Dr. Ginsberg: Hello. My name is Dr. Claudia Ginsberg. I am a primary care sports medicine specialist at Tri-County Orthopedics where I've been practicing since 2003.
A stress fracture is an injury to the bone where there has been an accumulation of stress, or what we call microtrauma. This usually occurs in athletes or active individuals that are participating with a lot of running and exercises that involve stress into the lower extremities. Stress fractures are usually caused by an accumulation of microtraumas or stress in one particular bone. This usually occurs in the bones of the lower extremities, especially in the feet, the shins, or even the thigh.
Most often a stress fracture is the result of abnormal stresses on a very normal bone, but sometimes stress fractures are the result of normal stresses on a bone that is inherently abnormal.
There are a variety of medical conditions that can change the metabolism of the bone and make it be much more vulnerable to injury, and especially fractures. That's mostly why it's important that the physician take a good history and perform a thorough physical exam to help figure out which type of stress fracture you have.
Any athlete that participates in a sport or activity that involves a lot of running is at higher risk for a stress fracture. Most stress fractures are in the lower extremities, and they occur in athletes that change the surface where they're running or they change the amount of activity, especially when they start running too much, too fast, too soon.
Athletes that are experiencing a stress fracture will usually have pain while they're participating in their sports. Usually, they will have difficulty running, but sometimes they will even have symptoms while walking. Pain will often be localized to the area over the bone where the stress fracture is located. Sometimes there can be swelling as well.
Stress fractures are diagnosed, first, by taking a good history, then a thorough physical exam, and sometimes we will order imaging such as X-rays, even MRIs, CT scans, or bone scans. Most stress fractures can be treated conservatively.
We will advise the patient to discontinue, or certainly modify, the offending activity. We will protect the area, sometimes with a brace or even a walking boot. Sometimes we recommend ice to the area, certain stretching exercises, and certain medications.
Most stress fractures are the result of running too fast, too much, too soon. In order to try to prevent stress fractures, we ask that patients gradually increase their activities, and especially their running group team. We also ask that they have a good lower extremity stretching and strengthening program. Often, they might need a new pair of running shoes or a pair of orthotics.