A stress fracture is a tiny crack in the bone from chronic overuse. Most stress fractures occur in the lower leg and foot. They can also occur in the hip and other areas.
A blow to the bone does not cause a stress fracture. Rather, it is typically caused by repeated stress or overuse. Some causes are:
Increasing the amount or intensity of an activity too quickly (most common)
Switching to a different playing or running surface
Wearing improper or old shoes
Stress fractures can worsen by continued physical stress. Smoking can also make stress fractures worse because it interferes with bone healing.
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for a stress fracture include:
Certain sports, especially involving jumping or running:
Track, especially distance running
Amenorrhea (women only)
Reduced bone thickness or density
Poor muscle strength or flexibility
Overweight or underweight
Poor physical condition
Localized pain on the bone
Pain when pressure is applied directly over the fracture and the area around it
Pain when putting stress on the affected leg
Swelling and warmth at injury site
The doctor will ask about your symptoms and medical history, and examine the injured area for localized pain and swelling.
Tests may include:
X-ray — to look for break in the bone (stress fractures are very tiny and usually not seen on an x-ray until at least two weeks after symptoms begin)
MRI scan — to look for swelling and inflammation inside the bone
Bone scan — to look for evidence of a stress fracture
Rest is the first thing you can do for a stress fracture. This includes avoiding the activity that caused the fracture and any other activities that cause pain. Rest time required is at least 6-8 weeks. Once you are ready to restart activity, your physician may prescribe physical therapy.
The following is a common progression for physical therapy treatment:
Begin with non weight–bearing activities, such as swimming, cycling, use of an Alter-G treadmill, etc.
Next, weight-bearing, nonimpact exercise may be prescribed.
Gradually, low-impact activity, starting with walking will be added to your treatment.
Once you can do fast-paced walking with no pain, your physical therapist will give higher impact activities, such as light jogging.
This gradual progression will continue until you have reached your pre-injury activity level and no longer feel tenderness of the bone.
To reduce your chance of getting a stress fracture:
Wear proper footwear.
Run on a softer surface, such as grass, dirt, or certain outdoor tracks.
Gradually increase the amount and intensity of an activity.
Do not overdo any activity.
Weight reduction can reduce stress on the bones
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