Stress Reaction vs Stress Fracture
About six months ago, I heard a term that sounded a little odd. Yeah, I’ve heard of stress fractures, being stressed out, and stressing a point, but have never heard of a stress reaction! As a doctor, I see people that pound their joints in order to reach their maximum potential. The more I worked with multi-level athletes, the more amazed I was with the resiliency of the human frame.
I once watched Chad Coy, an International professional strongman, do 1,400 pound squats for reps! This was a feat that really was amazing and should have surely broken or bent something! The same can be said for the gymnasts that I had the opportunity to work with. Spinning effortlessly in the air and landing with such precision was nothing short of beautiful. Invincibility was what always came to mind with the majority of the athletes I had the opportunity to help. This was the case at least until their bodies failed resulting in an injury. Sprains and strains were the most common and I was able to make corrections so they would heal faster. Stress fractures were a little different.
Repetitive activity involving the pelvis and entire lower extremity such as seen with track and field athletes, long distance runners and gymnasts can have severe effects on joints and the bones themselves. Often the resulting stress fracture cannot always be seen on x-ray but localized swelling and pain is noted by the athlete. The rule of thumb for treatment is to avoid weight bearing and anything that causes the pain to increase. Rest is the answer until healing is complete. The same is true for the stress reaction. There are however some slight differences.
A stress reaction often is only correctly diagnosed with a bone scan rather than an x-ray. The primary reason is that metabolic activity is visualized easier with a bone scan and typically can look at the entire body for comparative reasons. Stress reactions also may not necessarily be related to compressive forces either. Many times people with stress reactions have issues with pulling on the bone by tendons or ligaments and change according to those stressors. For elite level athletes, it is not uncommon to see a person out of commission for 6 months to even a year from competition. So, this diagnosis should be taken very seriously and rest is a major contributor to the healing process. Gradual re-entry into your chosen sport is also very highly recommended. It takes time to re-educate your body and to harden the structures that were previously weakened. So, take your time and plan carefully as you regain your health.
Copyright© 2010 Dr. Todd A. McDougle