What other things can help if you have had a lower limb bone stress reaction and want to return to running safely?


In my opinion as a health professional who has seen many runners go through this process, there are a few things we need to get right.


Firstly, we need to work out what underlying health issues may have caused the reduction in bone density. Refer to my previous blogs on what these may include, and having a good relationship with your GP can assist greatly in this process.

Beyond that, and particularly if there is a stress reaction only on one side of the body, then the BIOMECHANICAL components of the injury need to be thoroughly assessed. It just does not make sense to me that someone will just wear one leg more than the other without it being due to the way you are running. Maybe I am just a bit simple minded with this but the concept is that if it is purely your training load that is the problem then you will be the SAME issue on BOTH legs at exactly the same time.



So, that is where my head is at with this stuff.


Generally when I look at someones weight bearing and running, I am looking at where their centre of mass goes relative to their foot strike. This is a logical process; and then I also look at twisting within their spine and pelvis, which can strain the pelvis, femur and lower limbs differently and cause sub-optimal weight bearing.

Below is a video of one of my clients with some (not all) of the things I look at with a running assessment. Please note she does NOT have a bone stress reaction, this video is a good example of some of the things I am looking for.





Following the running assessment, this guides me on appropriate further testing which gives me a thorough idea of what is happening within the clients’ entire body. Examples of this may include:
  • Single leg balance
  • Single leg squat
  • Hop distance
  • Step up control
  • Gluteal activation in standing
  • Thoracic rotation control
  • Pelvic tilt
  • Pelvic floor activation
  • Muscular testing

This process then gives a good idea of the TRUE reason for a bone stress response on one side of the body. It creates a structured process to build strength relevant to the client, which can then be used to create goals and tests to show improvement.

As you might be able to tell, I love this process and love helping my clients!