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Athletic Training

How far can you push an old fracture?



i fractured my left hip 5 years ago and i have been afraid to push it to far i wolud like to know exactly how far i can push it and i am wondering if a nerve could be pinched because i still have pain in that side of my body


Hip fractures generally occur in one of three situations: 1) a violent traumatic fracture of normal, healthy bone, 2) a fracture related to weakened or diseased bone (e.g. osteoporosis) or 3) a stress fracture where you repeatedly stress the bone by overuse and don't allow it to recover (common in runners).  Without knowing your specific history including your age, the factors that lead to your initial hip fracture, the site of your fracture on the bone, your post-surgical care and outcome, and your current health and fitness status, it's impossible to give a definitive recommendation.  Couple this with your ongoing complaint of pain and it would seem that seeing your physician is probably a good idea.  Sometimes with previous hip fractures there can be ongoing degeneration of the hip joint that should be evaluated by a physician.

With that said, if your physician determines that your bone heath is good and your joint surfaces were not involved in your initial fracture, then an exercise program might be a good idea.  Mild exercise, in addition to its cardiovascular benefits, causes regular stress to bones.  This regularly occurring mild stress is a good thing because it causes your bones to remodel.  Remodeling is the process by which parts of your body adapt to their regularly applied stresses and become stronger. 

Remodeling follows a concept called the S.A.I.D. principle where SAID stands for Specific Adaptation to Imposed Demands.  Briefly, this means that if you regularly apply a stress to a body part (like through exercise 2 or 3 days per week) and allow that body part time for recovery (days off in-between), then the body part becomes stronger and better able to manage that specific stress.  For bones, exercise causes them to become denser and stronger and less likely to fracture again.  On the flip side, a lack of exercise or regular physical activity causes your bones to lose some of their mass and become weaker!  If you have been somewhat inactive, then work back into activity gradually to minimize your risk of another fracture.

When you do exercise, it's always a good idea to increase your exertion level gradually over a number of days or weeks.  Remember that remodeling is in response to specific demands, and if your bones and muscles are used to very little exercise, then they are not ready for highly strenuous exercise immediately.  They will become so by adapting to mild to moderate exercise first.  Usually, 20 - 30 minutes of activity two or three times per week is a good place to start.

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Response by:

Mark  A Merrick, PhD, ATC Mark A Merrick, PhD, ATC
Associate Professor
School of Health and Rehabilitation Sciences
The Ohio State University