The cells within the bones of our body are constantly changing in response to the loads we put through them. We try to maintain a balance between the breakdown of our bone (osteoclast activity) and the creation of new bone (osteoblast activity). When we place a bone under excessive load we create a stress response, which causes microscopic damage, weakening the bone. This is followed by formation of new bone cells to strengthen the weakened area.
When do fractures Occur?
If the bone is stressed again before the production of new bone cells can take place, further microscopic damage can occur. If this cycle persists without sufficient time for the creation of new bone to form and strengthen the area, then the microscopic damage can result in a fracture.
The stress reaction is a two way continuum which can then lead to a stress fracture.
In its early stages pain may not be evident during activity.
Pain can then start to become evident towards the end of an activity which settles with rest.
As you progress through the continuum, pain can present earlier in an activity, taking longer to settle and all the while becoming more localised.
Common areas effected:
Bones in the foot including: Metatarsals, Navicular and Calcaneous
Tibia (Shin bone)
Pubic Ramus of the pelvis
Pars articularis (a part of the lumbar vetebra bone)
If you think you might be suffering from a stress response or stress fracture then it is important to have an assessment to establish the best course of management.
Management could include:
Adjusting training loads/activity levels
Assessing movement control
We may need to refer you to your GP or an ankle/foot consultant for further assessment and investigations. We are fortunate to have good links with all local GP practices and Orthopaedic Consultants.
If you would like additional information then please contact us.