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Spinal Stress Fractures and Runners | Boddicker Performance

Filed under: corrective exercise, injuries, Running

Spinal Stress Fractures and Runners

by on Jan 22nd, 2009

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In climbing the road to the top of the performance mountain, most athletes realize that staying focused and consistent in training help tremendously to get to the top of his personal Everest.  Any injury to the athlete, obviously, interferes with the consistency of training and thus makes progress to the top of the road that much more difficult.  Recently, I’ve begun to see more and more athletes who have suffered from stress fractures to the sacrum and spine, which has led me to search for the causes and how I can go about helping athletes prevent such injuries.

The spinal stress fracture is an interesting animal in that many athletes could have an imaging study done on their lumbar spine and sacrum and have the results come back positive for a stress fracture, however, they feel no pain nor impaired function.  Others with a similar injury will be knocked down to their knees in pain with even the smallest impact.  The most common location for such fractures seems to be the L5 vertebrae.  So how can two athletes have the same injury, but one can train at full strength and the other can barely move pain free?  The answer lies in the efficient athlete.  The asymptomatic athlete is likely stable in the right places, mobile in the right places, and is efficiently activating the right musculature to accomplish the complex movement pattern known as running.  The injured athlete is likely exhibiting the hallmarks of Janda’s Lower Crossed Syndrome, which is characterized by tight Rectus Femoris, TFL, Erector Spinae, hamstring, and the short and long adductors while also exhibiting weakness in the Glute complex, Rectus Abdominis, and often the Psoas of runners.  Modern society has become a significant contributor to LCS as people are sitting far more than ever before, which leads to significant postural distortion.

How, then, should an athlete go about training to improve efficiency and prevent injury?  The best route includes a multi-pronged approach to training.  In other words, the days of kicking down the door and just going for a run is over.  Instead, the athlete should focus on the following:

  • Optimize hip extension range of motion with dynamic movement drills before training.
  • Facilitate hip extension by activating the Glute complex first in a simple, isolated scenario which is then progressed into a more complex pattern.
  • If determined necessary, activate the Psoas with simple, isolated exercises then progress into more complex tasks.
  • Stabilize the lumbar spine with planks, anti-rotational chops and presses, and other abdominal stabilization exercises.
  • Foam roll and static stretch the tight tissues following training sessions.

The above training considerations will go a long way in improving form and function while decreasing the likelihood of repetitive stress injury to the lumbar spine.

Until next time, train hard, train smart.

-Carson Boddicker

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  • Sheryl C June 25, 2011

    My son (now 19 years old) is a runner. He was diagnosed by MRI (April 2010) with 2 pars stress fractures at L4. I read this article with much interest. He is the runner with extreme pain.
    He was put in a back brace for 3-4 months, followed up with physical therapy. And is still in severe pain on the right side. We are currently with a sports medicine/back specialist (after seeing 2 specialists locally with no success). A recent CT scan shows that neither fracture has healed.
    A bone stimulator has been ordered.
    Can you suggest any treatments, supplements, etc. that could help in his healing so that he can get back to running.

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