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 .

Should You Arch Your Back ?

exercise arching back

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Audio file:

For people who don’t have vertebral pathology, arching their back during an exercise isn’t a problem. Arching a little bit the back for exercises such deadlift or squat is necessary because the spine is rounded so arching a little bit the back helps avoid injuries.

But for some people, arching the back during an exercise can be very dangerous :

  • This concerns people suffering from congenital spondylolysis (absence of welding of the vertebral arch). The lumbar spine’s extension may cause the vertebrae to slide (spondyloystesis), which can seriously compress the nervous elements and cause sciatica.

    spondyloystesis

  • This concerns people who have demineralization due to age (osteoporosis) or people who haven’t yet completed their growth. The lumbar spine’s extension may cause spondylolysis by fracture of the vertebral arch. This fracture which has broken the posterior attachement system of a vertebrae can slide and seriously compress the nervous elements and cause sciatica.

    osteoporosis

spondyloystesis

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

-Steph

Back To The Source Of Human Strength (Part 1)

source

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

When I’m in gym, people tell me why they started to train. There are several reasons, lose weight, gain muscles or to be in shape for a special event. There is a golden rule to have result in strength training, it’s eat clean and lift heavy.

Everybody says it, eat clean and lift heavy but what does that means ? I think it’s time to go back to the source.

Why

why

The life is easier when we’re stronger, did you notice it ? By exemple, to carry bags from supermarket, to carry a piece of furniture, to run to be in time, etc. Everything is easier.

Strength training is extremely efficient to build muscle and burn fat. Whether to lose 6kg (15lbs) or 45kg (100lbs), it’s the same thing.

Strength training help to build muscle and lose fat but it also help to stop or even reverse sarcopenia (it’s skeletal muscle reduction with aging). Train our skeletal muscle allow us to be independant (therefore avoid nursing homes) and live longer.

The profits list isn’t finished yet.

A nice athletic body

Strength training help you keep your muscles while you’re in calories deficience and losing weight.

Strength training allows you to have a better oxygen consumption than aerobic exercices. After training your body needs to make a lot of efforts to recover and return to the normal state so the state you had before the training. Scientific studies have shown that your metabolism‘s level increase for 38 hours after your training.

Strength training increase your metabolism, increase your Resting Metabolic Rate (RMR) because your body needs more calories to keep your muscls than to keep your fat. It’s estimated that for each 4.45kg (1lbs) of muscle, your RMR increase of 30-35 calories.

Improve your health

Strength training help you to improve your balance and coordination, improve cholesterol’s rate, help to control blood sugar, stop muscle loss, improve blood flow, reduces your resting blood pressure, build a stronger heart and increase bone density.

Feel better

It’s clear with strength training you have more self-confidence, your have more energy, a better mood, less anxiety and less stress . It also improves the quality of your thoughts, a scientific study has shown that this increases the cognitive function .

It’s not advisable to do a strength training 1 hour before sleeping. On the other hand to train early in the day helps to prevent sleep apnea  and insomnia.

Prevents diseases and degenerative diseases

You notices that many men and women die because of cardiac disease. Stength training helps to solve problems that are factors of heart disease such as inactivity, diabets, obesity, high blood pressure and cholesterol. Cardiologists begin to advise strength training to people who have heart attack.

Strength training helps to manage and improve the lifestyle of people with clinical depression , cancer survivors , have had a spinal cord injury ,who have recently had a stroke , fibromyalgia , Lymphedema , Down Syndrome , Parkinson’s Disease , Osteoporosis  and Arthritis.

It’s fun

Strenght training helps to reach your goals whether an effective training of 20 minutes to have a good naked body or to do a sports competition. It’s fun to see our progress because it’s like increase level in a video game. If you want to be better in a sport like badminton or rock climbing, strength training is a good choice.

People who shouldn’t train

The only people I’ve found who shouldn’t train are people who have an injury and it’s a break that doesn’t last long. We’re human being and it’s natural to carry things and move. Strength training is recommended for pregnant women , children and teenagers  and even paraplegics .

Obviously, it recommanded to see his/her doctor before beginning a strength training program to adjust the training program.

Basic objections

objection

But I’m too old, it’s not reasonable

When people between 30 and 60 years old tell me that they’re too old, I laugh because it’s a lie. It’s like say : « I don’t have time » and later I see a messsage on Facebook like : « Yestersay, Game of the thrones was epic ! ». Scientific studies have shown that people between 70 and 90 years old had impressive results in 10 weeks .

Other scientific studies have shown that this helps to avoid dementia  and to delay Alzheimer’s .

People who think they’re too old to train are exactly people who should train.

But I just want to be better for a sport and I want to stay fit

Strength training improve your muscle’s endurance, scientific studies have shown it. Resistance exercices help to increases overall muscles endurance , fix nervous system problems and increase activation of motor units within your muscles.

I don’t want to bulk too much

It’s a great strength training’s myth, it’s not in 1 year than you’ll have the bodybuilder’s body no matter wheteher you’re a man or a woman.

For women, here 2 exemples of moms who have become strong and fit without having a bodybuilder body. This is the story of Veronica  and Bronwyn .

Have a the body of a famous bodybuilder doesn’t happen in one night. Naturally we don’t have the amount of homones to have the body of a famous bodybuilder. We need to eat a huge amount of food (8 000 – 10 000 calories per day) and a huge amont of drugs (no, no, it’s another type of pharmacy, it’s true).

I’m fat, I want only lose weight

I’m fat, I want only lose weight

It’s a good reason to start strenght training. By losing weight, you surely want to keep your muscles. I mean, yout want to keep your muscles while you lose fat. With strength training you lose quickly centimeters (inches) in different body’s parts. It’s true that the overall weight loss may seem slow, that’s why is important to track your measurements. With strenght training when you eat with a caloric deficit, it’s increase your metabolism so you lose fat.

It’s boring

What I like with strength training, it’s we can see our progress quickly. It’s like increase level in a video game. I think people get bored when they expect nothing to do between 2 sets. This is why I advise people to have headphones to listen to their own music selection or an audio book to increase motivation.

Muscles and strength training

muscle fiber

Don’t be fancy, it’s interesting to understand how our muscles work to avoid failling into the Matrix’s trap. What I mean is that the only person you gave to impress is yourself and not the others.

It’s our muscle fibers that are small muscle cells that build up our muscles. Our muscle fibers are long, cylindrical and have the size of a strand of hair. Our muscle fibers are composed of myofibrils surrounded by sarcoplasm. I really summarized that but if you want to see it in detail, click here .

We have around 642 skeletal muscles that work together to make move our body. Imagine, when you bend your arm, your biceps contracts and your triceps does the opposite (elongates) to let the elbow bend. Every muscle of your body work as a team to make you move.

We have different type of muscle fibers :

Slow twitch (Type 1 fibers)

Slow twitch fibers are used to convert oxygen into energy for a long period of time. They don’t move quickly to be resistant to fatigue. These are the fibers we use most for marathons.

Fast twitch (Type 2 fibers)

Fast twitch move quickly so they’re not resistant to fatigue. Our body has 2 categories of fast fibers. The type 2A fiber has an endurence characterisitc used for long sprints. The type 2X fiber has « super fast » characterisitc used to short sprints or lift weights. I really summarized that but if you want to see it in detail, click here .

Each individual has a different percentage of slow and fast fibers. It’s for this reason that people are naturally better to run long distances or sprints. It’s funny because we can see it in strength training with people who are better to do sets with high or low repetitions.

It’s the end of the first part and the second part is event more interessting.

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

-Steph

P.S. To read Part 2, click here.