Modified activity is the basis of stress fracture rehab. Staying active and training around the injury without further stressing the bone is important. Timing return to weight bearing activity and carefully monitoring training load in the long term is also paramount.
Phase 1
Day to day activity:Weight-bear as tolerated. For occupations with significant walking/ weight-bearing a walking boot may be required. Limit any unnecessary walking wherever possible.
Exercise: You can undertake non weight bearing exercise including swimming, upper body weight training only and grinder. You should not undertake any unnecessary walking, running, cycling, rowing, elliptical or anything with weight bearing attached to it. A sample exercise session for an endurance athlete may include swimming preferably with pull buoy to limit kicking, intervals on the grinder, high rep no rest circuit of upper body weights.
Phase 2
Day to day activity:Weight-bear as tolerated. For occupations with significant walking/ weight-bearing a walking boot may be required. Limit unnecessary walking wherever possible.
Exercise: Swimming, upper body weight training and cycling however there can be no walking, running or rowing. A sample exercise session for an endurance athlete might be as previously stated above in phase 1 but including cycling. You should aim to be performing a spin class by the end of week 4. It needs to be noted that the increase in exercise needs to be done gradually. You cannot expect to recover fully if you are increasing your high resistant loads 7 days a week. Best results will occur if your exercise regime is done slowly and progressively while adding variety wherever possible.
Phase 3
Day to day activity:Weight-bearing as tolerated.
Exercise: Swimming, upper body weight training, cycling and rowing while avoiding unnecessary walking and definitely no running. A sample exercise session for an endurance athlete might be as previously stated above in phase 2 but including rowing.
Sample rowing targets
• Aim for 2500m in 10 minutes. 1 minute row with 1 minute of rest. 10 intervals of 250m per minute.
• 2000m in the shortest time possible
• Concept 2 have a VO2 max calculator and well established records which you can test yourself against. Refer to:-http://www.com/us/interactive/ calculators/vo2max.asp
Phase 4
Day to day activity:Weight-bear as tolerated.
Exercise: Swimming, upper body weight training, cycling, rowing, low volume jogging on grass but definitely no running.
Sample exercise session for an endurance athlete: trial of 4 x 500m jog on grass 3 times over 2 weeks separated by at least 2-3 days
Pneumatic leg brace:
A pneumatic leg brace can help with symptom relief and allow you to tolerate earlier weight bearing activity without slowing recovery. A relatively aggressive rehabilitation protocol allows a quicker return to sport for uncomplicated, low-risk fractures. For these fractures, a systematic review found that treatment with a long air splint, also called a long air cast enables return to activity up to six weeks sooner than standard casting and other treatments.
Exogen:
Exogen is a form of Low Intensity Pulsed Ultrasound (LIPUS) which has been shown to accelerate bone healing. It needs to be applied daily at as close to the same time every day as possible. There is free use of Exogen at Sports Clinic NQ 5-6 days per week depending on opening hours.
Alter G:
Sports Clinic NQ has the only publically available ALTER G treadmill in Queensland. Previously only available to professional athletes and members of the armed forces, the Alter G treadmill allows you to run at only a fraction of your bodyweight. The ALTER G treadmill allows you
to run at as little as 20% of your bodyweight. This unit provides the following benefits:-
- Sport specific conditioning
- Graded return to running
- Appropriate bone loading to assist healing.
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