Stress Fractures - What you need to know
Figure 1: Ankle and Hip Pain - Stress Fractures - Physio Frenchs Forest, Physio Macquarie Park
What is a stress fracture?
A stress fracture is a crack in the bone that occurs when your body receives too much stress. This can come from impact or overuse of the affected area, or from muscle fatigue. Stress fractures are common in weight-bearing bones like the feet, ankles, legs and hips. They also frequently occur in the spine (spondylolysis), lower back (lumbar vertebral stress fractures) and pelvis.
When can a stress fracture occur?
Stress fractures can occur in any bone, but they're most common in the lower leg, foot and ankle. They occur when a stress (a force) is applied to a bone with insufficient time to recover between activities. You can get a stress fracture if you:
Run too much on hard surfaces (like concrete) or do not run enough on soft surfaces (like grass).
Train for a marathon without properly building up your mileage first.
Play sports involving quick starts, stops and changes of direction like basketball or soccer; or high-impact activities like gymnastics or volleyball.
Figure 2: Ankle and Hip Pain - Stress Fractures - Physio Frenchs Forest, Physio Macquarie Park
What are the symptoms of a stress fracture?
A stress fracture is usually a very painful injury. If you have one, you may experience the following symptoms:
Pain in the affected area
Swelling of the injured area
Tenderness to touch or pressure over the affected bone
Stiffness in or around your joints or muscles
Pain during/after running or sport
Pain at night time when sleeping
What are the risk factors for developing a stress fracture?
The risk factors for developing a stress fracture are the same as those of any other injury. In fact, you could say that they're the risk factors of life in general: overuse, underuse and poor nutrition. If you run too much or too little; if your food is processed or not; if your feet aren't well-supported—all these things increase your risk of musculoskeletal injury because they put undue stress on your body.
There is one more major risk factor for developing a stress fracture: genetics. It's been shown that some people have weaker bones than others due to their genes, so it stands to reason that if you have weak bones, it will be more likely for them to break when put under strain (as happens with running).
How are stress fractures diagnosed?
A physiotherapist will take your medical history to see if there are any risk factors for fractures, such as previous broken bones or an underlying condition. Then they'll examine you and ask questions about your symptoms. A CT scan or an MRI is commonly used to diagnose a stress fracture.
How are stress fractures treated?
If you have a stress fracture, the Physiotherapist will tell you to rest a for a period (anywhere from 6 weeks to 6 months). A physiotherapist might suggest using crutches or splints while resting the injury.
Once the initial period of resting has occurred, the Physiotherapist will prescribe strengthening exercises in a slow manner. These are aimed at restoring the strength of the muscles, and assessing if the body is going to tolerate loading.
In conclusion, it is important to understand that stress fractures are common in athletes and can be difficult to treat. Risks for developing a stress fracture include having weak bones, being underweight or overweight, having tight muscles (tendinitis), and participating in sports that involve repetitive stress on the same bone area such as running or jumping. If you think you might have one of these injuries, please contact your doctor immediately!
See our expert Physiotherapy team at Frenchs Forest and Macquarie Park!