What are stress fractures?
When we think of fractures, we usually think of a definitive break in the bone, usually associated with a traumatic event such as a fall. However, bones can also be damaged in more subtle ways – enter the stress fracture. In contrast to normal fractures, stress fractures occur due to overuse and repetitive activity rather than a single high energy event.
Stress fractures are typically seen in running and jumping athletes due to the repetitive impact to the lower limbs associated with those activities. Whilst stress fractures typically occur in weightbearing bones, especially in the lower limbs, they can also occur in non-weightbearing bones, such as those in the torso or upper limb. Although these are far less common, they are still the result of overuse and repetitive loading over time.
How do I know if I have a stress fracture?
There are a few key things to look out for when diagnosing a stress fracture:
- A sudden increase in activity, especially in repetitive loading (e.g., running distance, jumping volume)
- Pain with activity that eases with rest
- Pain that worsens over time when continuing the aggravating activity
- Tenderness or swelling after activity (especially after a recent increase, or limited rest)
Other factors such as having low bone density, female sex, presence of an eating disorder, and some medical conditions may also increase the likelihood of sustaining a stress fracture. Your physiotherapist may ask you questions about the above to get a more thorough picture of the condition.
I think I have a stress fracture – what can I do?
If you think you have a stress fracture, it’s best to have this examined by a physiotherapist. They may then refer you for other tests such as a bone scan, x-ray or MRI to have a look at the condition of the affected bone and to exclude other potential causes of pain.
In the meantime, the best course of action is to reduce the load on the bone to allow it to heal properly and to prevent potential worsening of the fracture. Depending on the location of the stress fracture, your physiotherapist may provide you with a cam boot or crutches to help offload the affected limb. It is also advisable to discontinue the aggravating activity for a period of time and find substitute activities to maintain fitness. Once the bone has been given a sufficient amount of time to heal –usually between 4-6 weeks, most people will be able to gradually return to their desired activity without issue!