Definition

What are stress fractures?

Stress fractures are tiny cracks in a bone. They’re caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of a bone that’s weakened by a condition such as osteoporosis.

Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Track and field athletes and military recruits who carry heavy packs over long distances are particularly susceptible, but anyone can have a stress fracture. If you start a new exercise program, for example, you might develop stress fractures if you do too much too soon.

How common are stress fractures?

Stress fractures are one of the most common injuries in sports, especially for track and field athletes, gymnasts, dancers, tennis players, and basketball players. Stress fractures aren’t just a problem for active people, though. They also affect people with weak bones or nutritional deficiencies, and can happen in the foot, leg, spine, arm, ribs, and other bony locations. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of stress fractures?

The common symptoms of stress fractures are:

  • Pain in the foot or leg, spine, and other locations when exercising that goes away when resting
  • Pain that starts happening earlier in the activity each time it’s done
  • Pain that gets worse with time and can be felt even after rest
  • An area of the affected bone that is painful to touch
  • Occasionally, mild swelling and redness

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Severe pain
  • Persistent pain even at rest
  • Pain that doesn’t respond to rest, ice, and elevation

Causes

What causes stress fractures?

Stress fractures often result from increasing the amount or intensity of an activity too quickly.

Bone adapts gradually to increased loads through remodeling, a normal process that speeds up when the load on the bone increases. During remodeling, bone tissue is destroyed (resorption), then rebuilt.

Bones subjected to unaccustomed force without enough time for recovery resorb cells faster than your body can replace them, which makes you more susceptible to stress fractures.

Risk factors

What increases my risk for stress fractures?

There are many risk factors for stress fractures, such as:

  • Certain sports. Stress fractures are more common in people who participate in sports such as track and field, basketball, tennis, dance or gymnastics.
  • Increased activity. Stress fractures often occur in people who suddenly shift from a sedentary lifestyle to an active training regimen or who rapidly increase the intensity, duration or frequency of training sessions.
  • Sex. Women, especially those who have abnormal or absent menstrual periods, are at higher risk of developing stress fractures.
  • Foot problems. People who have flat feet or high, rigid arches are more likely to develop stress fractures. Worn footwear contributes to the problem.
  • Weakened bones. Conditions such as osteoporosis can weaken your bones and make it easier for stress fractures to occur.
  • Previous stress fractures. Having had one or more stress fractures puts you at higher risk of having more.
  • Lack of nutrients. Eating disorders and lack of vitamin D and calcium can make bones more likely to develop stress fractures.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How are stress fractures diagnosed?

Doctors can sometimes diagnose a stress fracture from a medical history and a physical exam, but imaging tests are often needed.

  • X-rays. Stress fractures often aren’t apparent on regular X-rays taken shortly after your pain begins. It can take several weeks — and sometimes longer than a month — for evidence of stress fractures to show on X-rays.
  • Bone scan. A few hours before a bone scan, you’ll receive a small dose of radioactive material through an intravenous line. The radioactive substance accumulates most in areas where bones are being repaired — showing up on the scan image as a bright white spot. However, many types of bone problems look alike on bone scans, so the test isn’t specific for stress fractures.
  • Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your internal structures. An MRI usually can visualize stress fractures within the first week of injury, and can visualize lower-grade stress injuries (stress reactions) before an x-ray shows changes. This type of test is also better able to distinguish between stress fractures and soft tissue injuries.

How are stress fractures treated?

To reduce the bone’s weight-bearing load until healing occurs, you might need to wear a walking boot or brace or use crutches.

Although unusual, surgery is sometimes necessary to ensure complete healing of some types of stress fractures, especially those that occur in areas with a poor blood supply. Surgery also might be an option to facilitate healing for elite athletes who desire a more rapid return to sport or laborers whose work involves the stress fracture site.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage stress fractures?

The following lifestyles and home remedies might help you cope with stress fractures:

  • Stay off the affected limb as directed by your doctor until you are cleared to bear normal weight.
  • To reduce swelling and relieve pain, your doctor might recommend applying ice packs to the injured area as needed — up to three or four times a day for 15 minutes at a time.
  • Resume activity slowly. When your doctor gives the OK, slowly progress from nonweight-bearing activities — such as swimming — to your usual activities. Resume high-impact activities, such as running, gradually, increasing time and distance slowly.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 15, 2017 | Last Modified: August 15, 2017

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.