Credit: https://www.ncbi.nlm.nih.gov/books/NBK65798/figure/CDR0000378089__273/
Bone stress injuries (BSI) include stress reactions, stress fractures and complete fractures.
A BSI occurs when there is an imbalance between bone resorption (breakdown) and bone formation. This is usually in response to an abrupt increase in training volume and/or intensity.
BSIs occur more frequently in high load sports such as gymnastics, basketball and cross country. They can occur in any bone. The tibia, metatarsals and the pars interarticularis (lumbar spine) are some of the most commons sites.
These injuries are most common at the beginning of a training season or in the lead up to competition (often due to an abrupt increase in training volume/intensity).
These injuries can be very debilitating and require medical, physiotherapy and often nutrition management.
What can you do?
Prevention is always better than cure! One way we can reduce our risk of developing BSIs is to build a strong skeleton as a child.
After puberty the outer size of the bone cannot be increased so it is important to build strong bones as children. Ensure children are exposed to a wide variety of physical activities that encourage things like running around, changes of direction and lifting weights. These sports that put force on the bones which then stimulate them to adapt to these force and become stronger.
Sports like swimming and cycling, while good for other areas of health, do not place added force onto the bones so are generally not adequate for encouraging bone growth.
Early sport specialisation is not recommended. Early specialisation results in a significant increase in overuse injury compared to young athletes who do multiple sports. Keep things general for most children until high-school where they can specialise with less risk.
If you are currently struggling with a BSI we would suggest getting the help of a Physiotherapist who can help you with load management and return to sport.
By Jason Ciccotosto
Physiotherapist & Gymnastics Coach
B.Sc. Physiotherapy
jason@formotionphysio.com
Formotion Physio is a Physiotherapy practice based in West Perth & Osborne Park, Western Australia