Bone Stress Injuries - High Risk vs Low Risk

Bone Stress Injuries - High Risk vs Low Risk

In the final part look at bone stress injuries, we are going to look at high versus low-risk injuries. First of all, what makes some injuries high risk and others low, well, essentially this relates to how likely it is that an injury in this is area is to fail to resolve, or progress to more serious injury.

Thus high-risk stress fractures are those where evidence has shown that there is a likelihood of the injury at best failing to resolve, and at worst progressing along the spectrum to more significant pathology. The implication of this is that higher risk injuries are often managed more aggressively, be that adoption of non-weight-bearing, or in some instances surgical management.

The difficulty for athletes and coaches, and health professionals for that matter, is knowing which injures are high versus low risk. Take the example of lower bone stress injuries of the tibia, when these occur in the inside of the lower tibia (distal medial tibia) they are associated with excellent recovery and can often be identified early and managed with a simple modification of training and recovery, conversely, injuries to the front of the upper tibia (upper anterior tibial cortex) can present a much more complex clinical decision process and are best managed with input from orthopedic specialists and potential surgical intervention.

While there are multiple resources which provide lists of which regions are high and low risk, understanding the implications of this means also understanding a patient's other risk factors, including sporting and injury history, dietary history, hormone status and a myriad of other factors, and for that reason, if unsure, it is always best to get guidance on how to best manage these early.

Thanks, and please post a comment if you have any questions.

Michael Hedger