab­sorb and trans­fer forces. For ex­am­ple your hip joints need a cer­tain amount of ex­ten­sion on the back leg and your glute mus­cles need a cer­tain amount of strength and con­trol to keep the pelvis level when you land. It is a good idea to in­cor­po­rate strength and con­di­tion­ing in your pro­gram­ming. Here are some ex­am­ples of good ex­er­cises:

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