BSI- Demir

Question 1

Bone stress injury development period time and factors?

Answer 1

3-4 weeks following a major workload
Cumulative load> ability to repair
Fatigue feeling lead to increase BSI risk with 14% more-foot strike and 6% accumulated peak vertical load
- Cardiovascular fitness and muscular capacity progress at a faster rate than bone capacity. Therefore, it should be controlled loading session
-Changes in running intensity

Question 2

What is RED-S risk stratification tool?

Answer 2

• Assocation of the female athlete risk assessment for the development of BSI

Question 3

Name exercises that are poor and strogn at building bone?

Answer 3

Poor: Running, swimming, downhill mountain bike
Strong: Zig zog hopping, Box depth jump
Multi directional load is vital for bone strength
* Prior sport history very important- Less likely to develop BSI

Question 4

Where are low risk BSI and how to manage it?

Answer 4

-Posteromedial Tibia, 2nd and 3rd metatarsal head, distal fibula, cuboid and cuneiform, calcaneus
- Typically heel with activity modification, followed by progressive loading and return to activity

Question 5

Where is High risk BSI in the foot?

Answer 5

• Anteiror Tibial cortex
  -Medial malleolus, Navicular
  -Talus
  -Base of 5th Metatarsal
  -Base of 2nd Metatarsal
  -Sesamoids
  prone to refracture or failure to return to sports

Question 6

BSI presentation

Answer 6

• Localised bone tenderness, aggravated by loading- does not warm up
• Pain free in NWB, advanced BSI is painful at rest and night
  -Assess risk factors including particiapation in an at risk activity, Hx of previous bone stress injury, their physical activity levels, Indcation of RED-S
  Recent hiking or work requirments

Question 7

What are the clinical test for BSI assessment?

Answer 7

-Calcaneal squeeze test
-N spot
-Metatarsal load test
-Axial compression
-The hop test*

Question 8

BSI management for low risk BSI

Answer 8

• Pain free status in bone- carbon plate, cam walker and footwear- rocker profile
• The only acceptable pain with BSI is 0 out of 10
• Cross training activity - activity modificaiton

Question 9

What is the process of returning to activity?

Answer 9

Cross training (swimming)
Anti-gravity treadmill
Progressive walk
Running intensity