Stress fractures are small cracks in a bone. These fractures are most often a result of “overuse” and are commonly seen when someone has a recent increase in their activity.
Stress fractures occur most commonly in the weight-bearing bones of the legs. When these bones are subjected to a “new stress,” such as a new exercise routine, they may not be well-adapted, and as a result, they may crack under the new stresses being applied.
Since stress fractures most often occur as a result of overuse, the first treatment needs to include stopping the activity that brought on this condition. Simply put, a period of rest is needed. Taking time away from the activity may be needed for 6 to 8 weeks. Usually exercise can continue, but picking a low-impact form of exercise, such as swimming, elliptical training, or cycling is recommended.
Additional measures, such as shoewear modification, may be prescribed. A stiff shoe insert or bootwalker could be part of the treatment and in certain cases, your doctor may recommend a cast or crutches. Calcium and vitamin D supplemention is often prescribed.
Most stress fractures will heal with the conservative measures outlined above. However, there are instances when surgery is needed. The most common situation that requires surgery is when the bone fails to heal; this may be called a nonunion. Surgery would usually include placing screws to secure the bone. Sometimes this surgery also includes placing “fresh” bone into the area that is slow to heal; this is called bone grafting.
The most common complication that occurs with stress fracture is the nonunion. Other complications include malunion (healed bone, but in a abnormal position) and recurrent fractures. Recurrent fractures typically occur if the underlying problem is osteoporosis. There are medications that may be prescribed if the osteoporosis is severe.
*Source: American Orthopaedic Foot & Ankle Society® http://www.aofas.org