Too Much Too Soon

Continued...

Reactivating

Your return to activity should be slow and steady, with small amounts of weight-bearing activity done on alternate days on a cushioned surface. For instance, if you have a stress fracture you might be biking 30 minutes a day to maintain aerobic fitness. When you are medically cleared to resume running, you may start by running for five to 10 minutes on grass, then biking for 20 to 25 minutes to complete your 30 minutes.

As long as you are pain-free, you can run every other day and increase your running time by five to 10 minutes per session. This allows time for the bone to adapt to the forces of impact again, helping to prevent a recurrence of stress fracture.

Most stress fractures can be effectively treated in this manner; but a few deserve special attention. A stress fracture in the neck of the thigh bone (femur) where it angles toward the hip socket is serious and may become a complete fracture. Surgery, including a pinning of the hip with orthopedic screws, would then be needed. To avoid surgery women are immobilized on crutches until such stress fractures heal.

Stress fractures in the small bones of the wrist and foot can be difficult to diagnose and may not heal completely. They may require surgery and bone grafts for healing to take place.

Seven Ways To Decrease Your Stress Fracture Risk

1. After resuming physical activity, gradually increase its duration and intensity over four to six weeks to allow the bone time to adapt to the increased load.

2 Assure yourself a daily intake of 1,000 milligrams of calcium, the principal mineral in bone. Amenorrheic women need 1,500 mg of calcium a day. One 8-ounce cup of skim milk has 300 mg, a cup of plain yogurt has 415 mg and 1 oz of cheddar cheese has 200 mg.

3. Don't train in shoes that have lost their cushioning and supportive properties. Look for wear patterns on the bottom of the sole or buy new shoes after 300 miles.

4. If you have stopped menstruating for two months or more, see a physician for a full evaluation and consideration of hormone replacement therapy to maintain bone mass.

5. Be aware of your exercise surface. Hard, unyielding floors and concrete or asphalt surfaces don't provide shock absorption and transmit more forces to the bone.

6. If you run on the side of the road, change direction regularly to even out the time you spend running on the slanted surface.

7. Strengthen the muscles in the front of your lower leg by heel-walking, toe-tapping and doing ankle flexing exercises with 1- or 2-pound weights strapped around the toes. Strengthening these muscles will balance the strength in the larger calf muscles.

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About the authors: Carol L. Otis, M.D., is Chief Medical Advisor to the Sanex WTA and a UCLA student health physician. Roger Goldingay is a former professional soccer player. They are married and the co-authors of The Athletic Woman's Survival Guide.

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Table of Contents

Foreword: Billie Jean King

Comments by Barb Harris
Editor in Chief,
Shape Magazine

General Health
Nutrition
Exercise
Common Medical Problems
Dental Health
Emergency!
Infectious Disease
Sexual Health
Emotional Well-Being
Eating Disorders
Alcohol & Other Drugs
Environmental Health
Prevention