What Is a Stress Fracture?

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If stress fractures truly were the result of stress--that emotional stress that drains us all from time to time--I would probably have a lot of injured bones! However, a stress fracture has less to do with your mental state of health and nearly everything to do with how much physical stress in terms of load and weight you might put on your body, especially through certain athletic endeavors.

Basically, a stress fracture is a small crack in the bone. Stress fractures usually come about due to overuse, commonly seen in high-impact activities such as distance running or basketball. Most stress fractures are sustained in the weight-bearing bones of the lower leg and of the foot. Individuals who engage in tennis, running, gymnastics, dance, and basketball are at an increased risk for sustaining a stress fracture. When you repeatedly strike your foot against a hard ground surface, this can create problems.

Described as an overuse injury, a stress fracture can happen when your muscles become overtired and they can no longer work to reduce the shock of repeated impacts. As such, the muscles will transfer the stress to the bones, creating small cracks or fractures.

Stress fractures are most commonly seen in the second and third metatarsals in the foot. They are also commonly found in the heel, the outer bone of the lower leg, and in the bone on the top of the midfoot.

How frequently you exercise and engage in high-impact activities, how long you exercise, and the level of exertion you employ all can contribute to the presentation of a stress fracture. Believe it or not, even those who do not exercise can suffer from a stress fracture. This is referred to as bone insufficiency, usually seen in those with osteoporosis or some other disease that has weakened the bones.

Those who are new to exercise or who have not been conditioning for a period of time may attempt to jump right into exercise without gradually preparing their bodies for the impact. As such, because the level of conditioning is lower, the muscles become fatigued faster and this can lead to a stress fracture of the ankle or the foot. When you have not exercised for awhile, or if you are new to it, be sure to give yourself ample time to work up to a higher level of conditioning. You don’t want to be sidelined from the start!

The use of improper sports equipment or ill-fitting shoes can contribute to stress fractures. Even a change of surface, such as playing on grass or clay and then moving to a harder surface, or running on a track to running on the pavement are all contributing factors.

If you are not training for a sport properly, you could be at risk for a stress fracture if you do anything that might alter the mechanics of how your foot absorbs any impact when it hits the ground. If you have a bunion, a blister, or inflammation of some sort that causes you to adjust the manner in which you put weight onto your feet, you could be putting undue stress on a bony area that is not capable of handling the extra load.

The symptoms of a stress fracture include pain that develops gradually and increases with weight-bearing activity. The pain may subside when you are at rest. You may notice swelling on the top of your foot or around the ankle. The area could be tender to the touch and you may even notice some bruising.

After visiting your physician for a diagnosis, he or she will most likely order some imaging tests to confirm the condition. Until they have begun to heal, stress fractures are difficult to see on an x-ray image. An MRI provides a more accurate reading.

In treating a stress fracture, the first thing to do is to stop the activity you are doing. You can apply an ice pack and elevate your foot above the level of your heart. Ibuprofen may help with the pain and swelling, but bear in mind that anti-inflammatory medications can interfere with the healing. Avoid putting weight on your affected foot until you have consulted your doctor.

A stress fracture does not heal overnight. You can expect it to take anywhere from six to eight weeks. During this time, you can maintain your level of conditioning by participating in lower-impact activities, such as swimming and cycling. However, do not commence any further physical activity until you have spoken with your physician.

If you sustain a stress fracture in the fifth metatarsal bone, expect this to take a longer time to heal. You may have to wear a cast to keep your bones in a fixed position until it heals. In some cases, surgical intervention may be necessary.

Once your stress fracture has fully healed and you are experiencing no pain, you will most likely be given the green light to gradually proceed back into your usual conditioning program. To avoid this type of problem in the future, consider cross-training, varying the types of exercise you do to avoid that repeated stress on your feet and ankles.

(Information for this article was found at http://orthoinfo.aaos.org/tpoic.cfm?topic=a00379)

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.