Jogging injury: Stress fracture

Dear Out of Synch, 

Injuries from physical activity can happen even to the most careful person. Though annoying, most injuries are neither serious nor permanent. However, an injury that isn't cared for properly (such as a stress fracture) can escalate into a chronic problem, occasionally being serious enough to curtail the activity permanently. 

Stress fractures are small cracks (fractures) in a bone that are usually caused by repetitive force, such as those that result from running. This repetitive force can cause bones to be unable to undergo remodeling fast enough, which is a continuous process where bone tissue is destroyed and then rebuilt. Furthermore, weakened bones that are unable to withstand the force arising from everyday activities can also lead to stress fractures (a problem for people with low bone mineral density or who have osteoporosis). 

Have you consulted a health care provider about your stress fracture? If not, it's a good idea to seek medical attention to prevent further complications, including a full-on broken bone. Your provider will probably ask you some questions, check out the area in pain, and order an X-ray, MRI, or a bone scan. Depending on your particular case, stress fractures may require several months to fully heal, and you’ll probably have to avoid non-weight bearing activities for some time. Your provider will be able to give you a better idea of how long you’ll have to stay on the sidelines. Moreover, they may also suggest physical therapy. 

In addition to seeing a health care provider, you may also want to keep in mind the four-stage process regarding rehabilitating your body after a minor athletic injury: 

• Reduce the initial inflammation using the RICE principle. Rest, ice, compression, and elevation. 
• Restore normal joint motion. Normal joint motion means being able to move a healed body part with full range of motion. Your health care provider will give you specific stretching exercises to do on your own, or a physical therapist may assist you in stretching the afflicted area. 
• Restore normal strength and endurance. During the rehabilitation process, your body will feel weaker and more fatigued because it's working hard to heal, and you’ll likely need to find ways to move your body with minimal impact. Athletic trainers and other sports medicine professionals often prescribe pool work, such as swimming or pool running, or other activities such as yoga, Pilates, or a stretch class. Rest is imperative for successful healing because as you slowly reintroduce movement and exercise, your body is working to rebuild strength and endurance. 
• Restore functional capacity. Restoring functional capacity involves gradually reintroducing the stress of your regular physical activity (in this case, jogging), until you are capable of returning to your full intensity. Before jogging full speed ahead, however, you need to have complete range of motion in your joints; normal strength and balance among your muscles; normal coordinated patterns of movement; no injury compensation movements, such as limping; and little or no pain. 

During recovery it’s key to pay attention to your pain. Pain is your body telling you to stop. Once you are pain-free, you can consider stepping up your activity to biking or using an elliptical trainer. As you mentioned, stress plays a large role in healing. Tending to your mind as well as to your body is critical, so increasing your level of mental self-care can help. To prevent injuries in the future, you can follow a few basic guidelines when physically active: 

• Stay in condition; haphazard physical activity programs invite injuries. 
• Warm up thoroughly before physical activity. 
• Stay hydrated. 
• Use proper body mechanics when lifting objects or executing sports skills. An exercise physiologist or trainer can demonstrate proper body alignment and position for these activities that's appropriate for you. 
• Don't be physically active when you're ill or over trained. 
• Use proper equipment and safety gear. 

Hope this information helps!