{"id":1949,"date":"2011-04-22T08:27:31","date_gmt":"2011-04-22T14:27:31","guid":{"rendered":"http:\/\/summit-education.com\/?p=1949"},"modified":"2011-04-22T08:35:26","modified_gmt":"2011-04-22T14:35:26","slug":"stress-reactions-in-recreational-endurance-athletes","status":"publish","type":"post","link":"https:\/\/summit-education.com\/blog\/general\/stress-reactions-in-recreational-endurance-athletes\/","title":{"rendered":"Stress reactions in recreational endurance athletes"},"content":{"rendered":"

\"\"<\/a>Entry By: Eric Folmar, MPT, OCS, PT<\/h4>\n

I am looking for some commentary on stress reactions of the lower extremity in recreational endurance athletes.\u00a0 In the spirit of the Boston Marathon this past Monday, I think this is an appropriate topic.\u00a0 I have had the privilege of treating 4 patients with stress related injuries directly related to training for Boston.\u00a0 As we all know stress reactions\/fractures are very delicate to work with,\u00a0for many reasons.<\/p>\n

First, and probably foremost, is personality associated with the injury.\u00a0 To me these fall into 2 categories:\u00a0 the crazy, insane, stop-at-nothing endurance athlete type\u00a0and the highly motivated, new to training, have to meet my goals type.\u00a0 Both can be difficult to reel in and get on board with the appropriate treatment plan.<\/p>\n

Second issue is what exactly are we dealing with.\u00a0 A stress fracture or a stress reaction.\u00a0\u00a0 Just like any other diagnosis….\u00a0 if we catch it early and correct the abnormal stresses we can get the patient back to sport much quicker.\u00a0 If it has progressed to a fracture, we obviously have to respect the fracture healing in additional to identifying the abnormal stress.<\/p>\n

The final issue is the actual treatment plan.\u00a0 What is right???\u00a0 Often times the plan goes something like this:\u00a0 immobilize, rest, rehab, and return to activity.\u00a0 What often is missing is the correction of biomechanical faults?\u00a0 These patients did not develop stress related injuries randomly….. at least not typically.\u00a0 There is often an underlying, unidentified biomechanical issue…. or perhaps it was simply a change thatoccurred in what the patient had been doing.\u00a0 For instance…. one of the patients training for Boston came to me with a diagnosis of a cuboid stress reaction.\u00a0 She was 10 weeks before marathon monday and had been told that she was out of the race.\u00a0 Easy to say for a doctor that hadn’t trained for a year and raised the required $3800 or so for running on a charity exemption.\u00a0 She is well known to my clinic.\u00a0 On evaluation she reported that she had rested for 2 weeks and was pain free for all activity except running.\u00a0 Pain was isolated over the cuboid.\u00a0 She had not strayed from her previously outlined training program.\u00a0 Her only change was her shoeware.\u00a0 She had changed 4 weeks prior from stability plus sneakers to Asics Gel Nimbus (neutral) shoes on a recommendation from a friend.\u00a0 Her mechanics are such that she is a severe overpronator and that was the final straw.\u00a0 A few weeks with no support and increasing mileage left her destined for trouble.\u00a0 Upon identifying this we decided to change her to Asics 2150 series sneakers (stability plus) and go with an OTC Vasyli orthotic with some varus FF and RF posting.\u00a0 We began a slow, gradual return to running program (100% painfree).\u00a0 Within 5 weeks she was back on track for her marathon training, albeit at a slowere, more controlled pace.\u00a0 She completed her marathon on Monday painfree.<\/p>\n

So after a drawn out entry what is my point.\u00a0 Identifying underlying mechanics and the stage of injury can lead to much greater success in treating an otherwise frustrating and frustrated patient population.\u00a0 2 of the stress injuries we worked with were able to complete their marathons.\u00a0 The other 2 were full stress fractures and were unable to run.\u00a0 We are working on making sure they make good on their goals next year.<\/p>\n","protected":false},"excerpt":{"rendered":"

Entry By: Eric Folmar, MPT, OCS, PT I am looking for some commentary on stress reactions of the lower extremity in recreational endurance athletes.\u00a0 In the spirit of the Boston Marathon this past Monday, I think this is an appropriate topic.\u00a0 I have had the privilege of treating 4 patients with stress related injuries directly […]<\/p>\n","protected":false},"author":13,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","om_disable_all_campaigns":false,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1949","post","type-post","status-publish","format-standard","hentry","category-general"],"aioseo_notices":[],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/posts\/1949"}],"collection":[{"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/comments?post=1949"}],"version-history":[{"count":6,"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/posts\/1949\/revisions"}],"predecessor-version":[{"id":2146,"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/posts\/1949\/revisions\/2146"}],"wp:attachment":[{"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/media?parent=1949"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/categories?post=1949"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/summit-education.com\/blog\/wp-json\/wp\/v2\/tags?post=1949"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}