My senior year in college, I was unable to compete in our conference finals track meet due to a hip injury, and would later find out it was a stress fracture— my second one in four years. It doesn’t mean I didn’t try to run, because I did; but it hurt so bad I could barely walk, let alone run. I was so disappointed because this meet was what I trained for all season. The injury took weeks to heal and required crutches, lots of rest, and proper nutrition. Here’s some information about stress fractures and the nutrition involved in healing bone.
What Is a Stress Fracture?
A stress fracture is an overuse injury, and is one of the most common sports injuries. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack in the bone, aka: a stress fracture.
What Causes a Stress Fracture?
Stress fractures are often the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface (soft court to a hard court), improper equipment (ie: shoes), and increased physical stress (ie: an athlete who has a substantial increase in playing time). The American Academy of Orthopaedic Surgeons says that more than 50% of all stress fractures occur in the lower leg or feet.
Are Women More Susceptible to Stress Fractures than Men?
Studies have shown female athletes seem to experience more stress fractures than males. Many orthopedic surgeons attribute this to a condition called “the female athlete triad,” which consists of disordered eating patterns, amenorrhea (infrequent menstrual cycle), and osteoporosis. As a female’s bone mass decreases, her chances of getting a stress fracture increases.
It isn’t uncommon for athletic women to consume a very low-calorie and low-protein diet. This drastic reduction in food intake can lead to amenorrhea. Research suggests amenorrheic athletes have a four and one-half times higher risk for suffering a stress fracture than do regularly menstruating athletes. Eating a balanced diet with adequate calories can enhance restarting menses, provide adequate protein for building and protecting muscles, and enhance overall health.
Nutrients Involved in Bone Rebuilding
Stress fractures need proper food and nutrition to optimize their healing ability. Consume adequate amounts of the following nutrients:
Vitamin D and Vitamin K Work Together
In order to properly absorb the calcium you consume, you need enough vitamin D. Vitamin D plays a very large role in protecting and preventing you from getting a stress fracture. Every single cell in the human body has a vitamin D receptor on it. Vitamin D stimulates calcium absorption in the gut, and balances calcium and phosphate levels in the blood. Keeping calcium and phosphate levels balanced allows for healthy bone mineralization. Osteoblasts and Osteoclasts, the cells that build and remodel our bones, require vitamin D to function. Without proper amounts of vitamin D, bones will become brittle and thin.
To determine how much vitamin D your body has requires a blood test. Here are vitamin D recommendations from three different entities.
Vitamin K2 is an important part of the processes that bind calcium to bone and is required for proper formation of the osteocalcin bone protein.
Inflammation Supporting Nutrients
When a stress fracture occurs, there is inflammation which generates free radicals. Antioxidants help your body fight damaging free radicals that hurt cells and damage tissue trying to repair the stress fracture. Antioxidant-containing nutrients that will fight for you include vitamin C, quercetin, and omega-3 fatty acids. In addition, here are five other powerful antioxidants to include in your diet regularly.
Sixty percent of the magnesium in your body is stored in bone tissue, and it has multiple key roles in bone health. Magnesium helps to change vitamin D2 into vitamin D3, its active form, which increases calcium absorption. Magnesium contributes to the structure of bones and regulates calcium transport into the bones. Magnesium also triggers the hormone calcitonin, which helps protect the bones when the body is imbalanced, by pulling calcium from the blood and tissues back into the bones.
Potassium is associated with greater gains in hip and whole body bone mineral density among young female distance runners.
Your body requires proper amounts of calcium to help repair your stress fracture. Under circumstances when you can’t get enough calcium from food, a calcium supplement may be warranted. However, calcium alone isn't sufficient because calcium works synergistically with various minerals including vitamin D3, vitamin K2, boron, magnesium, silica, and phosphorus. Healthy Goods Osteo-Mod is a wonderful blend for bone health!
The Recommended Dietary Allowances for calcium are currently 1,300 mg/day for males and females age 9-18, 1000 mg/day for males and females age 19-30, and for females who are estrogen-deficient and not menstruating, it has been recommended they increase their calcium intake to total 1,500 mg/day.
A protein deficiency, along with an overall calorie-deficient diet, is associated with medical problems, specifically loss of regular menstrual cycles. A female’s estrogen levels decline when menstruation stops, and this drop in estrogen leaves your bones more prone to a stress fracture.
The nutrients listed hold the potential power to prevent and protect you from a stress fracture.
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Healthy Goods
American Academy of Orthopaedic Surgeons. Stress Fractures.
Nieves JW et al. Nutritional factors that influence change in bone density and stress fracture risk among young female cross-country runners. 2010 Aug;2(8):740-50.
Carbon, R., Sambrook, P.N., Deakin, V., Fricker, P., Eisman, J.A., Kelly, P., Maguire, K., Yeates, M.G. Bone density of elite female athletes with stress fractures. The Medical Journal of Australia. 153:373-376, 1990.