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 .

How To Do T-Bar Rows

t bar rows

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

Podcast:

Lying on the belly on the inclined bench and take the handles with a pronated grip :

  • Inhale and brings the bar to your chest

  • Exhale at the end of movement

This exercise is similar to the barbell bent rows but it allows a better work of the back muscles because there is less need to focus on the body’s positioning.

This exercise works latissimus dorsi, teres major, posterior deltoid, arm’s flexor (biceps, brachialis, and brachioradialis), rhomboids and trapezius.

The machines with a belly support allow to focus less on the positioning, abs and spinal erectors don’t work. When there are very heavy weights, the rib cage can be compressed on the ventral support and this hinders breathing. When it’s difficult to breathe, doing the exercise is unpleasant.

Note

With a supinated grip, this exercise especially works the brachialis and the upper part of the trapezius at the end to the pull.

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-Steph

Dumbbell Pullovers

dumbbell pullovers

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

Lying on a bench with your feet on the ground. You take a dumbbell with both hands and your arms outstretched. The dumbbell is on your palms and your thumbs and forefingers encircling the handle:

  • Inhale and lower the dumbbell behind your head by slightly bending your elbows

  • Exhale returning to the starting position

This exercise work pectoralis major, triceps long head, teres major, lats and a little bit serratus anterior, rhomboids and pectoralis minor. The serratus anterior, rhomboids and pectoralis minor have the function to stabilize the scapulae (shoulder blades) and to allow the humerus to tilt over a stable support.

It’s possible to do this exercise only to open the rib cage. To do this, work with lightweights and be careful to not bend your elbows too much. And it’s necessary to use a bench in a transverse position so that your pelvis is lower than your shoulder girdles. It’s important to inhale as much as possible at the beginning of the movement and to exhale only at the end of the movement.

dumbbell pullovers

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

-Steph

Bench Press And Morphology

bench press morphology

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

I think you’ve noticed that the bench press is the most practiced exercise in a gym. And as this is the most practiced exercise, it’s also the exercise that create the most injury per year. This is why, it’s important to have basic morphology’s notions to be able to do this exercise correctly.

Arms length

bench press morphology

The majority of injuries with the bench press are muscle tears or rupture of the pectoralis major tendon (during the descent of the barbell).

The pectoralis major inserted on the humerus. As a result, during the descent of the barbell, more the arm go down and more the pectoralis major is stretched and vulnerable.

But the descent of the arm and the stretching of the pectoralis major vary from one individual to another. More the arm is long, more the humerus will go down, which causes the pectoralis major to be stretched. It’s for this reason that willowy people (a person with long body members) often have this type of injury.

Rib cage thickness

bench press morphology

More rib cage is thick and less the barbell can go down. This means a limited strech of the pectoralis major therefore less risk of injury.

It’s for this reason that the majority of great bench press champions are brevilineal type (a person with short body’s members). Having a thick rib cage and short members allow to achieve a record with a morphological safety that limits the risk of muscle tearing or rupture of pectoralis major.

Morphology has a fundamental place in sport success and it’s injuries that limit the progression. Sport progression isn’t only based on mental (mindset), diet and workout type.

It’s fundamental to adjust the training program with the morphology. Let couple things be clear : what’s good for the person next to you, is not automatically good for you.

Limit the injury risk

bench press morphology

There is a bench press variant and it’s close-grip bench press. This variant limits the arm’s descent and this reduces the pectoralis major’s stretch thus limits the injuries risks.

This variant used by bench press champions with willowy type but the disadvantages are reduced performances, triceps work more and the movement’s amplitude is more important.

There is also another variant, the partial bench press. The concept is to decrease the barbell’s descent for it doesn’t touch the chest. This avoids excessive pectoralis major’s stretching.

Muscle predominance

Depending on the muscular strength of a person, there are 2 ways to do bench press :

  • Elbows spread to make more work the pectoralis major

  • Elbows close (to close arm/chest angle) to make more work deltoids.

Regardless morphology, these techniques can be used to specifically target a muscle (elbows spread => pectoralis major or elbows close => deltoids).

Attention : for bench press, it’s necessary to adjust the technique according to the different morphologies

bench press morphology

Image A

A thin rib cage with long arms when the barbell approaches the chest during the descent dangerously stretch the pectoralis major. The risk of muscle tears or tendon rupture are increased with the weight on the barbell.

Image B

A thick rib cage with short arms when the barbell approaches the chest during the descent limits the movement’s amplitude and the pectorlis major’s stretching. It’s for this reason that there are many bench press champons with this morphology.

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

-Steph

Front Raise

front raises anatomy dumbbell shoulder

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

front raises anatomy dumbbell shoulder

Standing with your legs slightly apart. Take a dumbbell in each hand in pronation. You can keep dumbbells on your thighs or on the side :

  • Inhale and make an alternate raise of your arms forward (or antepulsion) until your eyes level.

  • Exhale at the end of movement

front raises anatomy dumbbell shoulder

This exercise work mainly deltoid’s anterior beams, clavicular beam of the pectoralis major and a little less the rest of deltoid. In all arm raise movements, scapula fixators (shoulder blades) on rib cage such as anterior serratus and rhomboids, are also used allowing humerus to tilt on a stable support.

front raises anatomy dumbbell shoulder

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-Steph