How to Design a Stress Fracture Rehab Plan

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Muscles, tendons, and bones. That's what I want to talk about today. So our muscles turn into tendons and they attach to bones. What happens is that tendon will attach to a specific site on a specific bone, and that allows us to move around, to jump, to squat, to run, and generally get about our day-to-day lives. Where that tendon attaches onto the bone, it creates a little tugging sensation. And when that tugging happens, the bone in that spot can get stronger. So when we stress bones with muscle contractions, they can get a little thicker in nature and their architecture, how they're set up, gets a little bit better. And that makes the bone stronger in the long run.
Let's do a little demo to show exactly how this works. Running is really predictable in nature. It's the same series of movements over and over again thousands, 10,000, 100,000 times as we get tired. This predictability is one of the reasons we think that runners tend to not have as strong of skeletons as other athletes. When we compare runners to people that play soccer, football, basketball, activities that involve cutting, jumping, stopping, starting, all these different things, we see that those athletes tend to have stronger skeletons than runners all on their own. Now, this can be a little bit of a problem because if we have a stronger skeleton, we lower our risk of developing a bone stress injury.
So what can we do to help runners develop really strong skeletons? There's three principles I think that we need to remember to help runners and other endurance athletes develop really strong bones. And I think a lot of this starts with that muscle, tendon, bone relationship. Bones like to get stressed a lot. We want our tendons to tug really hard on their insertion sites so the bones can get stronger. That's part of the reason I'm such a big fan of runners being involved with heavy strength training, heavy squats, heavy deadlifts, heavy calf raises, and plyometrics because these things produce higher loads on our skeleton than distance running by itself.
Bones get bored really quick. If we do the same thing over and over again, we see that our bone gets desensitized to the movement. Our body doesn't see any reason for it to continue to get stronger, so it just kind of goes to sleep. And that's the nature of distance running is that you're doing the same thing over and over again for sometimes hours at a time. So what we need to do is we need to split stuff up. We need those heavy loads that we mentioned in principle one, but we also need to make sure we're using rest breaks to our advantage because we see that if we insert some rest breaks into someone's strength training regimen or into their training, it gives our bones a chance to recover and eventually get stronger in the long run.
And the last thing we see is that our bones get comfortable after a while. So just like you wouldn't have the same training regimen indefinitely, we need to make sure we're continuing to progress what we're having someone do because at some point our bones adapt and they see no reason to continue to get stronger. You might start off with something like a goblet squat with a little bit of weight, but that needs to be progressed into a heavier front squat, a heavier split squat, a heavier back squat, whatever the variation might be, because that's what needs to happen for our bone to continue to adapt. We have to continue to increase the speed of movements, the weight that we're using, the volume of what we're training with, because we have to keep pushing the demands of that tissue so it continues to respond.
If we do the same thing over and over again, our bones see no reason to get stronger. And that's one of the errors that I see is that people get a set of exercises maybe after rehab or if they consult with the trainer and they're never progressed. They have to continue to get more aggressive in nature. I think we can even be better about being specific with our athletes with these exercises. When you think about a front squat, you would say that would load your quadriceps. And that makes sense. That's how we learn in kinesiology or whatever training regimen that you go through. But I also want you to think about how when our quads contract hard, it loads your femur. So movements like that make your femur more resilient in nature. And so if someone's coming off a femoral neck stress fracture or a femoral shaft fracture, that's a meaningful exercise for that individual. We need to be specific with the exercises we choose based off of what that individual is coming off of as well as what their past medical history looks like.

[@jonathanyoung4873]

Can you please do a video of a strength routine for stress fracture recovery thanks your videos are really helpful 💪

[@pelesaudavel7655]

Hi! :) How your recovery has been?

[@delfinapierrez8873]

Very knowledgeable, thank you

[@NathanCarlson]

Glad it was helpful!

[@edenstarodovich2791]

Well don
Helped a lot!

[@NathanCarlson]

Thanks!!

[@hoospoodles]

what are the exercises

[@iliasettaoussi4680]

this should be after bone has fully gone back to normal or this exercises should be throug out the pain ?

[@NathanCarlson]

The biggest key in early stress fracture rehab is that everything is pain-free!

[@edenstarodovich2791]

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