Stress fractures are a very common sports injury, but they are not always as obvious as other types of fractures. This type of fracture occurs when repetitive stresses lead to fatigue and ultimately, fracture of the bone. “Stress fractures can develop from overuse or overtraining in high-impact sports like running, or due to an abnormality of the bone that prevents it from tolerating normal stresses,” says Dr. Alejandro Pino, an orthopedic foot and ankle surgeon at Mount Sinai Roosevelt.
Q. What exactly causes stress fractures?
A. These fractures can happen to otherwise healthy people of any age who have just started training for a big event like a marathon, or who have suddenly increased the amount and intensity of exercise after a period of inactivity. “A change or increase in the stresses or forces on your bones can cause a stress fracture,” Dr. Pino says. Conditions that affect bone strength and quality include osteoporosis, vitamin D and calcium deficiencies, endocrine and hormone disorders or deficiencies, and certain medications like steroids.
Q. What are the symptoms of a stress fracture?
A. Stress fractures often occur in weight-bearing bones of the foot and lower leg. The most common symptom is an increase in pain and, on occasion, swelling in the location of the stress fracture. The pain will develop gradually, is more prominent during weight-bearing activities, and may diminish with rest. “It will often slowly worsen over a period of days to weeks as the bone becomes more intolerant of weight-bearing activities,” Dr. Pino says. “It just doesn’t get better, and actually worsens with even minor pressure.” After getting no positive response to methods like ice and rest, the pain is usually enough to encourage a patient to make a doctor’s appointment.
Q. How is a stress fracture diagnosed?
A. A clinical exam and a description of the symptoms often provide the clues Dr. Pino needs to suspect a stress fracture diagnosis, and certain diagnostic tests are used to confirm it. “The next step is an X-ray — though, a stress fracture may look completely normal if in the early stages,” he says. “So advanced imaging techniques like a bone scan or an MRI are occasionally used as well to confirm the diagnosis.”
Q. How is a stress fracture treated?
A. “The good news is, most stress fractures don’t require surgery to heal,” Dr. Pino says. Some stress fractures have a greater likelihood to heal, based on their location and blood flow to the bone in that area, and those can be treated with rest and activity modifications. Fractures in locations that aren’t as likely to heal quickly may require some degree of mobilization and restriction in weight bearing, or, rarely, surgery. On average, stress fractures heal in weeks to months.
If you suspect you may have a stress fracture, make an appointment with an orthopedist by calling 1-855-411-LWNY (5969) or visiting the Mount Sinai Roosevelt Orthopedics and Sports Medicine website.