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.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-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 .

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Heat Illness

heat illness

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.

Every summer, hundreds of people experience sun-related illnesses and heat. Being prepared and hydrated avoids theses situations.

Why

When an athlete exercises, his/her body temperature increase and the body sweats to cool the body. During this process, body fluids and electrolytes are lost. If the boy is not recharged with fluids and electrolytes, it’s dehydration and it increase the risk of heat illness as a heat stroke.

Symptoms

Symptoms are :

  • Chills

  • Dark colored urine

  • Dry mouth

  • Headaches

  • Thirst

  • Weakness

If the heat illness progress, there are more serious symptoms like :

  • Difficulty breathing

  • Body temperature increasing to dangerous levels

  • Muscle cramps

  • Nausea

  • Tingling of the limbs

  • Death

How to prevent

The most effective treatments for heat illness are :

  • Proper training for the heat

  • Fluid replacement before, during, and after exertion

  • Appropriate clothing (light colored, loose fitting and limited to one layer)

  • Early recognition via direct monitoring of athlete by other players, coaches and medical staff

  • Monitoring the intensity of physical activity appropriate for fitness and how an athlete has acclimated to conditions.

  • If possible, having an athletic trainer on site during events and practices to properly prevent and treat heat illnesses.

In situations where the training program is intense or during a trip in a hot climate, an athlete should limit the intensity and duration of the training session. Thereafter, the athlete will increase the training’s intensity for a period of 7-14 days to allow to the body, the time to adjust to the climate and environmental conditions. For athletes with respiratory, gastrointestinal or other diseases, they should especially evaluate these new conditions.

When an athlete should hydrate

hydrate

It’s necessary to hydrate before, during and after a training session. Drinking 47cl (16 ounces) of water is recommended 1 hour before exercises. Hydration should continue with 11-23cl (4-8 ounces) of water every 15-20 minutes throughout the effort

There is a trick to track the hydration’s level is to weigh before and after a physical activity. If the athlete is lighter after a physical activity, this means that there a deficit of fluids (indicated by weight loss) and it’s necessary to recharge them. For the next physical activity, it will be essential to drink more to evaluate the losses (perspiration). An athlete who loses more than 2-3% of his/her bodyweight during exercise may decrease the performance and the body’s physiological function.

If the athlete is heavier after a physical activity, it means that there is a surplus of fluids (indicated by gain weight). For the next physical activity, it will be essential to drink less to evaluate the surplus.

How to treat it

When you see signs of heat illness or heat stroke, it may be an imminent danger of death. It’s necessary that a person immediately call for medical assistance while you’re cooling the person at risk.

Treatment included :

  • Getting the athlete to a shaded area

  • If it heat stroke, cool the athlete rapidly using cold water immersion. If immersion is not available you may use spray from a hose, cold water sponging, or placing cold towels over the entire body

  • Monitoring body temperature

  • Providing cool beverage if possible (i.e., if the athlete doesn’t have altered consciousness).

  • Getting medical assistance as soon as possible.

Heat exhaustion is a type of heat illness that can happen after several days of exposure to high temperature and improper or unbalanced fluid recharging.

Statistics

  • Heat stroke is a type of serious illness related to heat. It can cause death to athletes and this is probably the leading cause of athlete death during the months of July and August.

  • The body produces 1.8 liters (a half of gallon) of perspiration to cool the body every hour. If there are not enough fluids or the heat is overwhelming the body, the person may develop heat-related illness.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-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.

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