Early rehabilitation of a lower-extremity stress fracture involves nonweight bearing exercises such as swimming to help maintain your overall fitness while reducing your risk of pain and further injury. The appropriate nonweight bearing exercises vary, depending on the location of your stress fracture. Therefore, consult your physical therapist before performing any new exercises.
Stress Fracture
The metatarsal bones in your feet, shinbone and thighbone are susceptible to stress fractures, according to a 2003 article published in "American Family Physician." During weight-bearing activities like running and jumping, your bones undergo a significant amount of stress. Over time, the repetitive stress can lead to a partial break or stress fracture of your bone. A sudden increase in exercise intensity and frequency can increase your risk of a stress fracture.
Deep-water Running
Perform deep-water running in a pool with a water depth that prevents you from touching the bottom. The leg and arm movements of deep-water running are similar to those of running on land but without the impact. Wearing a buoyancy belt, which is a dense foam belt that goes around your waist, helps you stay afloat and maintain an upright posture. Deep-water running provides an excellent cardio workout and helps strengthen your leg, core and arm muscles. With the approval of your physical therapist, perform deep-water running three to five days a week for 20 to 60 minutes at a moderate pace.
Swimming
Swimming is also an excellent nonweight bearing cardio exercise that strengthens your core and hip muscles. The kicking involved with swimming, however, may cause pain, depending on the location of your stress fracture. With a foot stress fracture, for example, the force or resistance of the water during kicking can put stress on the fractured bone and cause pain. Due to the possible adverse affects, swimming should be performed as directed by your physical therapist.
Bike and Arm Ergometer
Biking on an upright or recumbent stationary bike provides a cardio workout and strengthens your thigh or quadriceps muscles. Avoid biking outdoors due to the uncontrolled environment and the risk of falling off the bike. For stress fractures around your hip, cycling on an arm ergometer may be more comfortable. This involves or pedaling with your arms and is performed in a seated position. Bike for five to 10 minutes, and increase your duration and frequency according to your physical therapist's guidelines.
Strength Training
Nonweight bearing strength exercises for the upper body such as bench press and seated row can be performed throughout your rehabilitation. A 2002 article in the "Journal of Athletic Training" recommends upper body strength training three days a week. Nonweight bearing strength exercises for the lower extremities such as leg extension and hip abduction may be performed one to three days a week, with the approval of your physical therapist. Your therapist may recommend lowering the resistance of lower extremity strength exercises as well. Under no circumstances should the weight or resistance be placed on top of the fracture site.
References
- "Cross-Training"; Matt Fitzgerald; 2004
- "American Family Physician"; Common Stress Fractures; Brent W. Sanderlin, LCDR, M.C., USNR, et al.; October 2003
- "Journal of Athletic Training"; Mechanisms and Management of Stress Fractures; William A. Romani, et al.; 2002
- "Journal of Athletic Training"; Femoral Stress Fracture; Mark Casterline, M.S., ATC, et al.; March 1996
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