How can we reduce bone stress injuries?

Cross-training and Multidirectional Activities Are Key!

Running is such a great form of exercise. Pop your shoes on, head out the door, and you’re into it.

It’s bang for your buck, low cost, and easily accessible for everyone.

We're runners too, and we are acutely aware of the loading that goes through your body as you run and increase your running.

Bones are fascinating structures, immensely strong, and in a state of continual regeneration. Simply put, bone stress injuries happen when the load increases too quickly, and the body doesn’t regenerate new, stronger bone fast enough to cope with the increased stress.

This stress could be due to an increase in volume, frequency, speed, distance, or—worst of all—any combination of these factors!

So what can we do to prevent this, apart from being careful with changes in training?

A relatively recent study looked at this in collegiate cross-country runners -where bone stress injuries are especially prevalent in young female athletes.

A study by Warden et al. (2022) investigated whether participating in multidirectional sports (MDS) during youth influences bone health in female collegiate cross-country runners. Bone stress injuries (BSIs) are a common concern for these athletes, and stronger bones could potentially reduce their risk.

The study looked at whether playing sports like football or basketball during childhood helps build stronger bones in female college runners. The research compared two groups: one that only focused on running and another that also played multidirectional sports when they were younger.

The Takeaway:

The results showed that the women who played multidirectional sports as children had stronger bones in key areas like the legs and feet compared to those who only ran. This suggests that participating in a variety of sports during youth might help build stronger bones, potentially lowering the risk of injuries as they get older.

Important to Note:

• This study only looked at female athletes.

• The design doesn’t prove cause-and-effect, just an association.

• The study involved a relatively small group of participants.

The researchers recommend that young athletes delay specialising in just one sport (like running) and consider including MDS in their training to promote bone health.

This echoes our previous blog post on kids specialising in sports, which you can read here: https://www.urbanathlete.co.nz/blog/kidsspecialisinginsport

Now, I don't imagine many of you out there reading this are female college runners, so how does this apply to adult runners?

While the study focuses on collegiate athletes, the implications are significant for adult runners too.
As we age, bone density naturally decreases, particularly in women post-menopause, making it even more important to adopt strategies that strengthen bones and reduce the risk of injuries.

Highlighting the Importance of Early Prevention and Continued Care

• Multidirectional activities: The benefits of multidirectional sports during youth can have lasting effects, but it’s never too late to start incorporating these principles. For adults who didn’t engage in multidirectional sports in their youth, cross-training with activities that challenge the body in different planes of motion (e.g., tennis, gym classes, dancing, or strength training) is still very beneficial.

• Ongoing Strength Training: Strength training, particularly exercises that load the bones (like squats, lunges, and deadlifts), should be a key component of any runner’s routine. This helps to maintain bone density and reduce the risk of stress fractures.

Additional Tips for Reducing Bone Stress Injuries:

• Gradual Increase in Training Load: Reinforce the importance of increasing training intensity, volume, and frequency gradually. The 10% rule, where you don’t increase your weekly mileage by more than 10%, is a useful guideline.

• Proper Nutrition: Adequate intake of calcium and vitamin D is essential for bone health. Consider discussing the role of nutrition, emphasising foods rich in these nutrients, and the potential need for supplementation, especially in women.

•  Bone Density Screening: For female runners, especially those with a history of disordered eating, amenorrhea, or early menopause, regular bone density screening can be an important preventative measure.

• Listen to Your Body: Try to figure out how your body is coping to increased training and what feels more than your normal aches and pains when increasing your loading. Early intervention can prevent a minor issue from becoming a major one.

Conclusion:

The research backs up importance of a well-rounded approach to training that includes multidirectional activities- variety is key!

For adult runners, whether or not they benefited from this type of training when young, having variation in your training program now that includes strength training, proper nutrition, and gradual progression in running can go a long way in preventing bone stress injuries.

Final Thoughts:

This is a great time to think and reflect on your current training and exercise routine.

Could you also include multidirectional activities (simple things like pump classes will add a touch of this) to complement strength training?

Any other changes you could make to support your bone health?