Five Keys to Prevent Bone Stress Injuries in Runners

When a bone is loaded sufficiently, a microcrack develops, and it takes about 10 days for osteoclasts to arrive at the microcrack. After those osteoclasts arrive, they resorb, and that damaged bone temporarily makes the bone more porous and less stiff. This resorption happens for about 21 days, during which the bone becomes increasingly vulnerable and sensitive to loading. After all, this bone begins remodeling, and bone mass is restored to pre-microdamage levels. 

What can runners do to prevent Bone Stress Injuries? 

A number of factors contribute to bone stress injuries, but here we will focus on 5 key training considerations that can decrease your risk of Bone Stress Injuries. 

• Monitor Environmental Changes-  

There is a difference in the direction and magnitude of load in different environments. For instance, compared to running on a treadmill, running on trails and hills indicates a distinct stress pattern for the lower extremities. Any adjustments to the surroundings should be made gradually, just like changes in intensity. One day per week should be set out to launch a new environmental change (e.g., if you run 5 days per week on asphalt, trade 1 day per week for trail running). Additionally, as we previously noted, athletes who have a history of Bone stress injuries may be more sensitive to specific surface alterations (e.g., tarsal bone stress injuries and uphill running). 

•  Avoid Major Spikes in Loading - 

As we have mentioned earlier that bones can remodel and adapt if loads are progressively increased. The commonly used paradigm is the 10% rule. The workload should be increased by a maximum of 10% each week but this tends to work at a population level and this may not fit all runners, this progression may be too fast, while others may be able to tolerate spikes in loading in excess of this guideline. i.e. For more details, you can visit our orthopedic center in Baner. 

There are two common situations where we see a large spike in loading: 

• The sedentary person starts running. In a study of military recruits, those with one month or less of running experience were more likely to suffer from Bone Stress Injuries during basic training. 
• According to research, collegiate athletes have a 43% increased risk of Bone Stress Injuries during the preseason because they may be ramping up training too quickly after taking a break from their sport. 

Runners in these situations will most likely require a slower progression to reduce the risk of Bone Stress Injuries. Examining other Bone Stress Injuries risk factors also helps determine how conservative their workload increase should be. Hormonal status, nutrition status, the presence of bone disease, and injury history are all risk factors to consider (i.e., recent immobilization, history of Bone Stress Injuries) 

• Running Rest Periods -  

We want to include regular breaks from the repetitive loads of distance running to allow adequate recovery and adaptation. While this will vary depending on the individual, the following rest schedule could be a good starting point for cross-country runners (who may be running high volumes all year). 

• 1 day off in a week. 

• 1-2 weeks off every 3 months.  

• Limiting your participation to 9-10 months. 

Runners with a lower training volume do not need much rest, and this rest can be adjusted based on the individual’s target training and competition schedule. In the rest period, we should employ other forms of training such as swimming, biking, and other activities to expose the body to a different loading profile than that of our regular running training. 

• First Increase Volume, then Intensity - 

The workload applied to a bone is proportional to its volume (the number of loading cycles) and intensity (the magnitude and/or rate of load). While we want to gradually increase both, bone is more sensitive to intensity changes. According to research, increases in intensity increase fracture risk much faster than increases in volume. So, when considering training changes, consider volume first, then intensity. You can get more detail on this from Dr.Sumitz team the best physiotherapy clinic in Baner. 

• Modify Running Technique -  

Running technique has a significant impact on the magnitude and direction of lower extremity loads. Increasing step cadence by 5-10% is a simple and effective technique modification. According to research, this decrease in stride length results in lower braking forces upon landing, resulting in a lower magnitude of the load on the lower extremities. If you want to know more then you can contact the best orthopedic doctor in Baner. 

Summary:  

• In summary, the following 5 training recommendations may help runners avoid bone stress injuries: 
• Avoid significant load increases. 
• amplify first, then intensify 
• Use weekly, monthly, and annual recovery periods Keep an eye on environmental changes and gradually introduce new training surfaces 
• Adjust technique and think about stepping more quickly