Health & diet affects on stress fracturesĪs well as low levels of Vitamin D being an issue, runners should take care to ensure they have adequate calcium levels. This can cause more medial overload on legs and therefore a greater chance of stress fractures. In addition, if you change too quickly to a more minimalist or barefoot running shoe, this can lead to steps fractures in the bones of the foot or ankle.Īnother issue can come for runners who over-pronate. However, forefoot strike can also increase the landing force on the bones of the foot and ankle, so this might not be your chosen running gait either. Running style – and stress fracturesĪssessing your running gait can give clues to the people who are more likely to suffer a stress fracture. For example, it’s been shown that runners who stretch out their stride, or over-stride, and therefore heel strike, are more prone to tibial stress fractures. Research has also shown that women are more prone to stress fractures if they have a low BMI and irregular periods. This is a crucial vitamin for strong bones. This could be that a lack of sunshine and daylight has lead to a Vitamin D reduction. It’s claimed that stress fractures are more likely in winter. This allows the muscles and bones to naturally heal and recover as stronger rather than forcing them to work hard again too soon. Older runners, or female runners going through menopause or post menopause, should allow more recovery time in between impact activities, such as running. While running is considered to be a good way to maintain denser muscles and bones, we also need to give our bodies time to recover. A reduction in the hormone oestrogen that comes with the menopause can lead to osteoporosis (brittle bones). For women, the peri-menopause and menopause years can exacerbate this issue. Production and hosting by Elsevier B.V.Women, especially in the menopause years, can be more prone to stress fracture from running (Image credit: Getty) Age and menopauseĪs we age, our bone density and muscles naturally become weaker or less robust. We encourage additional studies with larger sample sizes of runners with TSF and controls and adequate statistical power to confirm or refute these findings.īone stress injury Gait Kinematics Kinetics Tibial acceleration.Ĭopyright © 2023. However, many were reported by only a single study, and sample sizes were small. In individual included studies, many biomechanical variables were not statistically significantly different between groups. Meta-analysis indicated that discrete ground reaction force variables were not statistically significantly different in runners with TSF compared to controls. Individual studies found larger tibial peak anterior tensile stress, peak posterior compressive stress, peak axial acceleration, peak rearfoot eversion, and hip adduction in the TSF group. Meta-analysis of peak impact, active, and braking ground reaction forces found no significant differences between groups. Many variables were not significantly different between groups. Most studies were retrospective, 2 were prospective, and most had a small sample size (5-30 per group).
The search retrieved 359 unique records, but only the 14 that compared runners with TSF to controls were included in the review.
Risk of bias was assessed and meta-analysis conducted for variables reported in 3 or more studies.
The aim of this systematic review and meta-analysis was to evaluate biomechanics in runners with TSF compared to controls.Įlectronic databases PubMed, Web of Science, SPORTDiscus, Scopus, Cochrane, and CINAHL were searched. While many running studies refer to biomechanical risk factors for TSF, only a few have compared biomechanics in runners with TSF to controls. Tibial stress fracture (TSF) is an overuse running injury with a long recovery period.
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