Stress Fractures

Brukner, Peter; Bradshaw, Christopher; Khan, Karim M.; White, Susan V.; Crossley, Kay M

doi:10.1097/00042752-199604000-00004

Cited by 257 publications

(15 citation statements)

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“…When running on concrete surfaces for repetitive and long-distance training, a high peak pressure might load excessive stress on the human skeletal musculature. Previous investigators have shown that metatarsal stress fractures accounted for 14% to 18% of all stress fractures in high-impact sports involving jumping and running [35,36]. Approximately 80% of these fractures were found in the second and third metatarsals in the forefoot [37].…”

Section: Discussionmentioning

confidence: 99%

Plantar Loads of Habitual Forefoot Strikers during Running on Different Overground Surfaces

Zhang

et al. 2020

Applied Sciences

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The objective of this study is to investigate plantar loads characteristics of habitual forefoot strike runners while running on different surfaces. Twenty-six runners (age: 28.2 ± 6.8 y, height: 172.9 ± 4.1 cm, weight: 67.7 ± 9.6 kg, BMI (body mass index): 22.6 ± 2.8 kg/m2, running age: 5.0 ± 4.2 y, running distance per week: 14.6 ± 11.7 km) with habitual forefoot strike participated in the study. Runners were instructed to run at 3.3 ± 0.2 m/s on three surfaces: grass, synthetic rubber and concrete. An in-shoe pressure measurement system was used to collect and analyze plantar loads data. Running on the synthetic rubber surface produced a lower plantar pressure in the lateral forefoot (256.73 kPa vs. 281.35 kPa, p = 0.006) than running on concrete. Compared with the concrete surface, lower pressure–time integrals were shown at the central forefoot (46.71 kPa⋅s vs. 50.73 kPa⋅s, p = 0.001) and lateral forefoot (36.13 kPa⋅s vs. 39.36 kPa⋅s, p = 0.004) when running on the synthetic rubber surface. The different surfaces influence plantar loads of habitual forefoot strikers and runners should choose appropriate overground surface to reduce the risk of lower extremity musculoskeletal injuries.

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Section: Discussionmentioning

confidence: 99%

Plantar Loads of Habitual Forefoot Strikers during Running on Different Overground Surfaces

Zhang

et al. 2020

Applied Sciences

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“…Vertical loading, which is positively correlated with peak tibia acceleration [78,79], was most frequently used in the included articles to investigate the effects of wearable devices on running. Approximately 10% incidence of injuries are related to tibial stress fractures in runners [68,80], and there is a recurrence rate of 40% [81]. Tibial acceleration, VALR and VILR are good indicators for risk tibial stress fractures [82] and, therefore, key variables in running injury prevention.…”

Section: Discussionmentioning

confidence: 99%

Effects of Wearable Devices with Biofeedback on Biomechanical Performance of Running—A Systematic Review

Giraldo-Pedroza

Lee

Lam

et al. 2020

Sensors

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This present review includes a systematic search for peer-reviewed articles published between March 2009 and March 2020 that evaluated the effects of wearable devices with biofeedback on the biomechanics of running. The included articles did not focus on physiological and metabolic metrics. Articles with patients, animals, orthoses, exoskeletons and virtual reality were not included. Following the PRISMA guidelines, 417 articles were first identified, and nineteen were selected following the removal of duplicates and articles which did not meet the inclusion criteria. Most reviewed articles reported a significant reduction in positive peak acceleration, which was found to be related to tibial stress fractures in running. Some previous studies provided biofeedback aiming to increase stride frequencies. They produced some positive effects on running, as they reduced vertical load in knee and ankle joints and vertical displacement of the body and increased knee flexion. Some other parameters, including contact ground time and speed, were fed back by wearable devices for running. Such devices reduced running time and increased swing phase time. This article reviews challenges in this area and suggests future studies can evaluate the long-term effects in running biomechanics produced by wearable devices with biofeedback.

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“…A runner who suddenly increases the intensity and duration of training is at risk for developing a stress fracture [2]. A tibial shaft stress fracture is the most frequent such fracture in athletes [3, 4]. The tibia is reported to be the most common site of stress fractures, accounting for 35–56% of all stress fracture injuries [5].…”

Section: Introductionmentioning

confidence: 99%

“…In most cases, conservative treatment is sufficient, and surgical treatment is very rarely needed. The most predominant type is the low-risk posteromedial cortex (compression side) stress fracture [3, 12, 13]. However, to the best of our knowledge, no previous reports have specifically examined complete posterior tibial stress fractures.…”

Section: Introductionmentioning

confidence: 99%

A complete posterior tibial stress fracture that occurred during a middle-distance running race: a case report

Komatsu

Mogami

Iwase

et al. 2018

Arch Orthop Trauma Surg

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Posterior tibial stress fractures are more frequent than anterior tibial stress fractures, and they are considered to have a good prognosis for returning to sports; cases leading to a complete fracture are rare. A 17-year-old male involved in high school athletics middle-distance running had a 3-week history of pain with training. He was running up to 300 km/week on streets and cross-country in an even distribution. He had posterior tibial stress fractures, but despite the lower leg pain, he continued running. One year later, he was brought to the emergency department after having sustained an injury to the right lower leg while running in a middle-distance race; bilateral tibial stress fractures, with one side complete and the opposite side incomplete, had developed simultaneously. This relatively rare case of bilateral posterior stress fractures, with one side a complete fracture and the opposite side an incomplete fracture, that was treated surgically via exchange intramedullary nailing is reported. The patient could begin light jogging from 3 months after surgery and was without symptoms at 5 months after surgery. He could resume middle-distance racing after 1 year. Posterior tibial cortical fractures are more common and respond better to conservative treatment than anterior tibial stress fractures, and they are a common fracture type in runners. We believe that close, careful follow-up is necessary if patients continue excessive training.

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Stress Fractures

Cited by 257 publications

References 0 publications

Plantar Loads of Habitual Forefoot Strikers during Running on Different Overground Surfaces

Plantar Loads of Habitual Forefoot Strikers during Running on Different Overground Surfaces

Effects of Wearable Devices with Biofeedback on Biomechanical Performance of Running—A Systematic Review

A complete posterior tibial stress fracture that occurred during a middle-distance running race: a case report

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