Stress fractures are cracks that develop in bones, usually due to the combination of overuse and inadequate recovery time. All of our daily activities such as walking, movement, work, exercise and sports place varying levels of strain on the bones of the body. The bones undergo a continual process of repair and changes in response to the loads they withstand. Stress fractures can occur when high levels of strain are repeatedly placed on a particular bone, and there is inadequate recovery time for the bone tissue to repair completely. The bone first develops a stress reaction, and if unrecognized, this may progress to a partial or full thickness crack or "fracture"throughthe bone.
Stress fractures commonly occur in the weight bearing bones of the body, such as the bones of the lower leg and feet. Examples are the talus, navicular or metatarsals. These fractures commonly develop with a change in usual activity level. This may include an increase in training load, increased training intensity or a new type of training. Stress fractures may also develop as a result of poor fitting footwear, change in sports playing surface (eg.clay or grass tennis court) or due to underlying bone changes such as osteoporosis.
Signs and symptoms that may indicate 'bone stress' include:
- Pain with repetitive loading that gets worse as the activity is continued
- Reduction of pain with rest
- Localised swelling
- Tenderness when touching the affected area
Stress fractures are often not detected with plain x-rays. If your physiotherapist suspects a stress fracture scans may be ordered such as a CT scan or MRI to confirm the diagnosis.
Treatment of stress fractures primarily involves rest from the aggravating activity. Stress fractures occurring in the leg or foot may require a specialized boot or brace to support the bones while they are healing. This may take up to 6-8 weeks for full healing to occur.
All physica staff are trained in the diagnosis and management of stress fractures. Your physiotherapist will assess the problem, arrange appropriate investigations and then implement the best treatment available. This will be followed by prescription of a rehabilitation program to return to sport and work and ASAP.
