A stress fracture is a tiny crack in the bone, but it can put a dent in an active lifestyle. Mainly, stress fractures are classified into two groups: Low-risk and high-risk. The odds of having any of these stress fractures can be related to osteopenia, shin splints, running, weak bones, tendon injuries, and more.
Low-Risk Fracture
Low-risk fractures are often caused by repetitive motion or stress on the bone, which leads to small cracks in the area. This can mostly occur in runners and dancers. According to Current Sports Medicine Reports, 69% of stress fractures are related to running, making it the most frequently associated sport. According to other research, stress injuries account for 19% of injuries sustained by pre-professional dancers. Tibial stress fractures also take a longer time to recover, which is a necessity for dancers to fully return to their practice. While low-risk stress fractures typically respond well to traditional treatments, up to one-third of cases may not, which potentially progresses to high-risk stress fractures.
High-Risk Fracture
Unlike their low-risk counterparts, high-risk fractures can be caused by underlying health conditions, direct impact, or trauma that might not heal as easily. In fact, osteoporosis.ca reports that fractures from osteoporosis are more common than heart attack, stroke, and breast cancer combined. Canadians are at a higher risk of having a major fracture from osteoporosis in Canada due to weather and climate conditions, reports the same source. Not being able to treat high-risk fractures for a long period of time can lead to permanent disability.
Research and Scientific Evidence
A study published in the International Journal of Surgery in 2015 revealed that using shockwave therapy is a proven approach to treating stress fractures. Shockwaves, based on the stimulation of bone turnover, osteoblast stimulation, and neovascularization through mechanotransduction, have shown success in treating delayed unions. The study presents the use of focused shockwave treatments in professional athletes and military personnel, reporting a high rate of recovery and pain control.
Another study published in the National Library of Medicine in 2010 suggests that shockwaves showed an effective result in treating nonunions, avascular necrosis, and delayed healing of stress fractures.
Another recent study, published in the same journal in 2023, involved a review of 40 runners with 41 injuries, which focused on their experiences with shockwaves from August 2018 to September 2022. The participants, mainly females with an average age of 30, were diagnosed with BSI, and 63% of them were categorized as moderate- or high-risk for the female or male athlete triad. Shockwave was initiated at a median of 36 days from BSI diagnosis, with an average of 5 treatments per runner. Results show that, importantly, all runners, except one who opted for surgery, returned to pain-free running after the shockwave, and no complications were observed.
Conclusions
Success rates with shockwave are equal to those with standard surgical treatment and sometimes even more. This is because shockwave therapy is non-invasive, non-anesthetic, and requires no downtime, which makes it a feasible alternative for doctors and patients alike.
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