Archives of Orthopaedic and Trauma Surgery

, Volume 127, Issue 9, pp 809–813

Rapid rehabilitation programme following sacral stress fracture in a long-distance running female athlete

  • Karsten Knobloch
  • Louisa Schreibmueller
  • Michael Jagodzinski
  • Johannes Zeichen
  • Christian Krettek
Arthroscopy and Sports Medicine

DOI: 10.1007/s00402-006-0201-y

Cite this article as:
Knobloch, K., Schreibmueller, L., Jagodzinski, M. et al. Arch Orthop Trauma Surg (2007) 127: 809. doi:10.1007/s00402-006-0201-y

Abstract

Stress fractures occur in normal bone due to mechanical overload by cyclic stress increasing the osteoclastic activity, thus facilitating weakening leading to fracture of bones. Long-distance running may lead to stress fractures of the mid- and distal tibia and of the metatarsal bones. Stress fractures to the sacrum are rare. Certain factors for stress fractures in runners have been identified, such as leg–length inequality, a high longitudinal arch of the foot, forefoot varus, and menstrual irregularities in case of female athlete triad. We report on a 22-year-old female runner (usually training 140 km/week) suffering a sacral fatigue-type fracture. The female athlete triad with eating disorders, dysmenorrhea, and osteopenia was ruled out. Sexual hormone blood samples proofed normal values. The diagnosis was performed using magnetic resonance imaging 2 weeks after the onset of buttock pain. A conservative treatment regimen was initiated with strict physical rest for the first 2 weeks, and then gradual increase of physical activity with 60–90 min of daily cycling and moderate 2 × 60 min cross-training. After another 2 weeks time, daily 60–90 min of walking, Nordic pole walking, and moderate strength training two times a week was performed. At 7 weeks running was started, gradually increased to 90 km/week without any pain. A rapid rehabilitation programme after sacral stress fractures involving low impact physical activity, such as Walking and Nordic pole walking, is applicable to female athletes after ruling out the female athlete triad.

Keywords

Running Fracture Stress Fatigue Rehabilitation Sacrum 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Karsten Knobloch
    • 1
  • Louisa Schreibmueller
    • 1
  • Michael Jagodzinski
    • 1
  • Johannes Zeichen
    • 1
  • Christian Krettek
    • 1
  1. 1.Trauma DepartmentMedical School HannoverHannoverGermany

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