Understanding Stress Fractures in Athletes: Causes, Types, and Prevention
A stress fracture, which is a small crack in a bone caused by repetitive stress or high impact force, often due to overuse, can result in significant pain for athletes.
Runners preparing for a 10km or marathon frequently experience shin pain. Intense training and high running mileage in preparation for a race can lead to a stress fracture.
Stress fractures make up 0.7% to 20% of all injuries seen in sports medicine clinics. Track-and-field athletes have the highest incidence of stress fractures compared to other athletes.
Categories of stress fractures
Metatarsal stress fracture. Metatarsal bones are the long bones in the foot that connect 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 resulting from high impact force, back hyper-extension, or repetitive stress.
Identifying spinal abnormalities in athletes is crucial to prevent the increased risk of acute or chronic injuries.
Frequently Asked Questions:
Why do I keep getting stress fractures?
The most common reason is a sudden increase in training – mileage and/or intensity. If you have small bones or low bone density, you are at higher risk for stress fractures. ... Low estrogen levels can reduce bone density. High arched feet may also raise 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 prone to stress fractures due to the repetitive forces they endure 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 severe stress fractures may require a longer healing time.
How do you diagnose a stress fracture?
X-rays. Stress fractures often aren't visible on regular X-rays taken shortly after the onset of pain.
Bone scan. ...
Magnetic resonance imaging (MRI).
Can you play sports with a stress fracture?
If you have a foot stress fracture, you should avoid running, but swimming or running in a pool may be possible to maintain cardio fitness without worsening the injury.
What causes recurrent stress fractures?
To reduce the likelihood of recurring stress fractures, determine the cause of the initial fracture. Gradually increase your training level. Supplement your diet with vitamin D and calcium. Try to run on softer surfaces whenever feasible. Have your running gait evaluated by a coach or specialist at a running store to find the best shoes.
Do stress fractures always heal?
While it can be difficult to take a break from activity due to an injury, returning too soon can increase the risk of larger, more challenging-to-heal stress fractures and prolong recovery time.
Diagnosing stress fractures can be quite challenging.
Hairline or stress fractures are tiny cracks in a bone that commonly occur in the foot or lower leg, often as a result of sports involving repetitive jumping or running.
A small crack develops in the bone, which may not always be visible on an X-ray. Think of bending a piece of metal repeatedly; eventually, it weakens and breaks.
Stress fractures can affect any bone, with common locations including the leg, hip, and foot (for runners and jumpers), the spine (for gymnasts, divers, and volleyball players), arms (for throwers), and ribs (for rowers). Bones in the feet and legs can experience forces up to twelve times a person's weight. Stress fractures are among the top five injuries in runners and account for up to half of injuries in soldiers.
In classical ballet, aerobics, tennis, and volleyball, stress fractures of the tibial shaft are most common. Basketball players often experience stress fractures in the tibial shaft, medial malleolus, and metatarsal bone, while track and field and soccer athletes commonly sustain stress fractures in the tibial shaft and pubic bone.
Indications and Symptoms
Athletes may experience the following symptoms indicative of a stress fracture:
Pain during activity (e.g., walking, running, jumping)
Sharp pain at a specific point on the bone (e.g., point tenderness)
Aching pain after activity
Swelling without bruising at the painful site
Difficulty tolerating usual recreational or occupational demands
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.
RESOURCES:
Stress Fractures
Hairline fracture: Symptoms, treatment, and causes
Stress fractures in athletes: Review of 196 cases https://www.researchgate.net/publication/10742716_Stress_fractures_in_athletes_Review_of_196_cases
Risk factors for stress fractures. - NCBI
Stress fracture in the lower part of the spine
A stress fracture of the lumbar spine in a professional rugby player https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659078/
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