How to Prevent Stress Fractures in Women
First of all, what is a stress fracture? It is basically a tiny crack in the bone that gets worse with time and certain activities.
So why does it happen? Well, our bones are pretty amazing and have a cool way of getting stronger. When our bones undergo a heavy load, they become stressed out and experience micro trauma. Little messengers in the bone signal a process that sweeps in to take the damaged bone away and replace it with new and improved bone. In a setting where the bones have plenty of time for recovery and bone remodeling, they come back even stronger.
In the case of a stress fracture, the bones experience repetitive micro trauma, the messengers in the bone still signal the process to take the damaged bone away, but now there is no time for the new bone to set in. Over time, this process makes the bones weakened and more porous, placing them at the utmost risk of fracture!
An example of someone who may be at a high risk for a stress fracture would be a new runner. New runners sometimes tend to do WAY too much too soon in terms of volume of running. This is why it is important to progressively increase activity in a way that allows the bone, muscle, and joints to adapt and build strength along the way.
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Some of the most important things that you can do to PREVENT stress fractures include: ⠀
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1. Make sure to meet your nutritional needs. Remember that this varies from person to person and should include an individualized approach. A registered dietician (I recommend Holley Samuel from Fit Cookie Nutrition) is the perfect healthcare professional to help you meet these needs in a safe and healthy way.
2. Track your periods to ensure they are coming regularly.
3. Take recovery from your workouts seriously. You aren’t finished with your lift or your run until you have had a proper cool down and re-fueled and hydrated your body.
4. Get at least 7-8 hours of good quality sleep each night. Our bodies heal during our sleep!!⠀
5. Incorporate strength training 2-3 times per week and really challenge yourself. Controlled progressive overload training can have tremendous effects on bone density, muscular strength and neuromuscular adaptation, thus reducing likelihood of musculoskeletal injury. Stronger people are harder to break!
6. Wear comfortable and well fitting shoes. This one is practical, but can make a huge difference, especially when talking about stress and strain on the foot. ⠀
7. Avoid overtraining or doing too much too soon. As a Physical Therapist, I work with countless clients recovering from injury. It is really hard to lose hard-earned progress, and sometimes the excitement of getting back into it can result in re-injury or stress fractures. Pace yourself and use the guidance of a trained Physical Therapist to help design a program tailored to you. ⠀
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Taking the steps above will be critical in preventing stress fractures, however there are some risk factors that are just out of your control. Below are some of the RED FLAGS 🚩 to be aware of.
🚩missing periods or having irregular periods⠀
🚩chronic GI issues and malabsorption⠀
🚩history of or current eating disorder ⠀
🚩deficiencies--vitamin D, B12, or overall underfueling (if you’re currently training for a marathon and eating less than 2000 calories daily...it’s highly likely that you’re underfueling)⠀
🚩PAIN during activity that persists with rest or at night ⠀
🚩history of stress fractures
I hope you learned a little more about what stress fractures are and how to prevent them! If you think you may have a stress fracture, collaborate with your healthcare team to get on the path to recovery so you can live your healthiest life!
XOXO Dr. Miranda Robles PT, DPT
Wildflower Physical Therapy & Wellness
(This information was collected in collaboration with Holley Samuel, Registered Dietician and personal trainer at Fit Cookie Nutrition)
Resources
Hughes JM, Popp KL, Yanovich R, Bouxsein ML, Matheny RW Jr. The role of adaptive bone formation in the etiology of stress fracture. Exp Biol Med (Maywood). 2017;242(9):897-906. doi:10.1177/1535370216661646