Stress fractures, particularly of the lumbar spine, is a common injury affecting the adolescent population. Due to the current social media landscape (especially with these tech savvy kids), we are getting so many different opinions and “quick fixes” for how to manage all sorts of injuries and conditions, and unfortunately, I see all too often they are poorly managed and sometimes missed all together.
Put simply, stress fractures are small changes (fractures) in the bone with associated bone swelling, often caused by repetitive force or changes in normal exercises/sport loading. Sports involving increased extension and rotation put the young spine at risk of this injury. Sports such as cricket (fast bowlers in particular), gymnastics, soccer, basketball, athletics and rowing to name a few.
A diagnosed stress fracture must be taken seriously and should be dealt with a short period of relative reduction in load from their given aggravating activity. Now that doesn’t mean we can’t do anything (often what we see), there is still capacity to complete so many different exercises, gym routines, cardio sessions, sports sessions etc. whilst allowing proper bony healing. After this, a gradual return to training/sport should be planned and mapped out. Importantly, each case is different, making it very important to involve the patient and their parents in the decision-making process for treatment.
There are also new forms of MRI technology that helps identify stress fractures in more detail and can also allow clinicians to make more informed decisions regarding healing and return to play/sport timeframes. It’s called MRI “VIBE” and it allows detailed images of bone swelling (oedema) within the bone and has promising statistics to indicate bone healing/not healing.
All in all, I would I encourage adolescents to seek guidance from a qualified clinician in person so they can conduct a thorough examination and get you back on the field.
Author – 
Ryan Farrell (MGS Manly)
Ryan has undertaken a considerable amount of PD, as well as personal experiences with his cricket population treating those with stress fractures, particularly adolescence with lumbar stress fractures. He believes there are so many stress fractures and stress reactions missed due to poor clinical reasoning and diagnostic screening. Not to mention incorrect time frames for returning to sport once it has been diagnosed, I have seen kids who were told to push through the pain and kids who were told to take 12 months off with no sport, completely ludicrous.
The diagnosis and management of shoulder conditions is another skill and passion of Ryan. Having his own shoulder battles and treating so many throwing athletes has helped his knowledge and appreciation of how complex the shoulder can be.
Ryan also has an interest in treatment and differentiation of peripheral and central nerve conditions of the upper and lower limb.
For those wanting a physio who is obsessed with golf, or sport in general, Ryan is happy to have a good yarn during treatment. Alternatively, for any foodies out there, he is happy to chat about restaurants and red wine.
Click here to learn more about Ryan.