Stress fractures are a form of bone injury caused by excessive use of a particular bone. These fractures occur when the usage of a bone exceeds its ability of natural repair, leading to cracks in the internal bone structure. The bones most prone to stress fractures are those of the legs, the pelvis, and the feet. This condition is commonly seen in sportspersons, and is brought about by excessive jumping or running, and other repetitive movements like bowling or rowing.
If you do encounter this unwelcome injury, it could develop in your foot, outer leg, heel or hip. It can even cause a problem in your back, as spondylolysis is a stress fracture that usually presents an issue to children, teens and active younger adults.
Causes:
- Overuse of bones in the lower extremities
- Low estrogen levels in women
- Lack of warming up before excessive physical activity
- Decrease in bone density with age
- Weakened bones due to osteoporosis
- Long-term use of corticosteroids
- Poorly cushioned shoes
- Anatomical abnormalities like fallen arches
- Poor-quality sports equipment
While an unwavering commitment to your workout regimen or sports activity is commendable, your habitual workout or activity can sometimes result in a repetitive motion that eventually leads to overuse.
That can cause stress fractures, which are actually tiny cracks in the bone as the result of continual running, jumping and participation in certain sports. Any change in the intensity of your workout routine could also lead to a stress fracture since you are more likely to overdo your regimen. The problem can also develop if a change in your activity involves running or jumping on a harder surface because that increases the degree of impact that your body is forced to absorb.
If you haven’t been exercising regularly and suddenly decide to begin a regimen, then you are also at risk of doing too much too soon. Also, anyone who suffers from osteoporosis – which involves a reduction in density and strength in your bones – is more vulnerable to experience a stress fracture.
Finally, if you attempt to ignore your pain, you may also overcompensate by changing your technique. This can create a number of issues while providing yet another cause of stress fractures.
According to the American Academy of Orthopaedic Surgeons, studies show that athletes, especially runners, are at high risk for stress fractures, which are small cracks in the bones commonly located in the foot or ankle. Dr. Brian Straus, an orthopedic surgeon at OrthoTexas, said in 2014 that he dealt with this injury often. “Most stress fractures are due to training errors, such as increasing mileage or activity faster than the body can repair itself.” Dr. Straus said in some cases the origin of the fracture is due to underlying issues with alignment, nutrition or metabolism, though the majority of incidents occur as a result of training error.
Symptoms:
- Dull pain around the affected area, which worsens with physical activity and resolves with rest.
- Swelling around the site of the fracture.
- Spot tenderness upon touching.
- Pain that worsens at night is a typical symptom of stress fractures.
- Ignoring these symptoms can cause the condition to worsen, leading to earlier onset of pain with light physical activity.
If your level of pain is reduced when you are resting, then reemerges when you are engaged in your exercise or workout activities, then that is an indication that you might be contending with a stress fracture. This is also the case if you notice tenderness, bruising or swelling at the area of discomfort.
If the source of pain is located in your back, then any increase in discomfort when standing or arching your back could be a sign that you have a stress fracture.
Women are more susceptible to this injury, as is anyone with flat feet or high arches. Also, previous instances of stress fractures will increase your chances of experiencing another injury.
When to See a Doctor
The pain from your stress fracture might not be serious when it initially appears. But it usually must be dealt with one way or another. If your discomfort increases over time or remains problematic even after you attempt to rest, then you should absolutely visit a doctor.
Any problem that you already have can become worse if you ignore the pain by refusing to alter your normal activities that have created the fracture in the first place. Any failure to avoid the repetitive motion that has caused your issue can intensify your injury, which can then develop into a chronic problem or even a more complete break.
It is also possible to develop arthritis if your problem is not treated in a timely fashion. This makes it essential that you seek the attention of a physician so that a plan will be developed for the area of your stress fracture to heal properly. This will also reduce your pain, and eventually eliminate it.
If you wisely allowed a minor stress fracture to heal but later resumed your previous activity too quickly, then any new pain should also result in a visit to your physician.
Dr. Straus also recommended that athletes listen to their body. “If a localized pain is worsening with activity and not relieved by the usual tincture of time and TLC, get a diagnosis and be safe.”
What a Doctor Will Do
If you are concerned that you may have a stress fracture, and decide to visit a doctor, he or she will ask you a series of questions. This will enable your physician to review your medical history and determine your degree of involvement in physical activities. X-rays, MRIs and bone scans might also be used to finalize a diagnosis. Forms of treatment can include rest and ice. Surgery is an infrequent but potential option depending upon the seriousness of your situation.
Treatment: Home care for stress fractures follows the same regimen as that for most orthopedic disorders, constituting RICE (Rest, Ice, Compression, Elevation). You might need to see a doctor if the pain gets worse with time or refuses to subside.
The treatment begins with the administration of anti-inflammatory medication, combined with analgesics. If the condition does not subside with these medications orthopedic treatment consisting of casts, crutches, walking boots, or braces, all of which help to limit the movement. A healing time of 1-3 months is recommended before physical activity can be gradually reintroduced. Physical therapy aimed at improving strength and flexibility is also recommended in the treatment of stress fractures. This can help to prevent the recurrence of the stress fractures.
In the case of extreme pain, patients might need to be administered with pain medications. The final line of treatment that is opted for in severe cases of stress fractures is surgery. This is usually needed in case the fractures displace.
OrthoTexas offers advanced treatment for stress fractures with specialized orthopedic surgeons at multiple, convenient locations.
Only a health care professional should perform the hop test, or foot stress fracture test, because it cannot isolate the cause of pain and could make some conditions worse.