Bone Stress Injuries: Difference between revisions
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== Pathophysiology == | == Pathophysiology == | ||
When the bone is subjected to mechanical forces the forces cause adaptive changes in the trabecular (i.e internal architecture of bone), followed by secondary adaptive changes in the bone cortex (i.e external architecture of bone). In trabecular bone, the initial response to mechanical forces is the microdamage of the trabecular which is repaired by a microcallus. In cortical bone, the initial response to an increase in mechanical forces is osteoclastic activity (bone break down) which leads to resorption of bone. Osteoblastic cellular activity fills the resorption cavities with what is known as a lamellar bone. However, bone formation is slower than bone resorption. | When the bone is subjected to mechanical forces the forces cause adaptive changes in the trabecular (i.e internal architecture of bone), followed by secondary adaptive changes in the bone cortex (i.e external architecture of bone). In trabecular bone, the initial response to mechanical forces is the microdamage of the trabecular which is repaired by a microcallus. In cortical bone, the initial response to an increase in mechanical forces is osteoclastic activity (bone break down) which leads to resorption of bone. Osteoblastic cellular activity fills the resorption cavities with what is known as a lamellar bone. However, bone formation is slower than bone resorption.<ref>Kiuru MJ, Pihlajamäki HK, Ahovuo JA. [https://journals.sagepub.com/doi/abs/10.1080/02841850410004724 Bone stress injuries]. Acta Radiologica. 2004 May;45(3):000-.</ref> | ||
== Resources == | == Resources == | ||
Revision as of 09:25, 22 February 2021
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Original Editor - Puja Gaikwad
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Introduction[edit | edit source]
Bone Stress Injuries (BSI) are overuse injuries associated with repeated loading of bone by strenuous weight-bearing activities (such as running, jogging, marching) and inadequate recovery periods. BSI’s represent the failure of skeleton bone to withstand repetitive loading, leading to structural fatigue, localized bone pain, and tenderness around the area.[1] Bone Stress Injuries (BSI) are commonly seen in avid runners, track and field athletes, endurance athletes, military recruits, gymnasts, dancers, but also among otherwise healthy people who have recently started the new or intensive physical activity.[2]
Bone Stress Continuum[edit | edit source]
There is a continuum of bone stress injury varying from "normal to bone strain to stress reaction to the ultimate progression of a stress fracture. These injuries sit on a continuum whereby they start with a stress reaction (often called a ‘hot spot) which can progress towards a stress fracture and finally towards a complete bone fracture. Essentially, as the BSI progresses along the continuum, the longer it takes to recover.[3] Therefore, an understanding and early recognition of these injuries are critical to any athlete and their sports-specific goals.
BSI differs in severity, with initial findings of periosteal edema and marrow edema. In more severe conditions, stress fractures with distinct fracture lines are present. Stress fractures account for > 10% of total sports-related injuries and it could be as high as 30% in running. [4] Bone stress is common in the athletic and activity community, accounting for 10% of all sports-related injuries.[5]
Pathophysiology[edit | edit source]
When the bone is subjected to mechanical forces the forces cause adaptive changes in the trabecular (i.e internal architecture of bone), followed by secondary adaptive changes in the bone cortex (i.e external architecture of bone). In trabecular bone, the initial response to mechanical forces is the microdamage of the trabecular which is repaired by a microcallus. In cortical bone, the initial response to an increase in mechanical forces is osteoclastic activity (bone break down) which leads to resorption of bone. Osteoblastic cellular activity fills the resorption cavities with what is known as a lamellar bone. However, bone formation is slower than bone resorption.[6]
Resources[edit | edit source]
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References[edit | edit source]
- ↑ Song SH, Koo JH. Bone Stress Injuries in Runners: a Review for Raising Interest in Stress Fractures in Korea. Journal of Korean medical science. 2020 Mar 2;35(8).
- ↑ Pegrum J, Crisp T, Padhiar N. Diagnosis and management of bone stress injuries of the lower limb in athletes. Bmj. 2012 Apr 24;344.
- ↑ Tenforde AS, Kraus E, Fredericson M. Bone stress injuries in runners. Physical Medicine and Rehabilitation Clinics. 2016 Feb 1;27(1):139-49.
- ↑ Robertson GA, Wood AM. Lower limb stress fractures in sport: optimising their management and outcome. World journal of orthopedics. 2017 Mar 18;8(3):242.
- ↑ Spitz DJ, Newberg AH. Imaging of stress fractures in the athlete. Radiologic Clinics. 2002 Mar 1;40(2):313-31.
- ↑ Kiuru MJ, Pihlajamäki HK, Ahovuo JA. Bone stress injuries. Acta Radiologica. 2004 May;45(3):000-.
