The Runners Zone Episode 61: A Practical Guide to Bone Stress Injuries
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Oct 27, 2023 The podcast covers how the hosts got into teaching continuing education and the need for seasonality in training. They also discuss common questions about bone stress injuries, differentiating between fatigue and insufficiency fractures, and managing bone stress injuries. The importance of avoiding judgment as a healthcare provider and understanding the volatility of the rehab process for runners with bone stress injuries are also emphasized. Additionally, optimizing bone health through exercise prescription and the approach to rehab for bone stress injuries are discussed.
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Bone Stress Injury Is A Spectrum Not A Single Event
- A bone stress injury (BSI) is a spectrum from stress reaction to stress fracture to complete fracture.
- It represents a mismatch between applied loads and the bone's capacity, often shown as MRI edema or a fracture line.
Triage Bone Stress Sites By Risk Before Treating
- Classify the site as low risk or high risk immediately because management differs drastically.
- Low-risk (medial tibia, most metatarsals) may allow walking; high-risk (femoral neck, navicular, some fifth metatarsals) often needs nonweightbearing and urgent imaging.
Screen Energy Availability And Refer To A Dietitian
- Routinely screen energy availability and reproductive health with intake forms and follow-up conversations.
- Send every BSI patient to a dietitian because even a 350–500 kcal deficit impairs bone metabolism.