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.


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).


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.


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.


  • 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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How To Do Straight-Arm Lat Pulldowns

straight arm lat pulldowns

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


Standing in front of the machine with your feet slightly apart. You take the bar with a pronated grip and your hands’ position are wider than your shoulders width:

  • Having your back straight and squeeze your abs. Inhale and bring the bar down to your thighs with your arms stretched (or your elbows slightly bent).

  • Exhale at the end of the movement.

This exercise works the latissimus dorsi, teres major, and triceps long head. This exercise helps you to have a stable arm-torso junction.


This exercise is great for swimmers to have a better power stroke. Many international coaches have integrated this exercise into their swimming programs.

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Dreams And Social Pressure

social pressure

This Saturday morning I had a discussion with my father. He asked me why I continue to train as often and if I earn money with my websites. I replied that it’s a passion and I hadn’t reached my fitness goal. For my websites, I don’t make money with.

He explains that he is worried about my situation, I might have a better career (work in a bank); I am quite muscular, if I continue I will become ugly; I began to spend a lot of money for my websites. He said he sees no future in my projects.

I explain my vision. My training doesn’t serve me just to gain muscle but also to make my mindset stronger and have more self-confidence. This self-confidence is for my 2 websites that I see as startups, digital companies. The thing is that in my entourage, I don’t know entrepreneurs so that I learn everything on the field almost alone.

I have online courses (The Family) with people who worked in Silicon Valley, it helps a lot but I don’t live in USA and the culture isn’t the same. So I have to adapt the Silicon Valley’s culture with the culture of my area and my environment has the reputation of being toxic. I’m aware that I made many mistakes but I have to go through it, may be my websites could work faster but I doubt.

sillicon valley

My father told me it’s interesting but he thought it would be good that I put myself a deadline to see if it works or not. By this way if it doesn’t work, I could find a well paid job, live with a girl, have children and live happy for years.

I told him I would think about it. He’s right for the deadline but I will not stop wanting to create my startup, if it doesn’t work I would make another until it works. In the courses, it’s said that when someone decides to be an entrepreneur, he must continue it until it works because the cost is too high to stop. Nonexistent social life, less money and work 7/7.

I confess that after the discussion I have doubted, a lot, a lot, a lot. I thought he’s a little right.


There is a metaphor that I like which is used in my course. It’s a swimmer who will cross the Atlantic Ocean. At first, when he told his project to everyone, everyone is happy and encouraged him. When he crossed the finish, it’s the total triumph, he’s the world champion. When he’s in the ocean everyone takes him for a dumb and want him to they board of abandoned.

I’m in the ocean and everyone thinks I’m a dumb. People want me to give up to live like everyone else.

I have decided to finish. It’s true, I don’t know how long it will take but the triumph will be phenomenal because it’s the realization of my dream.

You must know it too ? People put you some pressure to give up ? I call it the social pressure because you’re outside the system, you live your dream.

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