Stress Fractures In Athletes

Stress fracture, a tiny crack in a bone caused by repetitive stress or high impact force, often from overuse can cause athletes great pain.

Athletes/ runners who prep for a 10km or marathon have complained of shin pain. Strenuous training, running mileage in preparation for a race can cause a stress fracture. Stress fractures account for 0.7% to 20% of all sports medicine clinic injuries. Track-and-field athletes have the highest incidence of stress fractures compared with other athletes.

Types of stress fractures

  • Metatarsal stress fracture. Metatarsal bones are the long bones in the foot that link the ankle to the toes. ...

  • Navicular stress fracture. ...

  • Tibia stress fracture. ...

  • Rib stress fracture. ...

  • Hip stress fracture...

  • Back Stress fracture (Spinal Compression Fracture: The main symptom you'll notice with a spinal compression fracture is back pain)

Spondylolysis may or may not cause symptoms, such as low back pain. ... Spondylolysis is a stress fracture in the pars of the vertebrae in the lumbar spine. Stress fractures are tiny hairline breaks in the bone. Stress fractures result from high impact force, back hyper-extension, or repetitiveness.

It is crucial to detect spinal anomalies in athletes to avoid the “over risk” of acute or chronic injuries.

People ASK:

Why do I keep getting stress fractures?

The most common reason is a sudden increase in training – mileage and/or intensity. You state that you have small bones; if your bone density is low, you are at increased risk for stress fractures. ... Low estrogen levels decrease your bone density. High arched feet may increase the risk of developing a stress fracture.

​Can you walk on a stress fracture?
The weight-bearing bones of the foot and lower leg are especially vulnerable to stress fractures because of the repetitive forces they must absorb during activities like walking, running, and jumping.
​How long does it take to heal a stress fracture?

6 to 8 weeks

Recovery. In most cases, it takes from 6 to 8 weeks for a stress fracture to heal. More serious stress fractures can take longer.

​How do you diagnose a stress fracture?
X-rays. Stress fractures often aren't apparent on regular X-rays taken shortly after your pain begins.
Bone scan. ...
Magnetic resonance imaging (MRI).

Can you play sports with a stress fracture?

If you have a foot stress fracture, you can't run, but maybe you can run in the pool or swim, so you can maintain your cardio without exacerbating the injury.

​What causes recurrent stress fractures?
To decrease the likelihood of a recurrent stress fracture, determine why the first one developed. Build your level of training more slowly. Supplement your intake of vitamin D and calcium. Run on softer surfaces as much as possible. Have your coach or a running store specialist evaluate your running gait to determine the best shoes
​Do stress fractures always heal?
Although it can be hard to be sidelined with an injury, returning to activity too soon can put you at risk for larger, harder-to-heal stress fractures and an even longer down time.

Stress fractures, however, can be much more difficult to diagnose.

Hairline or stress fractures are tiny cracks on a bone that often develop in the foot or lower leg. It is common for hairline fractures to occur as a result of sports that involve repetitive jumping or running.

A tiny crack subsequently develops in the bone that may or may not be obvious on an X-ray. Think of bending a piece of metal over and over; eventually it weakens and breaks.

Stress fractures can involve any bone, but the most common locations and their associated sports include the leg, hip and foot (runners & jumpers), the spine (gymnasts, divers & volleyball players), arms (throwers), and ribs (rowers). The forces experienced by bones in the feet and legs can be up to twelve times a person’s weight. Stress fractures are one of the five most common injuries in runners and account for up to half of injuries in soldiers.

Classical ballet, aerobics, tennis, and volleyball athletes predominantly sustained stress fractures of the tibial shaft. Basketball athletes predominantly sustained stress fractures of the tibial shaft and medial malleolus and the metatarsal bone, whereas track and field and soccer athletes predominantly sustained stress fractures of the tibial shaft and pubic bone.

Signs and Symptoms

Athletes may Develop the following symptoms suggesting a stress fracture:

  • Pain during activity (eg, walking, running, jumping)

  • Sharp pain over a specific point on the bone (eg, point tenderness)

  • Aching pain after activity

  • Swelling without bruising at the painful site

  • Difficulty tolerating usual recreational/occupational demand

The pain typically comes on gradually and initially is felt at the end of the activity that causes the pain. The pain then becomes more severe, causing the person to limit participation. During the early phase of injury, the pain is relieved with rest, while it may not be as the damage progresses. Many patients complain of pain at night, and athletes frequently have a hard time pinpointing a specific spot where it hurts.

Risk factors of stress fractures in female athletes can include, menstrual disturbances, caloric restriction, lower bone density (known as osteoporosis), muscle weakness and leg length differences are risk factors for stress fracture.

During military training, stress fractures are the second-most common injury among women and the fifth-most common injury among men, affecting up to 21% and 5% of female and male recruits, respectively. (1,2) It has been estimated that stress fractures cost the US Department of Defense approximately $100 million annually. (3) Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are commonly prescribed for their analgesic and anti-inflammatory properties, and their use is widespread in the general, (4) athletic, (5) and military popula- tions. ... Get in and see a pain management doctor. The physical exam will shed some light on the diagnosis. One sure way to determine what may be causing your pain is by pressing or tapping the affected area. Any swelling or redness in the pained area is also an indication of a stress fracture. Having the patient put stress on the bone by hopping, etc. may worsen the pain.

Diagnosis is not so simple. Often CT or MRI scanning is needed to locate and assess the severity of the fracture. Nuclear bone scans can also be useful. What study to order is usually determined by the site of the possible fracture and other medical conditions the patient may have.

Treatment of a stress fracture – take the pressure / stress off the bone. Rehabilitation usually takes 4 to 12 weeks depending on the site and severity of the fracture. Occasionally stress fractures do not heal and require surgical stabilization. One rule of thumb is to increase activity about ten percent a week during rehabilitation.


Stress Fractures

Hairline fracture: Symptoms, treatment, and causes

Stress fractures in athletes: Review of 196 cases

Risk factors for stress fractures. - NCBI​

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