What is the most important ingredient for healing a stress fracture? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
We all know stress fractures are common in runners and if you get one it’s a real bummer because the most common advice you’re going to get from a doctor is to stop running, rest, relax, let it heal and then start training after it heals. But you know as a runner that if you do that, it’s going to take a long time for it to heal. You want it to heal quickly as possible so you can get back to running as quickly as possible.
In the Injured Runners Aid Station, I got a question from a runner who wanted to know what the most important ingredient for healing a stress fracture actually was. And we’re talking about nutritional ingredients like what you eat, is there some missing thing, and well, maybe you may have something missing but most people want to go try to get some kind of blood tests and chase down to see if they have a vitamin D deficiency or something like that. You can check all that if you want.
But the way I think about it is really simple. You need to eat a healthy diet. You also need to make sure you have the ingredients available for repairing the fracture at the appropriate phase. When you first get a stress fracture, believe it or not what I think is one of the most commonly missed ingredients is water.
What happens when you get a stress fracture? Well, when it first starts your foot may be swollen, it may be red, it may be hot and it may be distended where you don’t even see the wrinkles in the skin anymore. Why? Because you have an inflammatory process happening. There’s swelling, and the fact is, is that when you crack the bone, there’s bleeding in the tissue, an immediate repair starts and the only way to get the broken stuff out, the garbage out and the ingredients or the raw materials to rebuild the bone and repair the bone in is through fluid.
The fluid is your highway to actually get the cells in there to do the repair work and to get the raw materials in to do the repair work and to get the metabolic waste products or the junk out of your foot that are resulting from the actual injury itself. So, you’ve got to stay hydrated during that initial period, that’s really important. And of course, what happens is that you know, we’re training, we’re drinking lots of water, we’re doing that kind of stuff, then you get a stress fracture. Your foot hurts, you’re not training anything, it doesn’t matter. Well, it does matter. So, during that first phase, water is super important.
The second one is collagen. The initial phase of stress fracture healing, when it goes from inflammatory phase to actually like repairing it and holding the bone still when the crack is, well that’s the phase where you get soft callus forming within the bone. And that soft callus is mostly made of collagen. So, if you think that you need vitamin D and calcium, you may, but not during that part. It’s not calcifying yet. It’s not ossifying or turning into bone yet. It’s just forming this sort of glue made of collagen that holds it all still and you have to get that before it can actually turn into this hard mineralized bone that you would see on an x-ray.
The third phase is where you actually need vitamin D and calcium and that’s where you’re starting to get ossification. You’re getting mineralization. It’s turning from basically a crack that’s glued together with collagen to a crack that’s being welded together with solid bone and that part you do need vitamin D and calcium for that.
If you want to understand what you really have to do with stress fractures is not about finding one missing ingredient. It’s not about waiting for the next x-ray and it’s not about trying to get some fancy gizmo that’s going to shortcut the process for you. It’s really trying to figure out how you can get back to running as quickly as possible and maintain your running fitness while you heal the stress fracture.
If you want to learn about my framework for how I do that with injured runners, you can get it for free at stress fracture masterclass. It’s www.docontherun.com/stressfracturemasterclass. So, go check it out, and I’ll see you inside the training.