stress reaction Archives - DOC

#861 Chronic stress reaction versus acute on chronic stress reaction in a runner

I just had a consultation with a runner who had foot pain that she thought might be a stress fracture that had been coming and going for about a month.

She had been increasing her training volume and doing strength exercises that are supposed to build her running fitness.

The pain seemed to be volume related. The more training she did, the more she would notice the discomfort in her foot.

But when we x-rays of her foot, the radiologist suggested this could be an “acute on chronic” stress reaction.

What does that mean?

What is the difference between a chronic stress reaction, or an acute on chronic stress reaction in a runner?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#844 When is fracture boot really needed with metatarsal stress fracture?

I believe the most commonly prescribed and most overprescribed treatment for injured runners is probably a fracture walking boot.

The big question for your doctor is…

Is the fracture walking boot really necessary or not, given my stage of injury recovery?

When is a fracture walking boot really necessary for a metatarsal stress fracture?

Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.

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#841 Why Stress Fracture Grading is BS for Runners

I just had an interesting call with an elite runner, who’s a high school cross country runner.

He developed a tibial stress fracture, or stress reaction.

But he thought it was shin splints.

When I looked at it with ultrasound, I saw some stuff that made me really worried about it. So, I got an MRI to confirm.

The first question he had was, what’s the grade?

Grading scales cause confusion.

Today on the Doc On The Run Podcast we’re talking about why stress fracture grading is BS for runners.

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#840 What is periosteal elevation in tibial stress reaction?

When you get a stress fracture, one of the earliest visible indications on an X-ray or an MRI or a CT scan is a thing called periosteal elevation. Your doctor might see it on ultrasound, x-rays or MRI studies….way before your ever see a crack in the bone.

Since it’s one of the earliest changes in the bone when you start to get a stress fracture, I thought it might be useful to talk about the term “periosteal elevation” really means.

What is periosteal elevation in a stress fracture in a runner?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#838 My Stress Fracture Framework simplified

If you’re a runner and you get a stress fracture, the number one most important thing that you do is get it to calm down while you maintain your running fitness.

Based on those ideas, I built a framework that I’ve been using for years with injured runners who want to heal and want to get back to running.

In this episode we will go through my stepwise process of how I do it.

Today on the Doc On The Run Podcast we’re talking about my stress fracture framework simplified.

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#821 I had a sudden injury but my doctor called it a stress fracture

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I had an interesting question from an athlete who asked,

“I had an injury, I went to see the doctor and got an X-ray. There was no crack on the X-ray, but my doctor called it a stress fracture. So, I’m confused.”

“I thought that a stress fracture happens when you run too much, too far, too soon, it overloads the bone, and you get a little crack in it. I didn’t do that. It was trauma, a sudden injury, not a bunch of force applied over a long period of time. I wasn’t training for anything. I don’t get it. Why is my doctor calling this a stress fracture?”

I had a sudden injury, but my doctor called it a stress fracture.

That’s what we’re talking about today on the Doc On The Run Podcast.

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#817 What causes most of the pain when I have a stress reaction?

If you get a metatarsal stress fracture, the first thing that you’re going to notice is not that you have a broken bone in your foot.

You are going to notice pain.

Typically, the feeling starts as a little vague discomfort in your foot that progressively gets worse as you continue to train and run on it.

The soreness gets worse the longer you run, feels worse when you walk barefoot on hard surfaces and becomes more notable going up and down wooden stairs.

As I explained this to a runner in the Injured Runners Aid Station, she asked “What really causes the pain?”

What causes most of the pain when you have a metatarsal stress fracture?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#812 Difference between a mild stress fracture and a serious stress reaction in a runner?

I had a call with a runner who asked me an interesting question about the difference between a mild stress fracture and a serious stress reaction in a runner. She wanted to know if the difference was based on the amount of tenderness or pain that she had.

Although it stands to reason that the more tenderness, the more pain you have, the worse it must be. However, that is not really what differentiates a mild stress fracture from a serious stress reaction.

What’s the difference between a mild stress fracture and a serious stress reaction in a runner?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#753 Fibula stress reaction vs stress fracture what is the difference?

If you have ankle pain and you push around on that lump of bone on the outside of your ankle, you may realize that you have pain on the bone specifically.

If so, you might become worried that you have a thing called a fibular stress fracture.

If you start trying to figure out what to do, one of the first things you may find is a lot of discussion about something called a “stress reaction” instead of just a “stress fracture”.

What’s the difference between a fibular stress reaction and a stress fracture in a runner?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#702 Bone bruise vs stress reaction in a runner

Whenever I speak to a runner who wants to know if they can run with a bone bruise, I get confused. If you were “diagnosed” with a bone bruise, you should be confused, too. A bruise is a very simple thing. You fall down and land on your knee and you get a bruise. You get a bruise because your kneecap crushes the skin against the ground and you get bleeding in the skin that you see as discoloration that we call a bruise. You can’t see that in a bone. When you get diagnosed with a bone bruise, you have to think of it in terms of bone injury, like a stress fracture. The continuum of bone injury includes stress response, stress reaction and stress fractures. You have to understand the severity of the bone injury before you can decide whether or not to run. What is the difference between a bone bruise and a stress reaction in a runner? Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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