High Number of Daily Steps Recorded by Runners Recovering from Bone Stress Injuries
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ORIGINAL ARTICLE
High Number of Daily Steps Recorded by Runners Recovering from Bone Stress Injuries Brett G. Toresdahl, MD Stephen Lyman, PhD
& Joseph
Nguyen, MPH & Marci A. Goolsby, MD & Mark C. Drakos, MD &
Received: 31 January 2020/Accepted: 23 July 2020 * Hospital for Special Surgery 2020
Abstract Background: Bone stress injuries (BSIs) are common among runners for which activity modification is the primary treatment. The clinical utility of measuring activity during recovery has not been evaluated. Questions/ Purposes: We sought to measure the physical activity of runners recovering from BSIs and determine if activity can be correlated with symptoms. Methods: A prospective observational pilot study was performed of runners with a new lower extremity BSI treated non-surgically. For 30 days, activity of runners was measured with a physical activity tracker and daily pain scores were collected. Results: We enrolled 18 runners (average age, 33 years; 72% female). Twelve had stress fractures and six had stress reactions. The average daily steps of all runners during the observation period was 10,018 ± 3232, and the runner with the highest daily steps averaged 15,976. There were similar average daily steps in those with stress fractures versus reactions, 10,329 versus 9965, respectively. There was no correlation between daily steps or relative change in daily steps with pain or relative change in pain scores. Conclusion: Runners with BSIs averaged over 10,000 steps per day during early recovery. Clinicians may not be aware of the amount of activity runners maintain after being diagnosed with a BSI. Although daily steps and symptoms could not be correlated in this study, objectively measuring activity may assist clinicians in guiding runners recovering from BSIs.
Level of Evidence: Level 2B, Prospective Cohort Study Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-020-09787-z) contains supplementary material, which is available to authorized users. B. G. Toresdahl, MD (*) : J. Nguyen, MPH : M. A. Goolsby, MD : M. C. Drakos, MD : S. Lyman, PhD Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA e-mail: [email protected]
Keywords bone stress injury . running . physical activity . activity monitor Introduction Bone stress injuries (BSIs) are common among runners and participants of high-impact exercise and sports [5, 11, 14]. The incidence of BSIs in athletes is highest among female cross-country runners, with 11 per 100,000 athlete exposures in high school and 29 per 100,000 athlete exposures in college [3, 11]. BSIs are also the most frequent injury to prevent would-be first-time marathoners from being able to participate in a race [13]. Multiple risk factors for BSIs have been identified in runners, including females having a higher risk than males and those with a prior history of a BSI [14]. Lower extremity BSIs are suspected when there is gradual onset of pain in the context of high-impact activity or exercise. Radiographs have li
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