They occur when the rate of bone breakdown is not matched by the rate of bone regeneration.
Aside from biomechanical deficits such as strength and joint range, stress fractures can occur due to abnormal hormone profiles, poor eating habits and insufficient recovery in your training program.
- It is essential to identify 1-2 primary contributing factors as the focus of both rehab and prevention programs
- When looking for underlying factors, remember that one-sided injuries have one-sided cause (although not necessarily on the same side). This means that a sharp increase in running volume can’t be the primary cause of a stress fracture in only one leg – presumably you took both legs on all your training sessions!
- It is important to gradually rebuild your training program as you recover. After six weeks of reduced activity, there’s no moment when you’re suddenly OK to get back to 100%. You’ll need to rebuild your strength, joint movement, fitness and bone loading over an extended period to avoid increased risk of recurrences
- Complete rest isn’t always necessary with a tibial stress fracture. You may still be able to cross training and perform strength exercises to minimise the loss of performance during your recovery
- Eating more calcium isn’t a guaranteed way of avoiding stress fractures or shortening your recovery. The body can only use a limited amount of calcium so extra won’t help. Then there’s other factors (like Vitamin D) that determine how effectively you can use available calcium. If in doubt, get a blood test to look for contributing factors
- X-ray does not reliably detect stress fractures. MRI and bone scan are great at seeing the reaction around the fracture site but CT is the best for quantifying the fracture itself (however it can’t spot the reaction)