Stress Fractures: Causes, Symptoms, Treatment, Recovery, Complications
What are Stress Fractures?
Stress fractures are one of the most common injuries every athlete will get at least once in their lifetime. Stress fractures do not have anything in common with the psychological stress, but they have to do something with the physical stress that allows them to be formed. Stress fractures happen when you overuse your body. Thus, it is an overuse injury. Stress fractures can best be described by orthopedists who describe it as a small crack in the bone. Stress fractures is also known under its other name which is Hairline Fracture. Sometimes, it is also referred to as Fissure Fracture. Stress fractures a.k.a. hairline fractures are usually a result of repetitive force, often from overuse - such as running for a long time or jumping up and down with a great amount of force for a prolonged time. However, stress fractures not only happen because of excessive athletic activity, they also happen due to underlying bone conditions as well.
Where do stress fractures most commonly develop? They appear most commonly in the weight-bearing bones located in the foot and the lower leg. Military recruits and track and field athletes are most prone for developing stress fractures. However, anyone can get stress fractures. For example, people who start with a new exercise program can also develop stress fractures. The most common bones in which stress fractures develop are:
The less common bones in which stress fractures develop are:
Stress Fractures of Shin
Shin is a common bone where stress fractures develops. Medical professionals call shin by its Latin name tibia. The tibia is a larger bone of the two shin bones. Because it is a weight-bearing bone, it is more prone to stress fractures. Particularly, the lower third of tibia is susceptible to stress fractures. Let us first learn about the two bones in the shin.
The two bones which are located in the lower extremity are called fibula and tibia. The tibia is the larger bone and its role is load bearing. The fibula is a smaller bone. Its role is muscle attachment. Both the fibula and tibia are prone to stress fractures. However, the most common site where stress fractures happens is the site 3 inches above the bony bit on the inner side of the ankle on the tibia bone. Cause of stress fractures of the shin is mainly the overload of the bone by continuous muscle contractions. Runners who often change their running tracks, for example running on a grassy field and later changing to a paved road often get stress fractures of the shin.
The symptoms of stress fractures of the shin include pain, particularly the pain in the lower third part of the tibia that usually occurs after running for a long time. Most of the time, there will be swelling and tenderness in the shin area where stress fractures had occurred. An X-ray scan of the shin affected by stress fractures usually will not show any signs of stress fractures. However, X-ray scan will show some signs of stress fractures 4 weeks after the injury of the shin.
People who get diagnosed with stress fractures of the shin should rest for at least 8 weeks. They should also avoid weight-bearing exercises.
Stress Fractures of Heel
Stress fractures of the heel is a common condition of many athletes. Stress fractures of the heel is also called Calcaneal stress fractures since the latin name for heel bone is calcaneus. This type of stress fracture is commonly induced by overuse. Calcaneal Stress Fracture is very common in soldiers.
The symptoms of stress fractures of the heel might resemble the symptoms of a bruised heel. Pain will come and go and get worse with weight-bearing activity such as running or jumping. A medical doctor might diagnose stress fractures of the heel by squeezing the back of the heel and asking a patient if it experiences any pain.
Calcaneal stress fractures is an overuse injury. Ballet dancers, soldiers, and athletes are most prone to developing it. Calcaneal stress fractures is the second most common stress fracture after navicular stress fractures. An X-ray scan usually will not show any signs of stress fractures of the heel. Patients that were diagnosed with calcaneal stress fractures should rest for 8 weeks and avoid any physical activity. In severe cases of a calcaneal stress fractures, a plaster cast is applied.
Stress Fractures of Wrist
Stress fractures of the wrist is a very common injury among the athletes and the people who fall on solid surfaces. Stress fractures of the wrist can happen in any of the bones in the forearm or the wrist. Common causes of Stress Fractures of the Wrist include:
- Contact in an athletic sport.
- Car accidents.
- Repetitive force without rest.
People who suffer from osteoporosis are at higher risk of getting stress fractures of the Wrist.
STRESS fractures of the wrist usually causes sharp pain immediately after getting injured. The pain later on progresses into a dull pain. Also, the pain associated with stress fractures of the wrist worsens with the movement of the wrist.
An X-ray scan usually will not find any signs of this type of injury. However, an experienced orthopedist can diagnose stress fractures of the wrist just by palpating your wrist. The common treatment for this type of injury is wearing a cast and physical exercises that are prescribed after taking off the cast.
Stress Fractures of Metatarsal
Stress Fractures of the Midfoot, a.k.a. stress fractures of Metatarsal are a very common type of stress fractures. People who get this type of injury are usually athletes and soldiers. Stress Fracture of metatarsal usually happens due to a repeated stress to the metatarsal bones.
There are only five metatarsal bones in each foot. Stress fractures of the midfoot usually happen in the first, second, and the fifth metatarsal bone. An X-ray scan will most of the time be able to find stress injury of the metatarsal bones.
Treatment for mild cases of stress fractures of metatarsal includes taking simple painkillers and wearing a cast.
Stress Fractures of Knee
Stress fractures of Knee is not very common. However, when it happens it usually affects the part just below the knee called proximal tibia. The proximal tibia bone is the upper part of the tibia bone. It widens near the knee to help form the knee joint.
The symptoms of stress fractures of knee include:
- Pain that gets worse when weight is placed on an affected knee.
- Slight swelling around the knee.
- Pale and cool foot of the affected leg.
- Numbness in the foot of the affected leg.
- Casting and bracing are common treatment options for mild cases of stress fractures of knee.
Stress Fractures of the Back
The stress fractures of the back is called by the medical professionals spondylolysis. Stress fractures of the back is one of the most common causes of pain in the back.
Spondylolysis is most common in adolescents and young adults that participate in sports that stress the lower back such as football, weight lifting, and gymnastics. Spondylolysis is most often a result of stress fracture in the the pars interarticularis of the vertebra.
The symptoms of stress fractures of the Back include:
- Unilateral back pain.
- Dull back pain.
- Pain that radiates to buttocks or thighs.
X-ray scans and SPECT Bone Scan are used to diagnose underlying stress fractures of the back. The treatment of Spondylolysis is usually conservative. Hydrotherapy is often recommended for this type of injury.
Stress Fractures of the Hip
Hip stress fractures are serious injuries that mostly affect athletes. Stress fractures of the hip is a serious injury to the ball of the hip joint. Stress fractures of the Hip can happen to anyone.
If stress fractures of the Hip does not get treated, it can cause the hip bones to be weaker which later on can lead to the total misalignment of all hip bones. Hip stress fractures can damage the blood supply to the hip, which leads to a condition called hip osteonecrosis. Aching groin pain is the main symptom of stress fractures of the Hip.
In case your doctor suspects you might have hip stress fractures, he/she will order an X-ray scan or a bone scan. Hip stress fractures usually does not require any treatment. However, it does require treatment in serious cases when it could lead to bone displacement. Some people may also be prescribed to walk with the help of crutches as they heal from hip stress fractures.
What Causes Stress Fractures?
The main cause of any stress fractures is a prolonged micro-trauma to the bone. That means that prolonged walking, jumping, weightlifting, and other sport activities cause stress fractures.
Every bone tends to remodel itself after a physical activity. However, if a physical activity without rest is performed for a couple of hours, stress fractures usually happens.
How do You Get a Stress Fracture?
As it was said before, you get stress fractures if you expose yourself to demanding physical activities such as running and jumping for a prolonged time without any rest.
What are the Symptoms of Stress Fractures?
Stress fractures commonly present themselves as a pain that is associated with weight bearing that gradually increases with a physical activity.
The pain associated with stress fractures subsides with proper rest. Tenderness and swelling in the area affected by stress fractures is also present.
Tests to Diagnose Stress Fractures
If your physician suspects that you might have stress fractures, he/she will refer you to a specialist for conditions of the bone called orthopedists. An orthopedist can usually diagnose stress fractures by taking your medical history and by palpating area that is suspected to be affected by stress fractures.
However, your orthopedists might send you to perform the following tests:
- X-ray scan can be used to diagnose stress fractures. Stress fractures usually are not visible on an X-ray scan immediately after an injury. It can take weeks for them to be visible on an X-ray scan.
- Bone Scan can immediately diagnose stress fractures. Before a bone scan is performed on you, you will need to take a radioactive material intravenously.
- An MRI Scan usually shows signs of stress fractures a week after an injury.
Treatment for Stress Fractures
Treatment of stress fractures depends on fracture's severity. Simple painkillers and wearing a cast are two most common treatments for stress fractures. Surgical treatment is only needed in the treatment of severe cases of stress fractures.
Recovery Period/Healing Time for Stress Fractures
How Long Does it Take to Recover from a Stress Fracture?
It usually takes several weeks. An average time to recover from stress fractures is 6 to 8 weeks.
The recovery period from nonsurgical treatment of stress fractures is usually 6 to 8 weeks. The healing time from surgical treatment of stress fractures is usually 8 weeks.
During the recovery period from stress fracture, physically active people are not allowed to perform any exercise. It is also advised for them to eat food rich in Calcium that will heal their bones in a fast manner.
Prevention of Stress Fractures
Not exposing yourself to prolonged physical activity and having a proper rest is the best prevention method against getting stress fractures.
Risk Factors for Stress Fractures
Everyone can get stress fractures. However, the people who are highly active are at the highest risk of getting stress fractures. Particularly the population that is in the military and the athletes are at high risk of getting Hairline fractures a.k.a. stress fractures.
Elderly active people are at the highest risk of developing stress fractures. People that suffer from osteoporosis sometimes also develop stress fractures if they expose themselves to physical activity.
The lack of Vitamin D and the lack of calcium are also risk factors for developing stress fractures. The female population is at a higher risk for getting stress fractures than the male population. Persons that have flat or high feet also get more often stress fractures. Persons that had stress fractures in the past also get stress fractures more often.
Complications of Stress Fractures
Some cases of stress fractures do not heal completely, which leads to chronic pain. People that do not treat their hip stress fractures can develop a serious hip condition called hip osteonecrosis.
Coping with Stress Fractures
The support of your family and friends is the best coping method while you are recovering from stress fractures.