Stress fractures are a common sports injury that can appear to come out of nowhere. They can affect people of all ages and activity levels, though they are generally associated with an increase in activity or repetitive activities. A stress fracture occurs when the body does not have sufficient rest, or building blocks, to repair bone that is broken down during activity. This can result in pain with activity, local swelling and tenderness. The pain comes on gradually, and is usually relieved with rest. If the stress fracture worsens, the pain will also worsen and begin to appear in regular daily activities, sometimes even becoming chronic pain.
The main cause of stress fracture is repetitive activities. When a bone is repeatedly stressed in the same way, it breaks down. If the body has sufficient rest, this cyclical process is completed and the bone is built up again. If there is not sufficient rest, or there is not sufficient calcium in the body, the bone weakens in that area, forming tiny cracks that can progress to fractures through the thickness of the bone.
Who is at risk?
Anyone who has a recent increase in activity is at risk for a stress fracture. If you are a runner who has recently upped your mileage, have just decided to get in shape and have gone from zero workouts per week to bootcamp five nights a week, or have commenced an intensive sport training program, you may be at risk. Women are also more at risk than men, especially if their menstrual cycle is irregular. This can be a sign of a calcium deficiency, and calcium is an essential building block for bone. Even sports like swimming, tennis, and basketball can put people at risk for a stress fracture.
What to look for?
Since stress fractures come on gradually, the symptoms do as well. Initially there can be pain with the offending activity which is relieved with rest. As the tiny cracks in the bone increase in size, the pain can become more intense, and can be felt during regular activity as well as sporting activity. If left untreated this can progress to chronic pain. The pain is usually well localized to the injured area, and can be accompanied by point tenderness and mild swelling.
I think I have a stress fracture – what should I do?
The most important step is to get the right diagnosis. An appointment with one of our registered physiotherapists or our sports medicine doctor will determine the issue at hand, and further imaging may be required to confirm the diagnosis. Since stress fractures are usually very small they may not show up on an X-ray, additional imaging such as an MRI or a Bone Scan may be required to confirm the diagnosis.
What does treatment look like?
The main treatment for stress fractures is rest. If there are underlying causes of bone weakness your doctor may prescribe medication, or have you see a registered dietitian to ensure you are providing your body with the required building blocks for your bones. If the fracture has progressed, a brace, walking boot, or crutches may be required to allow the bone time to heal. Physical therapy may be required to strengthen the area and help prevent further injury.
If you think you have a stress fracture, contact us today and we will get you on the right track to diagnosis and recovery.