What is a Stress Fracture?

Sports are a terrific source of joy and stress relief, and they’re just as important for adults as they are for young people. They keep us fit and have tremendous benefits for our mental and physical health. But there are some dangers to navigate, especially as we get older. Stress fractures are one of the things that can sideline us as we look to stay healthy and active. A stress fracture, sometimes called a hairline fracture, is a small crack in the bone usually caused by repetitive motion. They often, but not always, affect athletes.

What Are the Causes of Stress Fracture?

The main difference between a stress fracture and an acute fracture is that stress fractures are usually caused by overuse over time rather than a single traumatic incident. The stress of repetitive use can cause tiny fissures in the bone, and this is most often related to athletic activity. According to the American Academy of Orthopaedic Surgeons, some of the main causes of stress fractures are:

• Changing or increasing physical activity, for example exercising more frequently or running longer distances.
• Bone density and bone health. Osteoporosis or low levels of Vitamin D can play a role in stress fractures. Because of a higher rate of bone density issues, women are more susceptible to stress fractures than men.
• Poor conditioning: this can mean not easing into an exercise program after taking time off or trying to move too quickly to achieve your athletic goals and pushing yourself too hard.
• Improper exercise technique and using the wrong form as you run, lift weights or play sports.
• Change in exercise surface, notably in tennis players and runners.
• Inadequate equipment, most often shoes that don’t provide the right support.

It’s important to note that stress fractures aren’t always sports-related. They can also be caused by changes in regular activities, like walking long distances when you’re not used to it or wearing shoes that are uncomfortable or don’t offer enough support for daily activities.

Where Do Stress Fractures Usually Occur?

The bones of the foot and lower leg usually take the most impact from sports and other activities. These key weight-bearing bones are the most vulnerable to stress fractures, and we often see stress fractures in the small bones of the upper foot, the heel, the ankle and the calf bone.

What Are the Symptoms of A Stress Fracture?

Some of the symptoms of a stress fracture include:

• Pain that gets worse during weight-bearing activity and feels better during rest
• Swelling in the ankle or at the top of the foot
• Tenderness to the touch
• Bruising (in some but not all cases)

How Can I Prevent Stress Fractures?

Good habits and a little caution are the best ways to prevent stress fractures. Some tips include:
Ease into a new physical activity and make changes to your exercise routine gradually.
Get help from a trainer or coach for proper technique, especially when you’re starting out.
Invest in shoes that truly provide support whether for sports or daily activities and use the right shoe for your sport.
Eat a diet rich in Vitamin D to promote bone health.
The AAOS also recommends varying your workout routine and including strength training to help boost bone density.

Treatment: Can Stress Fractures Heal Without Surgery?

Stress fractures can often heal without surgery, but rest and modifying your activities are key. A good physical therapy program can also help speed and improve healing. Stress fractures usually take at least 6 to 8 weeks to heal so be sure to listen to your orthopaedist and physical therapist before jumping back into your exercise routine. Here are some strategies for healing without surgery:
Follow the RICE protocol while your fracture heals: Rest, Ice, Compression and Elevation.
Avoid weight bearing activity and talk to your doctor about substituting other activities like swimming.
You may need a cast, especially for certain foot injuries or a brace, boot or crutches to protect the injured area.

Surgery is generally not needed in the case of a stress fracture, but when it is, it may involve fixing the bones with pins, screws or plates to help them heal properly.

Physical Therapy and Stress Fractures

Physical therapy can play an important role in healing a stress fracture. Programming suggested by the American Physical Therapy Association involves:

• Muscle strengthening activities for your legs and feet as well as your core to help you move more safely and shift weight-bearing to the core.
• Range of motion exercises for the joints in your legs.
• Functional training and activity-specific training to help you walk and resume daily activities and then get back to your sport.
• In-shoe orthotics to help with foot mechanics and support.
• According to APTA, the use of a bone stimulator may be useful in cases of difficult or delayed healing.

Recovering from a Stress Fracture with Countryside Orthopaedics

At Countryside Orthopaedics, our team of orthopaedists and physical therapists has extensive experience in treating and helping patients recover from stress fractures. From physicians to diagnose and recommend the best course of treatment to physical therapists to promote safe and timely healing, our skilled professionals work to get you back to the activities you love with greater strength and new strategies for playing it safe.