In simple terms, a stress fracture is a crack that develops in the bone. They can range in severity from periostitis, caused by inflammation of the periosteum, right through to a complete stress fracture which is a cortical break.
What are the causes of Stress Fractures?
Bone usually adapts gradually to increased loads through remodelling. If bone is subjected to repetitive and unnaccustomed force without enough recovery, it will reabsorb cells faster than it can replace them. Therefore, stress fractures often occur when the volume or intensity of an activity is increased too quickly.
What are the risk factors for developing a Stress Fracture?
Low Bone Mineral Density (BMD). Low bone mass (osteopenia) and more severe low bone mass (osteoporosis) are important risk factors for fractures.
Hormonal or Menstrual Irregularities.
Dietary and Nutritional deficiencies. Eating disorders, low BMI < 19, and deficiencies in calcium and vitamin D.
Previous Stress Fractures.
Sex. Females > Males.
Increased volume and/ or intensity of training.
Types of activity. Stress fractures are more common in high impact sports.
In which bones do stress fractures commonly occur?
Stress fractures occur most commonly in the bones of the lower limb (hip, thigh, shin, foot).
What are the symptoms of a stress fracture?
The symptoms of a stress fracture may vary depending on the location and severity. Usually the person will experience a gradual onset of pain with increased running or activity. If the aggravating activity continues, the pain will become more frequent and persist into normal daily activities and may continue at night.
Usually a cardinal sign is pain returning with the aggravating activity after several days or weeks of rest.
How are stress fractures diagnosed?
Stress fractures are usually suspected after a thorough subjective assessment including symptoms, medical history and risk factors. Your physiotherapist will then conduct an objective assessment of the area.
At Melbourne Sports Physiotherapy will often refer you straight for an MRI over an x-ray if we suspect a stress fracture. As stress fractures are sometimes unable to be seen on x-ray. In some cases you may need to be referred for a CT or bone scan (DEXA).
How are stress fractures treated?
Stress fractures are treated with a period of non-weight bearing on crutches. Depending on what area the stress fracture has occurred you may also be put into a CAM Boot.
Usually, your physiotherapist will refer you onto a Sports Physician or Orthopaedic surgeon to assist in the management of the fracture and provide advice on appropriate pain relief.
What are some tips to prevent stress fractures?
Cross Training: A variety of training such as swimming and cycling will assist in bone recovery on non running days and allow you to continue to work on your fitness goals. Adding weights training and mobility also allows for the most benefit.
A gradual increase in training: It is important to start any new exercise slowly and avoid increasing the amount of exercise by any more than 10% per week.
Address any nutritional deficiencies. It is important to have adequate calcium and get vitamin D
It is important to get any injuries or ongoing issues assessed by a health professional. Early intervention can potentially diagnose a stress reaction prior to it becoming a fracture or prevent a more serious injury. Stress fractures often have a good prognosis with conservative management. However, these injuries must be taken seriously and addressed to prevent surgery.
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!