Stress Fractures

stress. fractures, tibia, fibula

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

A stress fracture is an overuse injury. Human body creates a new bone to replace a bone that has been broken due to the stress of everyday life. This process is done every day to keep the balance. Unfortunately, this balance can be disrupted because of excessive physical training. There are several factors that can prevent the body from creating enough bone and this make microcracking, called « fracture stress ».

The most common factor of fracture stress is an excessive increase in the intensitiy or frequency of physical activity without adequate rest period. Other factors are nutritional deficiencies, mechanical influences, lack of sleep, systemic factors (hormonal imbalance, etc.) and metabolic bone disorders.

There are case of development of eating disorders and/or amenorrhea (infrequent menstrual periods) for some female athletes who are preparing for a competition. These 2 conditions can create a decrease in estrogen that can decrease bone mineral density. This increase the risk of stress fractures.

Stress fractures are often seen in athletes (especially runners) or military recruiting. For an athlete, 1.6km run is 110 tons of force absorbed by the legs. Bones aren’t made to resist this force (energy) so it’s the muscles that have the function of absorbing shocks.

When the muscles get tired, they stop absorbing the forces and eveything transferred to the bones. Stress fractures occur in almost all bones but are more common in lower bone, expecially the tibia. Depending on the type of sport, there’re distinctive stress fractures such as the elbow in throwing sports, the ribs in golfing and rowing, the spine in gymnastics, the lower extremity in running activities and the foot in gymnastics and bascketball.

Diagnosis

stress, fracture, foot, metatarsal, 5th
stress, fracture, foot, x-rays, metatarsal,2nd

Stress fractures create pain in a limited area directly above the tip of the bone where the fracture occurred. The pain is raw because of physical activity and relived with rest. The sensitivity of the bones is the most obvious conclusion to the physical examination.

With regard to X-rays, this isn’t a tool that actually helps to diagnose an early stress fracture because the bone often looks normal and the microcracking aren’t visible. It’s difficult because after several weeks of rest, the bone begins to repair itself and shows a healing reaction or callus on X-rays.

An early stress fracture is usually confirmed by a bone scan or magnetic resonance imaging (MRI).

Treatment

Stress fractures are generally classified as low-risk (will not become a serious fracture) or high-risk (will become a serious fracture).

Low-risk stress fractures usually require a rest period of 1-6 weeks of limited weight bearing activity progressing to full weight bearing may be necessary. Return to physical activity should be a gratual process.

Low impact activities like swimming or biking are recommended to maintain cardiovascular condition when the pain is gone. When the patient can comfortably perform low impact activities for long, pain-free periods, the patient can begin high-impact activities.

High-risk stress fracture have the danger of becoming a complete fracture. For athletes suffering from chronic pain and having normal x-rays results, it’s recommanded to use a bone scan or MRI. High-risk stress fractures should be treated as traumatic fractures (with cast or surgery) because of complications.

Prevent

food, vitamin,d, carrot, papay, meat, ,egg, chees, broccoli, fish, sweet, potato, mango, pepperoni, apricot, peach, melon, avocado
calcium, food, almond, amarant, grain, aparagus, apricot, artichoke, baked, bean, haricot, blackberry, blackstrap, molasse, blackcurrant, bok, choy, brazil, nut, bread, wholemeal, brocolly, chickpeas, cinnamon, edamame, soya, fennel, kale, kidney, olive, orange, sesame, seed, milk, spring, green, tofu, swede, walnut, watercress

Here are tips developed by AAOS to help to prevent stress fractures :

  • When an athete does a new sport activity, it’s necessary to program progressive goals. For example on the 1st day, don’t run 8km but rather increase the distance gradually per week.
  • Cross-training => Alternate activities to achieve the same fitness goal helps to avoid stress fracture injuries. For example to achieve a cardiovascular goal, alternate cycling and running (cycling one day and riding the other day) is excellent. Adding strength training and doing flexibility exercises help improve performance.
  • Have and maintain a heathy diet with foods rich in calcium and vitamin D.
  • Use good equipment. Don’t use running shoes, gloves, etc, very old and very worn.
  • If during physical activity it start to swell or the pain starts, stop the activity right away. It’s essential to rest for a few days. If the pain continue, you should see an orthopedic surgeon.
  • It’s important to recognize early symptoms and treat them appropriately to return to the sport with a normal level of play.

Stats

  • Stress fractures occur less frequently in those of black African descent than in Caucasians, due to a generally higher BMD (bone mineral densitiy) in the former.
  • Women and highly active individuals are also at a higher risk, The incidence probably also increases with age due to age-related reductions in BMD.
  • Children may also be at risk because their bones have yet to reach full density and strength.
  • The female athlete triad also can put women at risk, as disordered eating and osteoporosis can cause the bones to be severely weakened.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Deadlift Correctly (Part 3)

deadlift

If you didn’t read the first parts, click Part 1 and Part 2 

I read a Nerd Fitness article and I learned good stuff.

Grip the barbell

deadlift grip

The strength of the grip is an important part of the deadlift. There are 2 types of grip:

  • Overhand grip => The palms of your hands are towards your body (pronated grip).

  • Over-under ou mixed grip => One palm of your hand is toward your body and the other towards the outside (one hand with a pronated grip and the other with a supinated grip).

  • Hook grip => Your thumb is under your fingers

For beginners, the double overhand grip is the best to have a safe grip.

Use the mixed grip when you have more experience and you lift heavy because there are disadvantages. Stress on the shoulders is uneven and can create problems or injuries in the biceps whose palm is outside. As the stress on the shoulders is uneven, it’s easier to lift heavy weights.

When you begin deadlift, your grip’s strength is powerful enough to lift the barbell because your back’s strength is correct. The day of your back’s strength is more powerful than your grip’s strength (your hands slips slowly), that’s when you need to think about improving your grip.

If you don’t like the mixed grip, you can use the hook grip.

Wrist straps

Straps can help you lift heavier because your grip is assisted by a strap that is wrapped to the barbell and is hooked to your wrist.

I advise you to use wrist straps only when you lift very very heavy. This is not a thing to use all the time otherwise you’ll lose the natural strength of your grip.

Gloves

The truth is that the gloves don’t improve the grip. Gloves create a space between your hands and the barbell, this increases the diameter of the barbell and make the barbell harder to hold. Gloves prevent you from having a secure grip, I advise you to use them only if you have ripped callus to your hands.

With this video , you’ll learn to take care of your hands to avoid having this type of injury.

Belt

Many people in gyms use the belt in the wrong way, but you’re a smart one. The belt is useful only when you’re lifting very heavy weights and it’s not only for your lumbar. With this article , you’ll learn how to use the belt in an effective way.

Note

Use a mixed grip and a belt isn’t necessary to lift very heavy. Watch this video of Anthony Mychan  who do a deadlift at 249.47kg (550lbs) at a Nerd Fitness Camp with a double overhand with no belt.

Common mistakes

common mistakes

Rounded back

Having the back rounded throughout the movement may cause injuries. It’s necessary to have your spine in a neutral position.

Note => there are some powerlifters that purposefully round theirs upper back to decrease the range of motion, but this is a sport specific move, still a fault, and something you should not consider as a beginner.

Head raised and look up

To have a raised head create a hyperextension to your neck. This can cause injuries. Keep your head in a neutral position like your spine.

Hyperextending at the top

In fitness competitions, exaggerate the top of the deadlift has become popular for quickly show the judges that hip and knees locking is done.

Use the squat position

Deadlift is not squat. Deadlift doesn’t have the same start and end position as the squat. Deadlift is a different movement than squat.

Barbell makes a forward movement

It’s necessary that the barbell stays above your shoe’s laces and the barbell needs to be lifted vertically all along your body.

Barbell’s movements towards the front are to be avoided.

Your torso rises after your butt

We call it the « stripper deadlift ».

It’s important that your torso guides the movement and that your body moves in the same rhythm upwards.

Bend your arms

Often people bend their arms to lift the barbell more quickly. Unfortunately, this is a bad tactic because this can tear biceps muscle. Keep your arms straight during the movement.

Share this article if you think it can help someone you know. Thank you.

-Steph