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 .

Meniscal Tears

meniscus

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.

Meniscus tear

meniscus tear

Meniscal tear is one of the most common knee injuries in athletes. This is caused after a contact injury or a traumatic twist. The meniscus is a wedge-shaped cartilage that provides a cushion in the medial and lateral portion of the knee joint and acts as a « shock absorber ». It’s located in the area of joints contact to prevent the bones rub between them because of the bodyweight. It’s hard and rubbery to help cushion the joints and keep the knees stable.

It’s important to also know that the meniscus helps to nourish the knee by facilitating the diffusion of joint fluid. With this injury, athletes can experience acute pain with a swelling and often a catching or locking sensation.

Diagnose

A meniscus injury can be diagnosed on the basis of the story that the patient provides and a physical examination of the knee.

An orthopedic surgeon my also use other techniques to further diagnose such as magnetic resonance imaging (MRI), which gives a 3-dimensional image of the inside of the knee joint. In some cases, a surgeon can perform an arthroscopic inspection of the articulation, this is a minimally invasive surgical procedure.

Treatment

knee brace

A small meniscus tear can be treated with rest, ice and anti-inflammatory medications. When a meniscus tear causes a significant loss of movement or catching, the appropriate treatment is often a surgical operation. Depending on the location and type of tear, the treatment may be a simple arthroscopy to remove the torn fragment. Depending on how quickly the inflammation disappears, athletes can return to a full activity after a week or months.

For athletes with a repairable tear, sutures are used to sew the meniscus. In this situation, the knee is braced for 6 weeks. These athletes take at least 3-6 months to back to their activities but maintain the full cushion in their knees.

Prevention

There is not really any way to prevent a meniscus tear apart from a conditioning program to try to prevent an acromioclavicular ligament (ACL) tear and knee instability.

Stats

Women have meniscus tears more often than men and at an earlier age. These tears are often associated with an acromioclavicular ligament injury (ACL)

There are some variables of meniscus tears can be repaired and despite repair, they aren’t always heal. But arthritis can be avoided in the majority of cases when repair is successful. One study shows that 60% of patients who undergo meniscectomy (partial elimination) had some degree of progressive arthritis.

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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 .

Mature Athlete

mature athlete

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.

Physical exercises are for everyone, including the mature population. Exercises allow older people to keep a healthy body and maintain their independence. The main health problems of the mature population are arthritis, high blood pressure, heart disease, lung disease, depression and hearing and sight loss. With the exception of hearing and sight loss, all these health problems can be serious decrease with an adequate workout program.

All mature athletes should have a complete medical and musculoskeletal assessment before starting any workout program. Having a complete medical examination, medical advice and a workout program helps to avoid serious injuries and health accidents. These 3 things should meet the needs of a mature athlete to avoid disease, increase endurance, strength, body image and competitiveness.

Exercises are beneficial

It’s important that a qualified personal trainer create a specific workout program to improve strength, endurance, balance and flexibility. If the workout program includes sports such as golf or tennis, the technical knowledge of the golf/tennis instructors is helpful to avoid injury and improve performance. For results, workout programs must be consistent for at least 30-45 minutes, 3-4 days a week.

If physical conditions require correction, a cardiac or pulmonary rehabilitation program or physical therapy may be helpful before starting a workout program. These rehab programs should be taught to mature athletes at a fitness level where they could continue with their own workout program.

Exercise type for the workout program

physical exercise type

An athlete should use types of exercises based on his/her desire, pre-existing conditions and his/her ability to exercise without pain. For an athlete with lower extremity joint problems such as arthritis or instability, it’s recommended to avoid exercises with repetitive impacts like running. For athletes with an unstable shoulder, it’s recommended to avoid overhead exercises such as military press and pull-ups.

Using several types of exercise to improve strength, can allow better recovery of muscle and tendon tissue. If a mature athlete wants to make a sport that can aggravate a pre-existing problem on a muscle, tendon or bone, that athlete should be in a good condition before doing this sport. It’s recommended to decrease this sport’s frequency to reduce the painful symptoms.

What equipment to use

Having shoes that fit with the exercise and/or the sport is beneficial. If the person has a foot with significant deformity such as flat feet (fallen arches), using orthopedic shoes helps to reduce stress on the entire lower extremity. The symptoms of arthritis in the knee may be decrease by the use of specialized braces.

Prevent injury or discomfort during exercise

If there is discomfort during or after physical exercise, this should be analyzed to prevent it from starting again or getting worse. Over-the-counter painkillers and anti-inflammatory can be used in the short term if there is no interference with other medical conditions. It’s important to know that the use of ice, heat, massage and flexibility programs can decrease several symptoms caused by exercise.

There is more aggressive treatment with narcotic analgesic and/or cortisone injections but this should only be used to treat a specific lesion. This shouldn’t be used to allow an athlete to complete in the short term.

Summary

Creating a customized workout program with a medical professional and/or a qualified personal trainer helps a mature athlete to :

  • Keep independence

  • Increase physical abilities

  • Prevent injuries

  • Improve the quality of life

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.