Stress Fracture

Overview

Definition

A stress fracture is a tiny crack in the bone. They are most common in the lower leg and foot.

Stress Fractures of the Tibia and Fibula
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Causes

This fracture is caused by repeated stress or overuse from:

  • Increasing the amount or intensity of an activity too quickly
  • Changing to a new playing surface
  • Not wearing the right shoes or wearing old shoes for a sport

Risk Factors

Stress fractures are more common in women. Things that may raise the risk of this fracture are:

  • A sudden increase in activity
  • Not getting enough rest between physical activities
  • Playing sports that involve running and jumping, such as track and field, tennis, gymnastics, and basketball
  • Having female athlete triad
  • Bone disorders, such as osteoporosis and Paget disease
  • Low levels of vitamin D and calcium
  • Smoking
  • Alcohol use disorder

SymptomsandDiagnosis

Symptoms

Symptoms may be:

  • Pain that is worse with activity and better with rest
  • Swelling

Diagnosis

The doctor will ask about your symptoms and health history. You will be asked about the activities that you do. A physical exam will be done.

Images may be taken of the bone. This can be done with:

  • X-rays
  • MRI scan
  • CT scan
  • Bone scan

Treatments

Treatment

It can take six to eight weeks for a stress fracture to heal. The goals of treatment are to manage pain and support the bone as it heals. Options may be:

  • Medicine to ease pain and swelling
  • Shoe inserts or braces to help a foot or leg stress fracture heal
  • Crutches or a cane to keep weight off off of a foot or leg stress fracture
  • Exercises to help with muscle strength and range of motion will be needed.

Prevention

To lower the chance of a stress fracture:

  • Increase the amount and intensity of activities slowly over time.
  • Make any changes to playing surfaces slowly over time.
  • Wear the right shoes for sports.
  • Eat a diet that contains foods with vitamin D and calcium.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Fracture, Stress)

RESOURCES

American Orthopaedic Society for Sports Medicine http://www.sportsmed.org 

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org 

Canadian Orthopaedic Foundation http://www.canorth.org 

References

Femoral stress fracture. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/femoral-stress-fracture  . Updated May 3, 2018. Accessed September 30, 2019.

Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00112. Updated October 2007. Accessed September 1, 2017.

Stress fractures of the foot and ankle. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/stress-fractures-of-the-foot-and-ankle  . Updated March 20, 2017. Accessed September 30, 2019.

Tibial plateau fracture. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/tibial-plateau-fracture  . Updated December 22, 2015. Accessed September 30, 2019.

Welck MJ, Hayes T, et al. Stress fractures of the foot and ankle. Injury 2017 Aug;48(8):1722.