Bone Stress Injuries in Runners
Bone stress injuries (BSI) are overuse injuries which are associated with repetitive loading of the bones. These injuries sit on a continuum where they begin with a stress reaction which can progress towards a more serious stress fracture or full bone fracture.
The most common symptom is localised bone pain and tenderness.
Such injuries commonly occur at weight-bearing sites, which are exposed to repetitive loading. For runners, common sites include:
Neck of femur (thigh bone)
Tibia
Fibula
Navicular (bone in the mid-foot)
Prevention of Bone Stress Injuries
One prevention strategy to reduce the load going through your bones is to increase your cadence when running!
Cadence is the number of steps that you take per minute:
An easy way to measure your cadence is to count the number of times your right foot hits the floor in 1 minute, and then double that number. When running, the optimal number should be between 165-180 steps.
If your cadence is low, this can mean you are over-striding - taking big strides and landing with your heel too far in front of your body. Therefore, your body isn’t in an optimal position to absorb the load effectively from the ground.
Having a low cadence and over-striding means that your body is spending an increased amount of time in contact with the ground, thus also absorbing an increased amount of force. These high forces can increase your risk of developing bone stress injuries.
Here are some tips to increase your cadence:
Start by increasing your cadence by 5-10% and maintaining it for short distances
Run to a beat – listen to a metronome or find a song that fits the cadence rate you’re aiming for
Focus on taking smaller steps, rather than running faster
Land with a bent knee with the foot underneath the hip
Strengthen your lower limb muscles to help absorb force going through the bones
The quickest and easiest way to get extensive idea of your running technique is to have a running assessment by a trained professional. At Aevum Physiotherapy, our physiotherapists have an excellent understanding of the biomechanics of running. With our advanced technology and equipment, we can precisely analyse all aspects of your running.
Book an assessment with us here.
Treatment of Bone Stress Injuries
Initial Management
The initial goal of recovery is to return back to doing usual daily activities and walking pain-free.
A temporary halt in usual activity and a period of modified and lighter activity should be introduced to permit healing and prevent the injury from getting worse.
Return to Running
A progressive return to running program, that balances rest and load, is appropriate to get back to running! Appropriate load can be determined by using pain as an indicator. If you can tolerate your prescribed load, the BSI symptoms should not be aggravated during or after activity. Gradually progress through to longer runs and more intense activity if there are consistently no BSI symptoms experienced. Don’t forget, it is very important to remember to give your body a break after your runs, as your bones need time to recover and remodel!
Maintaining strengthening and conditioning during recovery is important for returning to running. Appropriate activities can include cycling, swimming, and anti-gravity treadmill training.
Anti-gravity treadmill training is beneficial during recovery, as it allows you to run at higher intensities with lower loading on the bones. Based in the Sutherland Shire at Aevum Physiotherapy, we are fortunate enough to have the AlterG Anti-Gravity treadmill © in our clinic! The AlterG Anti-Gravity Treadmill © fills a waist high chamber with positive pressure air, which surrounds a treadmill. With your lower body in the chamber, the positive pressure acts to push you up at the hips, which reduces the weight you put through your legs when running on the treadmill. This in turn also reduces the impact on your lower body while running!
To find out more about how our AlterG Anti-Gravity Treadmill can help with your recovery, please give us a call on 02 8544 3231.
