STRESS FRACTURE / BONE STRESS INJURY TREATMENT

Bone stress injuries: AKA Stress fractures

Understanding the mechanism of injury and Diagnosis is key. With almost 10 years of experience and previously being an elite tennis player, Dr Charles can assess these types of injury and may be able to refer to further assessments (imaging) to get a better understanding of your injury.

Dr Charles (chiro) has treated numerous low back bone stress injuries in teenage athletes over the last 12 years. He has done extensive research in the topic and is one of the leading chiropractors in this field in the Canterbury/Bankstown region.

Lumbar Spinal stress fractures, particularly in the pars interarticularis, are a frequent cause of lower back pain in young athletes. These fractures, often referred to as spondylolysis, are caused by repetitive stress on the spine from activities that involve hyperextension, such as gymnastics, cricket bowling, and tennis serves. In fact, up to 47% of adolescent athletes with lower back pain are found to have lumbar stress fractures (Diehl et al. 2006). Early symptoms include dull, persistent pain in the lower back that intensifies during physical activity and may subside with rest. If not addressed early, these fractures can lead to more severe spinal issues, including spondylolisthesis, where the fractured vertebra shifts out of place.

Management of lumbar stress fractures typically begins with conservative treatments, such as rest, chiropractic adjustments and physical therapy which allow the bone to heal. For most athletes, this approach has a high success rate, although recovery can take several months. Surgical intervention is rarely required but may be necessary for fractures that fail to heal or if the vertebrae become unstable. Preventing

Prevention is Key

Lumbar stress fractures is equally important and can be achieved by focusing on proper training techniques, core strength, and flexibility, which reduce the strain on the lower back during sports. A study by Robertson and Wood (2017) highlights the importance of biomechanics and adequate conditioning in reducing the risk of these injuries, particularly in high-impact sports.

Additionally, factors like Relative Energy Deficiency in Sport (RED-S) can contribute to the onset of lumbar stress fractures, especially in athletes who experience an energy imbalance due to insufficient caloric intake or overtraining. Athletes, particularly females, are more vulnerable to this condition, which affects bone density and makes them more susceptible to fractures (Mountjoy et al. 2015).

Chiropractors are essential in both the prevention and treatment of lumbar stress fractures. They can identify early warning signs, provide appropriate spinal adjustments, and guide rehabilitation to ensure a full recovery while preventing future injuries.

Read more about these in the blog post here.


Reference List

1.          Miller T, Kaeding CC, Flanigan D. The classification systems of stress fractures: a systematic review. Phys Sportsmed. 2011 Feb;39(1):93–100.

2.           Mallee WH, Weel H, van Dijk CN, van Tulder MW, Kerkhoffs GM, Lin C-WC. Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review. Br J Sports Med. 2015 Mar;49(6):370–6.

3.           Robertson GAJ, Wood AM. Lower limb stress fractures in sport: Optimising their management and outcome. World J Orthop. 2017 Mar 18;8(3):242–55.

4.           Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC consensus statement: beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014 Apr;48(7):491–7.

5.           Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC relative energy deficiency in sport clinical assessment tool (RED-S CAT). Br J Sports Med. 2015 Nov;49(21):1354–1354.

6.           Diehl JJ, Best TM, Kaeding CC. Classification and Return-to-Play Considerations for Stress Fractures. Clin Sports Med. 2006 Jan;25(1):17–28. 

To see if Chiropractic can help with your specific sporting injuries, enquire with our team or book online today.