Stress Fracture
One of the most common injuries in sports and any other fitness activity like army training is a stress fracture. Stress fracture can be very annoying and difficult to overcome and heal but it can be done.
What’s a Stress Fracture?
A stress fracture is one form of incomplete fracture in bones. It’s brought on by uncommon and/or repetitive stress as well as heavy continuous weight on the ankle or leg. A stress fracture is better referred to as an overuse injury which is different than other type of fractures that are usually characterized by a sole, severe impact.
A stress fracture develops when muscles become fatigued and are unable to absorb added shock which eventually results in that the fatigued muscle transfers the overload of stress to the bone causing a tiny sliver or crack in the bone which is known as a stress fracture.
A Stress fracture is frequently named a “hairline fracture” and it typically happens in weight-bearing bones, like the tibia which is a bone in the lower leg and metatarsals which are 5 bones in the foot.
Stress Fracture Causes
Bones are constantly trying to restore and repair themselves, particularly throughout a sport where extraordinary stress is applied to the bone. With time, if enough stress is put on the bone and it exhausts the ability of the bone to restore and reapeir, a stress fracture may occur.
It is important to understand that a stress fracture doesn’t appear out of the blue. It happens from repeated traumas, none of which is sufficient to result in a sudden break of the bone, however when added together these traumas overwhelm the osteoblasts that resotre and repair the bone.
Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly and in people who suddenly undertake a burst of exercise whose bones are not used to. They also can be caused by:
- The impact of an unfamiliar surface (a tennis player who has switched surfaces from a soft clay court to a hard court).
- Improper equipment (a runner using worn or less flexible shoes).
- Increased physical stress (a basketball player who has had a substantial increase in playing time).
They may also occur in Olympic-class athletes who do extraordinary quantities of high-impact exercise, in professional and amateur distance runners who run high weekly mileage, or in soldiers who march long distances.
As mentioned before, muscle fatigue can also play a role in the occurrence of stress fractures. In a runner, each stride normally exerts large forces at various points in the legs. Each shock, a rapid acceleration and energy transfer must be absorbed and both muscles and bones serve as shock absorbers. However, the muscles, usually those in the lower leg, become fatigued after running a long distance and lose their ability to absorb the shock which means the bones will experience larger stresses and that increases the risk of a stress fracture.
Suffering from a previous stress fracture is also known and considered to be a risk factor.
Stress Fracture Symptoms
Stress fractures don’t have too many symptoms. Actually, there is one main symptom and that is pain. Pain during walking, running or doing any activity that puts stress and pressure on the leg and foot.
Diagnosing Stress Fractures
Since stress fractures are more common is athletes or soldiers in training it is very important that during the medical examination the doctor evaluates the patient’s risk factors for developing a stress fracture.
X-rays are commonly used to determine stress fracture but in some cases no evidence for a stress fracture will be seen with an X-ray. In such cases a computed topography (CT) scan or magnetic resonance imaging (MRI) will be necessary in order to clearly diagnose the situation.
Stress Fracture Treatment
Rest is the most important and actually, the only real treatment for complete healing of a stress fracture. Most stress fractures take six to eight weeks to heal completely but cases of longer periods are not uncommon for the more severe cases (12 to 16 weeks).
After the rest period activities may be gradually resumed, as long as the activities do not cause pain. While the bone may feel healed and not hurt during daily activity. One general rule is to not increase the volume of training by more than 10 percent from one week to the next.
Aside from rest, bracing or casting the limb with a hard plastic boot or air cast may also prove beneficial by taking some stress off the stress fracture. An air cast has pre-inflated cells that put light pressure on the bone, which promotes healing by increasing blood flow to the area. This also reduces pain because of the pressure applied to the bone. If the stress fracture of the leg or foot is severe enough, crutches can help by removing stress from the bone.
With severe stress fractures, surgery may be needed for proper healing. The procedure may involve pinning the fracture site, and rehabilitation can take up to a six months.
You should also know that If the activity that caused the stress fracture is resumed too quickly, larger, harder-to-heal stress fractures can develop. Re-injury also could lead to chronic problems where the stress fracture might never heal properly.
Stress Fracture Prevention
Add More Stress To The Bones
One method of avoiding stress fractures is to gradually add more stress to the bones. Even thought this may seem counter-intuitive because stress fractures are caused by too much stress on the bone, moderate stress applied to the bone in a controlled manner can strengthen the bone and make it less susceptible to a stress fracture.
An easy way to do this is to follow the runner’s rule of increasing distance by no more than 10 percent per week. This allows the bones to adapt to the added stress so they are able to withstand greater stress in the future without risking a stress fracture.
Strengthening The Muscles
Strengthening exercises also help build muscle strength in the legs and strengthening the leg muscles will prevent them from becoming fatigued quickly, allowing them to absorb the strain of running for longer periods of time. Key muscles that need strengthening with lower leg stress fractures are the calves and the shin muscles.
Proper Equipment (Shoes)
Depending on a variety of factors such as weight, running surface and shoe durability, runners should replace their shoes every 300–700 miles to allow adequate mid-sole cushioning.
Nutrition
Nutrition plays a vital role in bone development and increasing the calcium and vitamin D intake can help in reducing the risk of stress fractures.