Dubai, UAE- Dr Ertugrul Karanlik – Consultant Sports Medicine specialist explains his approach to treating stress fractures.
A Sports medicine specialist’s approach to Treatment
Phase 1 of the protocol begins with pain control provided via ice massage, physical therapy modalities, and oral analgesic medications. The use of a non-steroidal anti-inflammatory drug (NSAIDs) should be avoided due to its potential adverse effect on bone healing. Weight-bearing, as tolerated, is allowed for daily activities, but participation in high impact & competitive sports should be discontinued. Walking boots can be provided for athletes who are unable to ambulate without pain. Minimal-impact aerobic activities (using an elliptical machine, cycling, pool running, etc.) can help maintain cardiovascular fitness.
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Phase 2 begins when the injured athlete has been pain-free for 10–14 days. One week after the resolution of focal bony tenderness, running may be resumed at half the usual pace and distance. Initially, athletes with a healing fracture should run only every other day for the first 2 weeks after pain resolution and should gradually increase running to the pre-injury level over 3 to 6 weeks under proper supervision. The progression of that type of exercise should be dictated by the patient’s pain level. The use of pneumatic braces may speed the healing of tibial stress fractures. High-risk stress fractures require different management.
Grades 1 and 2 stress fractures usually heal with nonoperative management, including weight-bearing restriction and immobilization that is based on the location of the fracture. To prevent progression to full fracture and associated complications, complete healing must be confirmed before the athlete returns to play. Factors such as the site of the fracture, a higher grade of fracture, and competitive participation requirements determine whether surgery is the treatment of choice.
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“Having built his practice in Germany, he has an extensive background in football medicine and general Sports medicine of all levels. He has headed the medical team of Bundesliga club FC Schalke 04, Germany” Dr. Ertugrul Karanlik, Consultant Sports Medicine