A stress fracture is an overuse injury that occurs when repetitive load is applied to a bone without allowing sufficient time to fully recover it. The bone fatigues and eventually gets ‘stressed’ and tiny cracks start to form in the bones.
Stress fractures are most common in youth athletes where a sport or activity involves continuous running and jumping. This is because the skeletal system is still being developed in a young person’s body while regular stresses are being placed on it. Typically, they occur in the body’s lower limbs such as the shin, and bones of the foot and hip. Another common site for stress fractures in youth is the spine.
Who is most at risk for stress fractures?
- Those with low bone mineral density
- Age <15yrs
- Female > male
- History of stress fracture
- Low BMI <19
- Eating disorders or those with low energy
- Metabolic disorders such as thyroid dysfunction
Stress fractures can be confirmed with a bone scan or MRI but in the clinical setting, patients will present with consist of increased pain during an activity that is relieved by rest, tenderness around the site of injury and possible swelling, and an onset of the same pain when returning to the sport or activity.
Treatment of stress fractures will vary depending on the severity. We find that conservative management is very effective although it is slow and can take months to fully recover.
Healing of the fracture site can take up to 6 weeks, sometimes even longer. Once healed, patients will gradually return to weight bearing exercises and sports.
Our Physiotherapists will assist in diagnosing and determining the cause of a stress fracture. A full assessment will also help to know the approximate healing time and techniques to recover.
Kiel J, Kaiser K. Stress Reaction and Fractures. [Updated 2020 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507835/
Denay KL. Stress Fractures. Current sports medicine reports. 2017 Jan 1;16(1):7-8. Available from: https://journals.lww.com/acsm-csmr/Pages/articleviewer.aspx?year=2017&issue=01000&article=00005&type=Fulltext (last accessed 1.12.2019)
Liem, B. C., Truswell, H. J., & Harrast, M. A. (2013). Rehabilitation and return to running after lower limb stress fractures. Current sports medicine reports, 12(3), 200-207.