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Stress Fracture

Stress Fracture

A stress fracture is an injury that can occur from overuse or extended use over a long period of time.   A stress fracture causes tiny cracks in the bone, but unlike a regular bone fracture that occurs when a high force comes in contact with the bone, a stress fracture is caused by lower forces on the bone that occur repeatedly over time.  The muscles around the bone become unable to absorb added stress placed on the area and the overload of stress is transferred to the bone, which can result in a small crack in the bone.  Stress fractures are most commonly seen in athletes and are most common in bones in the foot or shins, due to the repeated force that feet and lower legs take during running and while participating in many sports.

What is a Stress Fracture?

A stress fracture is an injury that can occur from overuse or extended use over a long period of time.   A stress fracture causes tiny cracks in the bone, but unlike a regular bone fracture that occurs when a high force comes in contact with the bone, a stress fracture is caused by lower forces on the bone that occur repeatedly over time.  The muscles around the bone become unable to absorb added stress placed on the area and the overload of stress is transferred to the bone, which can result in a small crack in the bone.  Stress fractures are most commonly seen in athletes and are most common in bones in the foot or shins, due to the repeated force that feet and lower legs take during running and while participating in many sports.

What causes a Stress Fracture?

A stress fracture is caused by repeated stress on a bone and the muscles surrounding the bone.  These injuries often occur when the level or intensity of an activity is increased too quickly.  The muscles around the affected bone cannot handle the increased stress and transfer it to the bone, where a tiny crack occurs due to what is known as “bone fatigue”.  In addition to increasing activity levels too quickly, other causes of stress fractures include not wearing the proper equipment for the activity, substantially increasing the duration or intensity of the activity, changing the surface on which an activity is performed, and other medical conditions, such as osteoporosis.


What are the symptoms of a Stress Fracture?

The most common symptom of a stress fracture is pain that occurs with activity but that is diminished with rest.  Over time, the pain may become more severe and may occur more quickly once an activity has begun.  Eventually the pain may be experienced even when not engaged in the activity.  Swelling and tenderness may also occur.


How is a Stress Fracture diagnosed?

A stress fracture is diagnosed by a medical professional based on the description of a patient’s symptoms, as well as a physical examination.  A medical history will be taken and the patient will be asked about any repetitive activities they are involved in.  X-rays may be taken, but may not show evidence of a stress fracture unless the injury has been there for some time.  The x-ray may show signs of the bone trying to heal around the location of the stress fracture.  In some situations, an MRI, CT or bone scan will be needed to properly diagnose the injury.

When should I seek care for a Stress Fracture?

Any time you experience severe, worsening or prolonged pain, you should consult with a medical professional to determine the cause.  Stress fractures tend to develop over time and the pain increases gradually, but if you believe that you may have an acute fracture of a bone, immediate medical attention should be sought.  Otherwise, if you find that self care and rest do not cause the pain to subside, or the pain does not subside when at rest, it is best to have it checked out by a doctor.


What will the treatment for a Stress Fracture consist of?

The best treatment for stress fractures is to rest the injured area and refrain from engaging in the activity that caused the injury in the first place.  Most stress fractures can take six to eight weeks of rest to properly heal (and can even take longer), and if the activity is resumed too quickly it can cause further damage to the bone at the location of the stress fracture.  In some cases, a brace, cast or sling may be needed while the bone heals to reduce stress on the bone.  Stress fractures that are not allowed sufficient time to adequately heal can lead to chronic pain.  Ice will help relieve pain and swelling and nonsteroidal anti-inflammatory medications are usually recommended for pain.  Once healed, activity will need to be resumed gradually to avoid re-injury.


Which muscle groups/ joints are commonly affected from a Stress Fracture?

Stress fractures can occur in just about any location, but primarily occur in the extremities.  They are most common in the bones of the foot and lower leg, where bones receive the most weight-bearing loads.
What type of results should I expect from the treatment of a Stress Fracture?
With proper rest, most stress fractures will heal completely.  If activity is resumed too quickly, re-injury can occur, resulting in a more severe fracture and more intense or chronic pain.  It is important to allow proper time for the injury to heal and to reintroduce activity slowly and gradually to avoid future problems.