When is it okay to add weight bearing exercises when you’ve had a bone injury like a stress reaction? Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.
Today’s episode comes from another YouTube viewer who posted a comment and posted a question, “I have a low risk grade to stress reaction in my posterior tibia, which is the shin bone. Interestingly, there is some research discussing the benefits of weight bearing bone building exercise once tolerated pain free, like hops jumps and step ups. Do you have any advice on when and how to integrate these types of exercises into a rehabilitation program?”
Well, the short answer is yes. I do have some advice on this a couple of things really and they’re extremely important because I get these questions literally every day from people I have not met, have not evaluated, have not diagnosed and they want to know always, it’s never really anything other than can I do this exercise now, was what these questions always amount to.
The short answer is yes, I do have some advice on when you can incorporate these kinds of exercises that could potentially stress the bone and stimulate it to develop bone, lay down bone, remodel bone faster, and it’s really simple. It comes down to two things.
Number one, you can do these kinds of exercises when your treating doctor says it’s okay. The fact that this person wrote in and said “I have a low risk grade to stress reaction in the tibia” tells me that a doctor has in some way evaluated it probably with an MRI and probably X-rays as well and has made this diagnosis presumably determining what’s really wrong with the patient.
So, that brings up point number two, you can do these kinds of exercises. Number one if your doctor says it’ okay, number two, when you have clear indication that you can do those exercises without stressing the bone too much. The goal with any injured runner is to figure out how to add more exercise and that is a lot of what I teach whenever I run the Fast Track challenge which only runs about once a month and I only let a few people in.
But all recovering runners are clearly in a race against time and we must face it, you built months or years building your fitness and then you get injured and you stop exercising, you start to rapidly lose that fitness and the loss of fitness is exponential as time goes on without exercising.
The goal is to always match the healing of the tissue that has been injured with the new level of strength in that healing tissue. And as this question implies that once it’s tolerated in some way that you should be able to add more exercise but many runners do get into a cycle of reintroduction of running too early and re-injury as a consequence of that. So that’s what you have to avoid at all costs. Getting injured again is not going to get you back to running your goal races any faster. You’ve got to make sure that you’re getting evaluated.
What I do not understand truthfully, is why so many people go to the doctor, get an accurate diagnosis and then ask me as a YouTube comment or in a random post about what would you advise I do. I advise you to ask your doctor number one, but number two, if you don’t have a doctor and you’ve made this diagnosis on your own, you can figure it out, just like I teach people how to do that in the stress fracture masterclass, the how to run with a stress fracture course and all of those things, the Fast Track challenge.
It’s really what we teach, but you have to be systematic about it the same way that a doctor would be systematic about it, just focusing more on running the hop test to stress the bone or doing box jumps or something like that or even step ups or running stairs. You’ve got to be systematic about this. You add those things incrementally, systematically, making sure that you’re not over stressing the bone.
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