Stress Fracture

Stress Fracture

(Fracture, Stress)

Definition

A stress fracture is a tiny crack in the bone. They are most common in the lower leg and foot.

Stress Fractures of the Tibia and Fibula

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Causes

This fracture is caused by repeated stress or overuse from:

  • Increasing the amount or intensity of an activity too quickly
  • Changing to a new playing surface
  • Not wearing the right shoes or wearing old shoes for a sport

Risk Factors

Stress fractures are more common in women. Things that may raise the risk of this fracture are:

  • A sudden increase in activity
  • Not getting enough rest between physical activities
  • Playing sports that involve running and jumping, such as track and field, tennis, gymnastics, and basketball
  • Having female athlete triad
  • Bone disorders, such as osteoporosis and Paget disease
  • Low levels of vitamin D and calcium
  • Smoking
  • Alcohol use disorder

Symptoms

Symptoms may be:

  • Pain that is worse with activity and better with rest
  • Swelling

Diagnosis

The doctor will ask about symptoms and past health. They will also ask about regular activities. A physical exam will be done. The doctor may suspect a stress fracture based on symptoms. Images may be taken if pain is severe or fracture is not healing as expected. Tests may be:

Treatment

It can take 6 to 8 weeks for a stress fracture to heal. The goals of treatment are to manage pain and support the bone as it heals. Options may be:

  • Walking boot, crutches or a cane to keep weight off of a foot or leg stress fracture.
  • Limiting activity that is causing pain or stress.
  • Medicine to ease pain and swelling.
  • Exercises to help with muscle strength and range of motion will be needed.

Prevention

To lower the chance of a stress fracture:

  • Slowly increase the amount and intensity of activities over time.
  • Wear the right shoes for sports.
  • Eat a diet that contains foods with vitamin D and calcium.

RESOURCES:

American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Femoral stress fracture. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/femoral-stress-fracture. Accessed September 30, 2020.
Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
...(Click grey area to select URL)
Accessed September 30, 2020.
Stress fractures of the foot and ankle. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/stress-fractures-of-the-foot-and-ankle. Accessed September 30, 2020.
Tibial plateau fracture. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tibial-plateau-fracture. Accessed September 30, 2020.
Welck MJ, Hayes T, et al. Stress fractures of the foot and ankle. Injury 2017 Aug;48(8):1722.
Last reviewed January 2021 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 9/8/2020

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