"The Masterclasses have been of immense value for my clinical reasoning. They have challenged me to think more deeply about different topics along with practical applications which have improved my patient outcomes."
Bone stress injuries (BSIs), including stress reactions and stress fractures, are frustrating. Frequently occurring in the lead up to a major event or competition, these injuries invariably require interruption to training as the prodromal pain and risk of progression to complete fracture is real.
This Masterclass aims to provide an overview of BSIs-from pathophysiology to risk factors and to management. Risk factors and subsequent preventative measures are divided into the loads applied to the skeleton and the ability of the skeleton to resist those loads.
Signs and symptoms of BSIs are discussed along with their clinical diagnosis. The Masterclass concludes by discussing the management approach for treating a low-risk metatarsal BSI, including the rationale and use of a graduated loading program.
Pathophysiology and bone risk factors
This module will discuss how bone stress injuries, which include stress reactions and stress fractures, develop. It will introduce risk factors for bone stress injuries and describe the mechanical loads to which bone best adapts. The module will conclude by revealing the importance of bone size.
Clinical assessment and diagnosis
This module will discuss the signs and symptoms of a bone stress injury. It will note features to be aware of during patient presentation and evaluation. The module will briefly discuss imaging and when to refer for specialised management.
This module will discuss loading risk factors for the development of bone stress injuries. It will highlight ‘at risk’ times and how loading may be tempered to reduce bone stress injury risk.
This module will present the management of an athlete presenting with a 2nd metatarsal bone stress injury. It will present the treatment approach taken and a graduated loading program for the controlled return to loading.