What are Stress Fractures?
Stress fractures are considered an overuse injury occurring when the muscles become overtired and less capable of absorbing shock from high-impact sports. The muscles become fatigued and eventually transfer the excess stress to the bone and ultimately cause tiny cracks or fractures.
Stress fractures usually occur at the second and third metatarsals of the foot. They are also common in the heel and at the navicular bone which is located on the top part of the midfoot. Repeated stress to the foot can injure these weight-bearing bones, and also the bones of the lower leg, producing fractures. Approximately 50% of all stress fractures occur in the foot.
Common Causes of Stress Fractures
Research has shown that stress fractures more frequently occur in high-impact sports such as track and field, tennis, distance running, gymnastics, and basketball. This is due to the repeated stress of the foot hitting the ground.
The risk of stress fractures goes up when intensity or level of exertion, the frequency of exercise, and the duration of exercise increases high-impact activities. Other causes include using improper equipment such as wearing shoes that are not as flexible as is ideal when running. Repetitive stress can also cause trauma to the bones.
Although stress fractures can affect people of any age, studies have shown that female athletes are more susceptible to them. Orthopedic surgeons accredit this to the fact that female athletes are at higher risk for other conditions, such as eating disorders, that can also weaken their bones and muscles. Amenorrhea, or infrequent menstrual cycles, and osteoporosis also decrease a females bone mass and increase her chance’s of getting stress fractures.
Symptoms of Stress Fractures
The most common complaint among stress fracture patients is increased pain with activity. The pain comes on gradually and increases with high-impact activities. As a fracture gets worse pain will also increase during normal, everyday activities. There is often a tenderness to touch at the site of the fracture and there can also be some swelling around the ankle or on top of the foot. In some cases this can be accompanied by bruising.
Treating Stress Fractures
The most important aspect of treating a stress fracture is to rest, especially from the activities that could possible have caused the stress fracture. It generally takes six to eight weeks for a stress fracture to heal so any high-impact or weight-bearing activities should be avoided for at least this amount of time. Returning to these activities to quickly makes it harder for a stress fracture to heal and can even cause a worsening of the fracture to a point where it may never heal properly or completely. Along with rest wearing braces or other appliances such as inserts for shoes can be helpful in healing stress fractures.
Stress fractures can be prevented by setting goals that help to gradually build up strength and stamina. Cross training is another great way to prevent stress fractures. In cross training, alternating activities that bring about the same fitness objectives help prevent not only stress fractures but other high-impact injuries as well. It is also very important to use proper equipment and to maintain a healthy diet.
Sources
Young, Warren, and Richard Budynas. Roark’s Formulas for Stress and Strain. Columbus, Ohio: McGraw-Hill Professional; 7th Edition, 2001.
Swindoll, Charles R. Stress Fractures. Grand Rapids, MI: Zondervan Publishing Company, 1999.
Ellis, Joe, and Joe Henderson. Running Injury-Free: How to Prevent, Treat and Recover from Dozens of Painful Problems. New York, NY: Rodale Books, 1994.
Brukner, Peter, Kim Bennell, and Gordon Matheson. Stress Fractures. Champaign, IL: Human Kinetics; 1st Edition, 1999.
