Overview

What is a stress fracture?

A stress fracture is described as a miniature crack in a bone. It's often caused by repetitive forces, especially as a result of overuse-for example, repeatedly jumping up and down or running long distances. Stress fractures also can occur in bones that are subject to normal use but weakened by conditions such as osteoporosis.

Stress fractures mainly occur in the weight-bearing bones of the lower leg and foot. Track and field athletes as well as military recruits are among those at greatest risk, but the injury could affect anyone. For example, a stress fracture could occur in you when you start an exercise program, doing too much too soon.

What are the types of stress fractures?

Stress fractures tend to affect weight-bearing bones in your lower body. These are bones that carry your body's weight when you're standing or moving around. You are most likely to suffer a stress fracture in one of the following bones:

• Lower leg (Your tibia and fibula)
• Foot: They tend to be more serious in the metatarsals, which connect your ankle and heel to your toes. Metatarsal stress fractures are located near the ends of these bones and near the bases of your toes.
• Heel: The calcaneus is the bone shaped like an inverted "L." It's associated with stress fractures of the heel.

What are the symptoms of a stress fracture?

They occur less often, but stress fractures can even affect bones in your:

• Lower back (You might get a stress fracture in your lumbar spine).
• Hips.
• Hand and wrist.

Common symptoms and signs of a stress fracture include:

• Activity-related and activity-worsening
• Does not respond to rest
• It is worse with time
• Is tender to touch over or near the injured bone
• Swelling

What causes a stress fracture?

Most stress fractures result from overuse or repetitive activity. Increasing either the amount of time spent or the number of instances performing an activity can lead to this type of fracture. So even if normally, you are accustomed to running, a sudden increase in how far you run or how often per week that you run may result in this type of injury.

A stress fracture occurs from changing the type of exercise. For example, if one is an excellent swimmer, there is still a possibility of sustaining an injury from suddenly getting into another intense activity like running.

Bones adapt to increased forces put on them by various activities; new bones that form to replace the old bone begin to form; this is called remodeling. When it breaks down at a rate faster than new bone can form, and then you increase your chance of having a stress fracture.

What are the risk factors of a stress fracture?

Stress fractures occur most commonly in athletes involved in exercises that place a high level of stress on the lower body, such as track and field, soccer, and football. 

• Track and field sports, including distance running.
• Basketball.
• Tennis.
• Gymnastics (gymnasts also are at greater risk for hand and wrist stress fractures).
• Dance.

Some medical conditions may increase your risk of getting stress fractures, including:

• Osteoporosis (these are sometimes referred to as insufficiency fractures).
• Bunions.
• High arch feet.
• Flat feet.
• Vitamin D deficiency.
• Being overweight or obese.
• Having an eating disorder.

How are stress fractures diagnosed?

A doctor will diagnose a stress fracture with a physical exam. They can make a confirmation and get photos of the fracture through imaging tests. They will check your hurt part. Tell them what you were doing when you first noticed pain and other symptoms.

Your doctor will have you stand or hop on one leg and then the other to see where you might have a stress fracture and how much that affects your ability to move normally.

What tests can help diagnose stress fractures?

Your doctor may use some of the following tests to take pictures of your bones.

• X-rays.
• Magnetic resonance imaging (MRI).
• Computed tomography (CT) scan.
• Whole body bone scans.

How can I avoid a stress fracture?

Here's how you can prevent a stress fracture:

• Avoid training or exercising when you're feeling pain. Never "play through pain."
• Gradually warm up and cool off when participating in physical activities.
• Dress appropriately for any sport or physical activity.
• Maintain a healthy diet and lifestyle.
• Consult a doctor if you have some form of discomfort, for example, your pain.

How long to recover from a stress fracture?

Most people will require resting for at least weeks after suffering from a stress fracture. Most of them may require one or two months before returning to their sports and other physical activities.

As long as you feel pain, your bone is still weak in that area and could break again in that same spot. Stress fractures generally take six to eight weeks to heal. Avoid activities that caused the stress fracture during this time.

Your doctor will instruct you on how long to avoid activities such as playing sports or working out.

When should I see my doctor?

Consult your doctor for any new symptom, like pain and swelling. Consult your doctor for any new symptom, like pain and swelling. Your provider will likely check your injury in any case, and even if the diagnosis is not a stress fracture, he or she can discuss possible treatments that can be done to prevent further serious complications.

Listen to your body, but if you have pain during and after physical activity, most of the time, it indicates that you should stop and rest. Most patients can prevent a stress fracture by stopping activities and visiting a healthcare provider the moment they feel and experience pain and other symptoms.

To seek an expert consultation for any orthopedic condition.

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