Stress fractures are common injuries that begin with repetitive and excessive stress on the bone. The most common location in the body for a stress fracture is in the tibia, the largest bone in the lower leg, followed by the foot bones. People who participate in repetitive, high-intensity training, such as athletes and military recruits, are at an increased risk of developing stress fractures. Runners who average more than 25 miles per week are also at increased risk of stress fractures, as well as those who participate in track and field, basketball, soccer, or dance. Additionally, women are at higher risk of stress fracture than men.
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Symptoms
Pain is a common symptom. Specifically, pain with walking, running or other activity. If the tibia is involved, there would be pain with focal tenderness (when tibia is touched) and swelling at the site of injury. Also, people say that they cannot “hop” on the affected leg without severe pain.
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Causes
Stress fractures are due to repetitive and excessive stress on the bone. This leads to the acceleration of normal bone remodeling, the production of microfractures and, eventually, a stress fracture or fine bone break. Risk factors include excessive physical activity with limited rest (running >25 miles/week for example), being a female, having osteoporosis, smoking, low levels of vitamin D or calcium, drinking >10 alcoholic drinks /week. Additionally, having faulty biomechanics, such as limited range of motion in an ankle or foot joint, can create a problematic gait cycle that predisposes you to a stress fracture.
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Treatment
Healing time for stress fractures can vary from 4 to 12 weeks or longer. Initial treatment should include reducing activity to the level of pain-free functioning. Treatment should begin as soon as the injury is suspected, because delayed treatment has been correlated with a prolonged return to activity. Daily supplements of calcium and vitamin D are often recommended, as are medications such as Tylenol or Advil. Rest, ice and elevation are all great treatment options. But ultimately, a long-term solution will include physiotherapy, and orthotics or a footwear modification or proper footwear to address any biomechanical concerns.
