Effect of Weather on Stress Fracture in Runners

Objective: To compare the effect of cold and warm weather on stress fractures in long-distance runners and athletes. Study Design: Prospective longitudinal Study. Place and Duration of Study: Combine Military Hospital, Abbottabad Pakistan, from Nov 2013 to Apr 2017. Methodology: Male athletes joining training in various institutions in November 2013 (Winter-Group) and May 2014 (SummerGroup) were included in the study and followed during two years of training and one year after training. All participants presenting with stress fracture (SF) symptoms were diagnosed by radiography. MRI or bone scan was done in symptomatic cases with negative radiographs. Most of the SFs were managed conservatively. Patients with complete fractures of long bones were fixedsurgically. Results: Out of 506 male participants of Winter-Group (WG) and 474 participants of Summer-Group (SG), 57 and 29 were diagnosed to have a stress fracture (p=0.005). There was no significant age difference between the two groups. Among the study subjects, 50.0% were from Punjab, and 26.7% were from KPK. In both groups, most of the SFs were found in the tibia. The stress fractures were more during the initial 16 weeks of training. Most fractures were treated conservatively, and only two cases from each group were operated on. All cases recovered fully after an average period of 11 weeks. Ten runners of Winter-Group had prolonged healing time.Conclusion: Modification in training guidelines may reduce weather-related stress injuries in winter.Keywords: Runners, Stress fractures, Tibia, Weather.