Stress fractures can occur in any physically active person. However, 15% of all stress fractures occur in runners. The lower leg and the foot are the most common areas to get a stress fracture. But they also can happen in other parts of the body, such as the arm, spine, or ribs. Although both men and women can get stress fractures, women report more such injuries than men.
What is a stress fracture?
A stress fracture —also called a hairline fracture — is a tiny crack in a bone that happens from repeating the same movement over and over (such as when someone trains for a sport). These kinds of fractures can also happen from everyday activities in people whose bones are weak.
Most stress fractures heal well, but if you resume physical activities before you’re fully healed you can make a stress fracture bigger and slow the healing process.
Other symptoms include:
- Swelling at the top of the foot or the outside of the ankle
- Tenderness when the fracture area is touched
- Bruises at the site of the fracture
It is important to see your doctor about any symptoms of a stress fracture to avoid further damage to your bones.
If you have very weak bones from a separate, underlying condition (such as osteoporosis), you might be at risk of sustaining a stress fracture in the foot. This may be possible even from a fairly low-impact activity like frequent walking.
Shoes that provide poor support like high heels, as well as old, stiff shoes, can also put you at risk, while high, inflexible arches or flat feet may increase the risk of stress fractures of the tibia (the bigger bone in the lower part of the leg).
Who can get it
Most stress fractures are caused by overuse and repetitive activity and are common in runners and athletes who participate in running sports such as soccer and basketball.
The bones of the foot and lower leg are most vulnerable to stress fractures because of the repetitive forces they absorb during activities like walking, running, and jumping.
You can get a stress fracture when you begin a new exercise, suddenly increase the intensity of your workouts, or change the workout surface, like running on a treadmill then moving to running outdoors.
Diagnosis/tests for a stress fracture
To diagnose a stress fracture, your doctor will first ask about your general health and physical activities (such as sports). Then they will do an exam to check for tenderness, swelling, or redness. X-rays are usually done as well.
Some stress fractures don’t show up on an X-ray until a few weeks after the bone starts hurting. Sometimes an magnetic resonance imaging (MRI) scan or a bone scan is needed to confirm the stress fracture.
Treatments for a stress fracture
Most stress fractures will heal on their own if you reduce your level of activity and wear protective footwear for a period of time. However, the most important treatment is rest.
You may need to rest from the activity that caused the stress fracture and engage in a pain-free activity during the six to eight weeks it takes the majority of stress fractures to heal.
Your doctor may recommend any of the following interventions to treat you.
The following are some of the things you can do to take care of a stress fracture at home:
- Protecting the fracture site by reducing weight-bearing activities (like walking)
- Using cold packs
- Wearing shock-absorbing shoes during exercise
- Running on soft surfaces, such as grass
- Switching to a less stressful activity, such as swimming or biking
- Wearing a brace, boot, or cast
Other methods you could use to help treat a stress fracture include attending physical therapy sessions and including calcium and vitamin D in your diet. Some studies have shown that vitamin D and calcium supplements can help strengthen bones.
Certain stress fractures may lead to complications, including progression to complete fractures. Do not use NSAIDs in place of other pain relievers that have no or little side effects.
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