Stress Fracture

Introduction

A Stress fracture is a  hairline crack in the bone.  They are extremely common in dancers, athletes, or military personnel who exercise muscles that are already fatigued or when their bodies are not acclimated to the activity level.  Most stress fractures can be healed with rest and therapy. Surgery is only necessary in select cases.

Anatomy

There are two bones in your leg.  The larger bone, commonly known as the shinbone, is the tibia.  The thinner bone on the outside of the leg is the fibula. The fibula is a more common site of stress fractures than the tibia.

Stress fractures are also likely to occur in certain bones in the feet. Stress fractures most commonly occur in the heel (calcaneus), the midfoot (navicular bone), and second and third metatarsals. The metatarsals are the bones that connect your toes to the rest of your foot.

Stress Fracture Causes

High impact, overuse, or improper form during sports or other movements cause stress fractures.  Stress fractures result from repeated stress to the bones. Because of the repetitive stress, the bones are not able to repair themselves before more stress is placed on them, fracturing them further. In some cases, stress fractures can occur with normal levels of activity if the bones are made vulnerable to fracturing by diseases like osteoporosis.

People that engage in a strenuous exercise routine before they are conditioned to do so or over train to the point of significant fatigue are at risk for stress fracture. Using subpar sports equipment like shoes that have been worn down, or not utilizing proper form, can contribute to stress fractures. Military members in initial training, dancers, and athletes that participate in high impact sports like football or soccer are at risk for stress fractures because of jumping, running, and marching.

Women have a heightened risk of stress fractures due to the effects of hormones on muscles and ligaments. Tall people, anyone with leg length discrepancies, and people who smoke cigarettes also have a higher risk. Some people also have a genetic predisposition to stress fractures. 

Stress Fracture Symptoms

Stress fractures cause gradual pain that tends to worsen with more activity. Rest may relieve the pain, although night pain is also common. Those who suffer from a hairline fracture may notice swelling, bruising, or tenderness at the top of their foot or the outside of their ankle.  

Stress Fracture Diagnosis

If you suspect that you have a stress fracture, the most important step to take is to keep weight off of your foot until you see a doctor.  A doctor can easily diagnose a stress fracture by a review of your medical history and an examination of the affected area. You should also tell your doctor about activities that may have contributed to your fractures, like uncommonly extensive exercise. 

To confirm the fracture, an X-ray or a bone scan will be taken of the affected area.  Fractures typically do not show up on X-rays until they become larger, so a bone scan, which is more sensitive and precise, is the alternative method.  Another effective method of diagnosing fractures is an MRI scan.

Stress Fracture Treatment

Rest is the most common treatment for stress fractures.  Your doctor may also prescribe medications to relieve or manage pain.  Depending on the location and size of the fracture, you may need to modify your activity for anywhere from 4 to 12 weeks.  Crutches may be necessary. Your doctor could potentially recommend a rigid soled shoe or removable fracture brace to help stabilize the area.  Some fractures may even require casting.

At the appropriate time in your recovery, you may be referred to physical therapy.  Physical therapists will teach you exercises to strengthen and balance your muscles, as well as overall general conditioning.  Aquatic therapy is great for conditioning because the buoyancy of the water removes stress from the legs and feet. This will help you learn to avoid stress fractures in the future.

Stress Fracture Surgery

Surgery is only used for fractures that do not otherwise heal using other methods, or in areas that typically heal more slowly.  Rather than an external method to stabilize the area and allow the fracture to knit back together, an internal method like surgical screws or pins will be used.

Stress Fracture Recovery

Recovery times depend on the extent of your stress fracture and the treatment you receive.  For instance, if your fracture requires surgery, recovery can last for several months. Non-surgical treatments typically have a shorter recovery period.  Recovery depends heavily on the individual, and your doctor will let you know what to expect. As your condition improves, your doctor will increase your activity level.

Stress Fracture Prevention

You can help prevent stress fractures by utilizing proper equipment, like the correct shoes for your preferred sport.  Make sure to not overdo training or exercise. Get plenty of rest, especially when your muscles are tired. It is important to condition your body for “spring training” before participating fully in any sport.  Stop smoking if you are a smoker, and eat a healthy well-balanced diet.

At SPORT, we will identify the source of your pain and then utilize state-of-the-art therapeutic techniques that focus on restoring your range of motion.

Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings and supports, cortisone shots, or surgery.

If you have an acute or chronic foot or ankle injury that needs medical attention, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.

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