Healthy Diet, Strong Bones: How to Prevent Stress Fractures From Reoccurring
Posted by Jenn F. on Monday, April 9th, 2018
The bone in our bodies is a specialized form of connective tissue comprised of 60% mineral (mainly calcium hydroxyapatite), 35% organic material (mostly collagen), and 5% water. Like any other tissue in the body, bone responds to stress caused by weight-bearing activity. Bone remodels in response to mechanical stress, depending on the load, cycle frequency, and the amount of strain. When collagen molecules are compressed, the strain causes microscopic cracks known as stress fractures, which can be a precursor to full fractures. The muscles are a helpful ally in protecting the bone, as they absorb some of the shock that would otherwise be taken up by the bone. Therefore, a muscle-strengthening program is often part of successful stress fracture prevention and a recovery routine.
The development of a stress fracture is complex. We must take into consideration intrinsic factors like sex, race, age, bone geometry, leg length, and foot structure, as well as extrinsic factors like shoe type, training surfaces, regimen, muscle strength, medications, and smoking. We cannot overlook the importance of a healthy diet in protecting against stress fractures or in expediting bone healing.
Who Is At Risk For Stress Fractures?
Stress fractures account for 2-15% of all injuries and up to 28% of lower extremity injuries seen by sports medicine clinics. The lifetime incidence of stress fractures in athletes generally ranges from 1.9 to 21.1% but is higher for some groups than others. We also see a lot of stress fractures in college-level long-distance track runners, hurdlers, and gymnasts, as well as tennis, volleyball, soccer, and basketball players. The highest risk groups are dancers (32% lifetime risk) and figure skaters (20% lifetime risk). Eating healthy is a way to prevent stress fractures and heal bones faster.
Ninety-nine percent of total body calcium is stored in the bones, so it is important to continually replenish your supply so the body does not remove too much calcium from the bones for use.
One study of 125 young, female long-distance runners concluded that higher intakes of calcium, including skim milk and dairy products, was associated with lower rates of stress fracture. Each additional cup of skim milk consumed per day was associated with a 62% reduction in stress fracture incidence. Diets high in dairy and low in fat were linked to a 68% reduction in stress fractures. High intakes of potassium were also observed to have a protective effect, though the study did not quantify how much.
Some of the best calcium sources include:
- 1 c. vanilla yogurt (389 mg)
- 1/4 c. powdered skim milk (377 mg)
- 3 oz. canned sardines (324 mg)
- 1 c. skim milk (302 mg)
- 6 oz. yogurt (300 mg)
- 1/2 c. tofu (258 mg)
- 1 c. cooked kale (245 mg)
- 1 oz. cheddar cheese (202 mg)
- 1/2 c. chocolate pudding (150 mg)
- 1/2 c. fat-free ice cream (100 mg)
- 1 c. of okra (82 mg)
- 1 oz. almonds (76 mg)
- 1/2 c. collards or bok choy (74 mg)
- 1/2 c. baked beans (70 mg)
- 1/2 c. cottage cheese (61 mg)
- 1 corn tortilla (42 mg)
- 6 medium oysters (38 mg)
Our bodies use alkaline from our bones to reduce excess acid. Once all the free-floating alkaline resources are used up, the alkalizing minerals are absorbed from our bones. Potassium is one of these free-alkalizing minerals that can be tapped, so our bones remain as strong as possible.
Foods high in potassium include:
- 1 c. dried apricot halves (1,511 mg)
- 1 c. pistachios (1,261 mg)
- 1 c. raisins (1,086 mg)
- 1 c. baked beans (906 mg)
- 1 c. sunflower seeds (903 mg)
- 1 c. stewed prunes (796 mg)
- 1 c. sliced avocado (708 mg)
- 1 c. pumpkin seeds (588 mg)
- 1 medium sweet potato (448 mg)
- 1 medium banana (422 mg)
- 3 oz. salmon (309 mg)
- 1 c. chopped broccoli (288 mg)
- 3 oz. halibut (228 mg)
- 3 oz. tuna (275 mg)
- 1 Medjool date (167 mg)
Sixty percent of magnesium is stored in the bones. Unless you want your bones robbed of their strength, you’ll need to keep reserves high. Magnesium works alongside calcium and phosphorus to trigger bone-building reactions and maintain a harmonious balance.
Foods high in magnesium include:
- 1 c. almonds (247 mg)
- 1 c. pumpkin seeds (168 mg)
- 100 grams dark chocolate (108 mg)
- 0.5 oz. dried basil (102 mg)
- 1 tbsp. molasses (48 mg)
- 1 tbsp. flax seed (40 mg)
- 1 tbsp. sesame seed (32 mg)
- 1 c. chopped broccoli (19 mg)
- 1 Brazil nut (19 mg)
Vitamin D-Rich Foods
Vitamin D stimulates calcium absorption in the gut and maintains a healthy calcium/phosphate balance to allow for healthy bone mineralization. Vitamin D fuels osteoblasts and osteoclasts used to remodel our bones. Sunlight promotes Vitamin D synthesis from cholesterol in our skin, so that’s an easy way to get more Vitamin D in your body.
Foods high in Vitamin D include:
- 3 oz. halibut (2,238 IU)
- 1 tbsp. cod liver oil (1,360 IU)
- 3 oz. salmon (400 IU)
- 3 oz. mackerel (400 IU)
- 3 oz. tuna (228 IU)
- 1 can sardines (178 IU)
- 1 c. orange juice (137 IU)
- 1 c. milk or almond milk (100 IU)
- 1 c. yogurt (100 IU)
- 1 c. breakfast cereal (50-100 IU)
- organic eggs (44 IU)
- 3 oz. beef or calf liver (42 IU)
- 1 c. shiitake mushrooms (40 IU)
- 6 oysters (1 IU)
Vitamin K-Rich Foods
Vitamin K is essential for the functioning of three different bone proteins that repair and rebuild tissue.
Foods high in Vitamin K include:
- 1/2 c. spinach (483 mcg)
- 1/2 c. kale (444 mcg)
- 1/2 c. scallions (103 mcg)
- 1/2 c. cabbage (82 mcg)
- 1/2 c. Brussels sprouts (78 mcg)
- 1/2 c. prunes (52 mcg)
- 1 medium cucumber (49 mcg)
- 1/2 c. broccoli (46 mcg)
- 1/2 c. asparagus (41 mcg)
- 1 tbsp. dried basil (36 mcg)
- 1/2 c. celery (29.3 mcg)
- 1/2 c. artichokes (14.8 mcg)
- 1/2 c. milk (10 mcg)
Silicon is a trace mineral that works alongside calcium to maintain bone strength. It’s a major constituent of collagen, too.
Silicon can be found in:
- green beans
- bell peppers
- raw cabbage
How To Prevent Stress Fractures From Reoccurring
Typically, athletes with stress fractures require four to six weeks of immobilization in a non-weight-bearing cast. During this time, it helps to take charge of your health and make conscientious choices that will aid in expediting recovery. While you’ll want to add more calcium, potassium, Vitamin K, and silicon to your diet, you’ll also want to avoid foods that may compromise your bone healing. Classic “bone robbers” include phosphoric acid (found in soda), sodium (found in processed foods), coffee (which robs 40 mg of calcium from your bones with every cup), wheat bran (which reduces calcium absorption), and sugar (which prematurely ages the bones). We have bone stimulating devices and other methods to help you heal faster, but ultimately what will prevent you from landing back in our office with another bone fracture are your lifestyle choices. The folks here at The Center for Podiatric Care and Sports Medicine wish you a happy and healthy recovery now that you are empowered to take charge of your health. Contact us today!
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.