WHAT IS A STRESS FRACTURE?
A stress fracture is a fracture of a bone caused by a repetitive, rather than sudden, mechanical stress. It is most commonly seen in the weight bearing bones of the lower leg and foot. But they can occur in any bone in the body that takes on too much stress.
WHAT CAUSES A STRESS FRACTURE?
Stress fractures are most often caused by overuse. They may occur if you change the kind of shoes you wear or change your level of activity to a higher intensity or frequency. High-impact activities and those that incur repetitive use include running, dancing, and sports. Osteoporosis is also a risk factor in developing a stress fracture because weaker bones are more susceptible to injury.
HOW DO YOU DETECT A STRESS FRACTURE?
The symptoms of a stress fracture may not be noticeable when the fracture is very mild. Some people feel a dull pain during high-impact activities such as running. If the injury is severe or worsens, the pain may increase. Pain may also interfere with movement, depending on its location. Swelling and tenderness may also be felt.
A doctor diagnoses a stress fracture by performing a consultation to find out more about the symptoms, such as their intensity, frequency, and duration, and by performing a physical examination and necessary tests. Examples of diagnostic tests that help diagnose a stress fracture include x-rays and magnetic resonance imaging (MRI). In some cases, doctors order a bone scan.
RISK FACTORS FOR STRESS FRACTURES
Although athletes, especially track and field athletes, have increased susceptibility to stress fractures, they can occur in anyone, particularly those who take up a new sport or begin a period of extreme exercise. Military recruits, who are abruptly required to engage in prolonged periods of intense exercise, frequently suffer stress fractures. Other risk factors for stress fractures include the following:
- Abnormal or absent menstrual periods
- Flat feet or high arches
- Bones weakened by osteoporosis, bone cancer or other diseases
Bones can also become weak from long-term use of corticosteroids and other medications.
TREATMENT OF STRESS FRACTURES
Treatment of a stress fracture depends on its location and severity, but usually consists of resting the affected bone, applying ice, reducing weight-bearing activity, and immobilizing the injured area with tape, a cast or a splint. For leg or foot stress fractures, patients often use canes or crutches during recovery. In some cases, surgery may be necessary to hold the bone in position (internal fixation).
Surgery is more common if the fracture is in a region in which blood circulation is poor, or if the patient has experienced more than one such fracture. When surgery is necessary, metal pins or screws may be needed to hold the bone in place as it heals. Physical rehabilitation is necessary after surgery, and patients should resume physical activity only gradually.
CAN YOU WALK ON A STRESS FRACTURE?
Whether or not your doctor will advise you to continue on with your normal activities (with relative limitations) depends on the severity and location of your fracture. When fractures are milder, a doctor may recommend refraining from any activity that causes pain. When the injury is more severe, it may also be necessary to avoid weight-bearing as much as possible for a period of time in order to allow healing.
Some bones are more susceptible to stress fractures because of lack of blood supply. In these cases, more restrictions are typically needed.
HOW LONG DOES IT TAKE FOR A STRESS FRACTURE TO HEAL?
Stress fractures often heal spontaneously with rest and protective footwear. This can take several weeks, depending on where the fracture is located and how severe the injury is. Being able to walk without pain indicates that the bone has healed and you can gradually resume normal activities.
To help a stress fracture heal, a doctor may recommend:
- Avoiding any activity that causes pain. Stress fractures are often related to repetitive use or stress on a particular part of the body.
- Applying ice to the area for 10-minutes a few times a day.
- Resting the injured area.
- Managing swelling by adjusting body position frequently and lifting the injured limb above the heart. For example, a foot with a stress fracture can be placed on several cushions while lying on your back.
- Using protective footwear such as a boot or using crutches if advised by your doctor.