Stress Fractures

A stress fracture is a very thin crack in a bone that can result from repetitive stress. Playing sports or performing other activities that put repeated pressure on bones are often causes of stress fractures. Although they can happen to anyone, stress fractures are more common in athletes such as runners, dancers, gymnasts, and basketball or tennis players. Stress fractures can also be caused by diseases that weaken bones.

Symptoms of Stress Fractures

Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Rarely, they occur in the forearm. At first, pain caused by a stress fracture may be barely noticeable, but it tends to worsen with time. There may also be swelling or bruising around the site of the injury. Definitive diagnosis of a stress fracture is made through diagnostic imaging tests such as X-rays, MRI scans and bone scans.

Risk Factors for Stress Fractures

Although athletes, especially track and field athletes, have increased susceptibility to stress fractures, they can occur in anyone, particularly those who take up a new sport or begin a period of extreme exercise. Military recruits, who are abruptly required to engage in prolonged periods of intense exercise, frequently suffer stress fractures. Other risk factors for stress fractures include the following:

  • Abnormal or absent menstrual periods
  • Flat feet or high arches
  • Bones weakened by osteoporosis, bone cancer or other diseases

Bones can also become weak from long-term use of corticosteroids and other medications.

Treatment of Stress Fractures

Treatment of a stress fracture depends on its location and severity, but usually consists of resting the affected bone, applying ice, reducing weight-bearing activity, and immobilizing the injured area with tape, a cast or a splint. For leg or foot stress fractures, patients often use canes or crutches during recovery. In some cases, surgery may be necessary to hold the bone in position (internal fixation).

Surgery is more common if the fracture is in a region in which blood circulation is poor, or if the patient has experienced more than one such fracture. When surgery is necessary, metal pins or screws may be needed to hold the bone in place as it heals. Physical rehabilitation is necessary after surgery, and patients should resume physical activity only gradually.

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