Yasmin Dhar, M.D.
Orthopedic Surgeon and Sports Medicine Specialist
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A stress fracture is a small break or weakening in the bone. Most stress fractures occur from overuse activities, like high-impact sports or distance running. Most commonly, stress fractures occur in the weight-bearing bones of the foot and lower leg. When the muscles are overused and fatigued, they are no longer able to dissipate the force from repetitive stress or impact. The stress then gets transferred to the bone, creating small cracks or fatigue fractures.
The most common site for stress fractures is in the long bones of the foot (metatarsals). They can also occur in the heel bone (calcaneus), shin bone (tibia) and other bones in the foot.
Stress fractures usually occur when you increase your activity intensity, frequency or duration. They can also occur in people who do not exercise, but have weakened bones, such as with osteoporosis. Usually, pain develops gradually over time with activity, but may improve with rest. Tenderness to touch, bruising or swelling in the area can also be concerning for a stress fracture.
Treatment is dependant on where the stress fracture occurs and the extent of symptoms. Usually, a period of rest, activity modification and the use of a splint or walking boot are first-line treatment.
The goal of any treatment plan is to help you return to the activities you enjoy. Once the fracture has healed and you are pain-free, you may gradually return to your activities and sports. You should slowly increase the intensity and duration of your activity, making sure you are pain-free as you progress, as resuming too quickly may reinjure the area and lead to chronic problems.
Prevention is a key component of maintaining a healthy, active lifestyle. When starting a new exercise routine, make changes in duration or intensity slowly, as too much too soon may over stress your bones. Always use the proper equipment (i.e. change worn out shoes) and be mindful of the surface on which you perform your activities (i.e. running on pavement, tennis surfaces). As always, it is important to maintain a healthy, balanced diet, with calcium and Vitamin D, to keep your bones strong.
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