At the Stress fracturealso known colloquially as Fatigue fracture is designated, it is a Damage to the bone. Depending on the degree of injury, the bone is partially or completely broken.
How does a fatigue fracture occur?
The human locomotor system is extremely resilient. The reason for this is an internal repair system. If the bone is particularly stressed at one point, the bone substance increases, while it automatically decreases in less stressed areas. This natural process is also known in medicine as Remodelling is called.
With a Overloading of the bonefor instance by Sporthigh weight or incorrect movements result in so-called Microfractures. These are Minimal injuries to the bone.
Cells that are responsible for bone metabolism then take over the repair of the injury: Osteoclasts degrade the damaged bone substance, while Osteoblasts are responsible for the development of stable, new substance.
A fatigue fracture occurs when the bone metabolism can no longer compensate for stress or gets out of balance:
- Stress fractures are usually caused by repeated overloading during sport. In particular, the musculoskeletal system benefits from Endurance sports such as running, hiking or regular strength training A fatigue fracture occurs when the body's own repair processes can no longer compensate for the wear and tear on the bone.
- In addition to excessive or incorrect training, the following can also occur Malposition of the bone Trigger for a fatigue fracture Due to the malalignment, the bone is exposed to permanent stress even with moderate movement.
- Stress fractures also occur in connection with diseases...like osteoporosis. In this disease the natural bone metabolism is out of balance. The osteoclasts, which are responsible for bone loss, work faster than the osteoblasts. The bone is broken down but not rebuilt and thus permanently weakened.
Unlike traumatic bone fractures, which are caused by a fall or a severe blow, a stress fracture develops over a longer period of time.
If the body's own repair system can no longer compensate for micro injuries to the bone, a stress reaction occurs: Water retention in the bone marrow, so-called Bone Marrow Edema. If the load continues, this stress reaction first damages the bone substance and later the stable bone shell.
Fatigue fracture: symptoms at a glance
Depending on the type of load, a fatigue fracture can occur in all bones and joints. The metatarsals and the shinbone are most frequently affectedStress fractures of the hip and knee joint are also possible.
If pain occurs in the areas mentioned, one should not hesitate to Consult a doctor to stop the damage to the bone at an early stage.
- Sudden pain in case of sudden acceleration or unusual load during repetitive movements often occurs in the early stages of a stress fracture
- Pulling pain ankle-joint
- With increasing damage to the bone, the often "burning" pain to and radiate into adjacent areas
- Also Swelling may indicate a fatigue break
- The Heel reacts sensitively to pressure and hurts when it occurs
- pain when the foot rolls
Prevent stress fractures: These measures help
Fatigue fracture usually occurs in combination with overload. In order to prevent a stress fracture as a result of overloading, it is important to recognise signals from the body in good time. Furthermore, the following measures can help to prevent stress fractures:
Increase training intensity slowly
Under load, for example through regular Running trainingthe foot automatically adapts to this new situation. At the point where the load is greatest, the bone builds up substance and gains stability.
A problem arises when the Bone too early heavily loaded will. Therefore, when preparing for a marathon, for example, it is essential to slowly increase running speed and running time.
Moderate training and breaks
Regular exercise maintains physical fitness, reduces stress and strengthens the immune system. As is so often the case: The right dose is what counts! If you train too hard and do not listen to your body, you tend to overload faster.
This is not only psychologically but also physically noticeable. Thus the musculature loses its damping properties. In addition, the bone is exposed to constant alternating stress due to muscle contractions with different pulling directions. In order to regenerate muscles, tendons and bones Regular breaks Compulsory.
The right technique is what counts
Apart from too hard training, incorrect technique and the associated incorrect loads can lead to stress fractures. No matter whether you are running or in the gym - make sure you have the right technique and consult an expert if necessary.
Pay attention to good footwear
Correct technology is one thing, suitable tools are another. Even the best running technique damages the foot if the shoe is not right. Because Malpositioning of the foot increases the risk of fatigue fracture.
To find the right shoe, specialist sports shops usually offer professional advice with a foot check. Using video analysis and pressure measurement, the sales staff examine the running technique and suggest suitable models.
compensate for malpositions
Even beyond training, malpositioning of the bone can be the cause of overloading. For example, to relieve hollow or buckled flat feet, the following can be done orthopaedic insoles help, which are made individually.
Diagnosis of stress fracture: How do you recognize a fatigue fracture?
Only an expert can determine whether a stress fracture is present or not by means of suitable procedures. At Suspected stress fracture you should get a Orthopaedists ...to visit.
First the Medical historywhere the physician will provide information about the Frequency and nature of the complaints is catching up. Furthermore, the specialist asks the patient about Underlying diseases as well as to possible risk factors. The type or frequency of exposure, for example, is discussed here.
At the local palpation the orthopaedic surgeon pays attention to pressure-sensitive areas, thickening of the bone or doughy swellings that can occur above a stress fracture. In addition, the orthopaedist examines the condition of ligaments, muscles and tendons.
In order to diagnose a stress fracture, it is first necessary to rule out other injuries. This initial examination is usually followed by a imaging process. In most cases the stress fracture is treated with Computer tomography (CT), volume tomography (DVT) or magnetic resonance imaging (MRT) diagnosed.
X-ray images, on the other hand, often provide inaccurate images: A fatigue fracture of the bone is only recognizable when the periosteum visibly changes. However, this is often the case between two and four weeks after the first symptoms occur.
What to do in case of a stress fracture? How the fatigue fracture heals
When a stress fracture is diagnosed, the doctor prescribes a Training break of several weeks. In individual cases joint-gentle sports such as swimming or cycling, is an alternative training option. However, painful strains should be avoided at all costs during this time.
Whether and to what extent the the corresponding area is immobiliseddepends on the location and the severity of the injury.
In addition to immobilization and relief, alternative therapies can have a positive influence on the healing of a fatigue fracture. For example, experts recommend the use of Heat to improve the metabolism in the bone and stimulate the body's own repair process in a natural way.
On the other hand, one should avoid taking painkillers if possible. In the case of a stress fracture, the sensation of pain is important in order not to accidentally strain the fracture.
Text: Natalie Grolig
- Kleinmann, Dieter (Dr. Med.) Running side effects. From fatigue fracture to sudden cardiac death: What can you do about it? Deutscher Ärzteverlag (2006)
- Mayer, Carolin. Fatigue fracture. Resting time for the bones. Mirror Online (31.03.2016)
- Mühlbauer, Roland (Dr. Med.) Fatigue fractures: Overloaded bones. Pharmacy Umschau. (14.04.2016)
- Schneider, Thomas. Rinio, Martin. Stress fracture or march fracture: fatigue fracture of the bone due to overload. www.gelenk-doktor.de