HealthPartners Institute
Lower extremity bone stress injury (BSI) is a common overuse injury in athletes and typically requires 4-12 weeks rehabilitation time, provided the injury does not require surgery. Current BSI treatment strategies include cessation of load-bearing sporting activities, consideration for crutches and/or immobilization, pain management, and a gradual return to activities until symptoms resolve. Premature return to sport can result in risk of complications and reinjury of the healing BSI. Moreover, our prior work reported that 1/3 of women with a tibial BSI will sustain at least one additional BSI within one year, indicating that current return to sport guidelines may be inadequate. However, there are no gold standard or validated clinical, functional or imaging outcomes that are consistently used to assess BSI healing and guide return to sport. In this prospective observational study, the investigators will enroll male and female athletes with a diagnosed BSI. The investigators will utilize diagnostic imaging, blood samples, and questionnaires to identify primary and secondary outcomes for assessing BSI healing in runners. Our long-term goal is to identify whether biomarkers, health and lifestyle factors, and training patterns associated with future BSI have the potential to inform and improve BSI treatment.
Bone stress injuries (BSIs) result from the accumulation of repetitive skeletal loading that exceeds the bone's capacity for repair. Although magnetic resonance imaging (MRI) is commonly used to diagnose and grade BSIs, there is no accepted standard for determining when an injury has healed sufficiently for an athlete to resume running or unrestricted sport. Previous studies have used measures such as pain-free hopping, pain-free running, completion of a return-to-run program, medical clearance, clinical examination findings, and changes on MRI. However, these measures have not been applied co…
Inclusion Criteria: * Diagnosed BSI of the tibia, metatarsal two, three, or four, femoral neck or femoral shaft by MRI, grade two or higher on the Fredericson grading scale7 * Age 16-35 years * Body Mass Index 17.5-30 kg/m2 * Self-reported minimum of three hours per week of endurance exercise that includes running at least fifteen miles per week during three months prior to injury * Study enrollment within three weeks of MRI Exclusion Criteria: * Self-reported history of endocrine disorder that impacts bone health (e.g., diabetes, hyperthyroidism, or primary hyperparathyroidism) * Self-repo…