Calcaneal Stress Fracture
The calcaneus is a bone positioned at the back of the heel commonly referred as the heel bone. It absorbs the initial impact during low-moderate running therefore is exposed to high levels of force and stress which it must absorb. The most common reason for fractures are from trauma incidence although two common forms of fractures seen in sporting and overuse injuries are stress fractures and avulsion fractures. Stress fractures can occur from overuse or repetitive abnormal stresses on the bone. Generally, due to poor biomechanics, technique or inappropriate footwear. An avulsion fracture is when a piece of bone has been pulled off the calcaneus due to the Achilles tendon.
The reason overuse stress fractures occur s because of repeated movement occur so often the weight bearing bone (calcaneus) has not got enough time to remodel or repair itself. Remodelling is constantly occurring at the sites of our bones, old bone is being eaten by special cells in the bone whilst new matrix is being laid down by other specific cells ‘osteoblasts’. In the case of excessive overuse, the new bone cannot be produced fast enough therefore the bone becomes weak and vulnerable to stress fractures. A person who is sedentary then engages in excessive exercise could also be vulnerable to stress fractures.
If you are suffering from pain that is reduced during rest, pain that occurs and intensifies during normal, daily activities, swelling at the top of the foot and the lateral aspect of the ankle, bruising and tendinous of the ankle then you may be suffering from a stress fracture of the calcaneus bone.
Acute treatment of a stress fracture should be in line with the RICE, (Rest, Ice, Compress, Elevate). Rehabilitation and corrective treatment will assist in the recovery and prevention of further stress fractures. Orthotics or appropriate footwear may be prescribed to redirect stress and force produced during training or sports.
To prevent stress fractures it is crucial you get training right. Starting at a high training threshold after a discontinued period is dangerous. Gradually increasing your training threshold like time, speed, distance or weight will let your body normalise and adapt to the new training threshold. Cross training will help to reduce repetitive stresses, people who primarily run for fitness will expose their ankle to a high volume of stress. Utilising cycling or swimming due to the low impact although similar training paradigms will help you reach your fitness goals safely. Strength training is a great way to reduce early muscle fatigue, it will also increase bone mass density which is ideal for aging athletes. If you begin to recognise swelling during or after training or experience pain it is best to see a professional health specialist to assist in training techniques or rehabilitation.
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