What is a Stress Fracture?

What is a Stress Fracture?

The quick answer is stress fractures are small cracks or severe bruising in the bone and usually occur in the shin. They also can occur in other parts of the body with overuse injuries and high impact exercise.

Athletes that participate in repetitive, high impact sports are also susceptible to stress fractures. Sports such as long-distance running, soccer, tennis, gymnastics, or basketball, and even non-athletes can also experience stress fractures with the increase of activities too quickly, changing activity surfaces, and even from wearing different types of shoes.

image of injured runner holding ankle - stress fractures are tiny cracks in the bon caused by repetitive forceStress fractures are tiny cracks in the bone caused by repetitive force

Where Do Stress Fractures Occur?

Stress fractures can occur anywhere there is overuse as a result of too much pressure on the bone due to repetitive stress. The foot, the lower leg, the hip, ribs, and even the lower back are some examples.

The shin bone or tibia is the place that stress fractures most commonly occurs. Another commonplace is in the foot and toes due to compression and excessive force. Although every bone in the body can be susceptible to stress fractures, the bones of the toes and foot have a high incidence.

Compression fractures of the Foot 

A force that with enough energy, it crutches the tissue. When forces can no longer be assimilated, that’s when stress fractures can occur.

Stress fractures of the toes often occur when muscles in the toe (s) become too weak to absorb the continuous stress of impact, such as running and jumping, which eventually creates a crack in the bone.

Stress fractures of the foot commonly occur in the metatarsal bones which are the bones that lie between the toes and bones of the foot (tarsal). The second and third metatarsal received most of the impact and is often referred to as a march fracture. Other bones in the foot that can receive such injury are the sesamoid bones, the navicular bone, the talus, and the 5th metatarsal base

Symptoms of a Stress Fracture or Microfracture

The most common symptoms of stress fractures, especially in the toes and foot are:

  • Pain that decreases when stopping activities
  • Swelling over the bone
  • Tenderness to touch over the bone.  
  • Possible bruising
  • Pain that intensifies with activities

So, pay close attention to these signs and symptoms when increasing intensity and weight with activities.

Do Stress Fractures Heal on Their Own?

The majority of stress fractures heal on their own after reducing or stopping the type of activity that initially caused your problem. It will typically take about 6-8 weeks to heal but it will depend on what bone is broken. Most serious cases can take longer.

Can You Walk with a Stress Fracture?

Your doctor will advise whether it’s safe or not to do so. He may recommend to wear proper footwear, a stiff sole shoe or maybe a removable medical walking boot. If the injury is severe, you may not be able to put pressure on your foot for a few weeks to let the fracture to properly heal.

image of JOI removable medical walking bootA removable walking boot

How Do You Detect a Stress Fracture?

Your doctor may need several specific tests to be able to detect a stress fracture depending on the physical examination and history of the injury. Initially, your doctor will get routine X-Rays shortly after the pain starts. Often, a stress fracture cannot be seen on regular x-rays and may take a few weeks to show. Another method to detect a stress fracture is through a Bone Scan but the test is not that specific for such injury. An MRI will be considered the best way to diagnosed stress fractures, and will also be able to differentiate a stress fracture vs a soft tissue injury. Read this ARTICLE about Tibia and Fibula Fractures.

image of bones of the foot. there are several bones of the foot and an x-ray may be used to determine stress fractureBones of the foot

Can a Stress Fracture Get Worse?

If it goes untreated, they tend to increase in severity and becomes intolerable and disabling. Without proper treatment, your bone is more vulnerable to reinjure affecting your daily living.  Returning to activity too soon can put a person at risk for a bigger fracture and/or more time down.

What is the Fastest Way to Heal a Stress Fracture?

Stress fractures can be treated in different ways. It will depend on the location and severity of the fracture.

First you will need to discontinue the activity that is causing pain.

  • Apply Ice along with pain medication to control symptoms as needed.
  • Non-impact activities such as bike riding and pool exercises.
  • Utilization of proper and protective footwear.
  • Start partial weight-bearing only when pain-free and cleared by your doctor.
  • Increase activities in a proper manner to avoid recurrence of the stress fracture.

JOI Physical Therapy for stress fracturesJOI Physical Therapy for stress fractures

Other conservative measures include physical therapy which will look at muscular restrictions that could be causing undue stress on the lower leg. The physical therapist will prescribe appropriate exercises to perform while resting from activity.

Some examples of different types of exercises include; stretching and foam rolling the leg muscles, thera-band to increase the strength in the legs, balance exercises which will help improve the response of the lower leg muscles.  Low impact cardio equipment may be used to help with muscular endurance. 

The best way to prevent stress fractures is to wear proper shoes. Start out an exercise program slowly and progress only when comfortable with the exercise. Performing stretching and mobility drills before and after training that will help limit stress to the lower legs. Take time to cool down properly after exercise.

The Jacksonville Orthopedic Institute has the team you need to help with a stress fracture. Come see us!

For physical therapy at JOI Rehab, please call 904-858-7045. 

Related Articles: Shin Splints and Direct Access to JOI Rehab for Physical Therapy. 

The Jacksonville Orthopaedic Institute will continue to monitor the latest developments of coronavirus disease (COVID-19). You can complete all of your new patient paperwork from home. To request registration paperwork electronically, click HERE.  To schedule with a JOI Physician, please call 904-JOI-2000, schedule online or click below. 

By: Fadel Taazieh PT, DPT, PES

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