Introduction:
Stress fractures are usually caused due to overuse. They occur when any physical activity exerts much pressure on the bone and no proper time is given for recovery. Stress fractures usually occur as bruises and when not proper time is given for healing it can result in small cracks in the bone’s surface. It is mostly caused due to sports activity or repetitive motion.
What Is Stress Fracture of the Leg?
A stress fracture of the leg is a repetitive trauma caused on the feet, heel, or shin bone. It is similar to a bruise that occurs due to multiple trauma on the same spot of the leg. The leg's muscles become fatigued and cannot absorb the added shock. Due to this, fatigued muscles transfer the stress to the bone leading to tiny cracks. The most common spot of stress fracture of the leg is the shin bone or tibia, which accounts for 25 to 75 percent of the cases. These stress fractures are common in obese and older people.
What Causes Stress Fracture of the leg?
Stress fractures are caused due to increased pressure or trauma on the foot while performing an activity. The fracture can also be caused due to unfamiliar surface impact; for example, a tennis player playing on a hard court surface instead of a soft clay court or a cricketer playing on a hard concrete field instead of a soft grass field and wearing loose shoes.
When an unfamiliar force is applied without proper recovery time, it resorbs cells faster than the body can replace them. Normally the bone adapts easily to the increased force through remodeling (a process that speeds up when bone load increases and the bone tissue is destroyed and rebuilt). It makes an individual more susceptible to a stress fracture. Some sports activities that can cause a leg stress fracture are basketball, tennis, gymnastics, and football.
What Are the Clinical Features of Stress Fracture of the Leg?
Some of the common symptoms include:
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Swelling and pain on the affected site.
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Tenderness.
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Pain while doing an activity and resolves with rest.
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Pain increases moderately throughout the activity, such as while walking.
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Severe pain throughout the day.
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Not able to hop on the affected leg or shift weight on the affected leg.
What Are the Different Modalities Through Which Stress Fractures of the Leg Can Be Diagnosed?
There are certain tests through which this condition can be diagnosed.
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Physical Examination: Firstly, the doctor will clinically examine the affected leg and check for symptoms like pain and swelling. The patient will be asked about regular physical activities, ongoing medication, profession, and medical history.
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X-rays: In most cases, X-rays are advised to look for a fracture. However, X-rays can miss out around two-thirds of stress fractures. It is helpful only when the callus or lump forms which are easily seen on an X-ray. Some imaging tests can be done to get a more accurate diagnosis of a stress reaction, even before it becomes a stress fracture.
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Bone Scan: This is done to detect the stress fracture. The affected bone site will appear darker in the scan. During the bone scan, radioactive material is injected intravenously into the bloodstream, which is collected in the bone and accumulates in the area of the bone that is being repaired.
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Magnetic Resonance Imaging (MRI) Scan: An MRI scan is advised for more detailed images of the bone. It is more beneficial as it takes less time than other tests, no radiation exposure occurs, and it is better for diagnosing different types of soft tissues. An MRI uses radioactive waves from the different angles of the foot, collected on a computer screen.
How Is Stress Fracture of the Leg Can Be Managed?
Treatment options include:
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An essential part of the treatment is rest. Not putting pressure on the affected leg, taking a break from playing any activity, and not engaging in any such activities for around six to eight weeks will help in faster recovery.
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Applying an ice pack daily on the injured foot reduces swelling and pain.
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When the doctor allows it, the low weight-bearing activities should be slowly resumed, such as swimming.
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Using supporters like crutches or braces for walking and faster healing.
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Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation.
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Elevating the foot above while lying on the back reduces swelling.
What Are the Risk Factors That Can Lead To Stress Fracture of the Leg?
Some of the factors that can increase the risk of getting this condition include:
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Age: Older people have soft and weakened bones and are often affected by a condition called osteoporosis (a condition that develops due to decreased bone mineral and mass density).
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Weight: Both underweight and overweight people have a high chance of having stress fractures. In underweight people, the bones are weak, and in overweight people, the loading weight pressure can easily lead to a stress fracture of the leg.
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Sex: Women with irregular periods are at higher risk of developing such fractures.
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Nutrient Deficiency: Lack of vitamin D and calcium can lead to weak bones.
How to Prevent Stress Fractures of Legs?
The following steps must be taken to prevent stress fractures of the legs:
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The individual must wear properly fitted shoes that are appropriate for the activity.
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Cross-training must be practiced.
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The patient must take proper nutrition to keep the bones strong.
Conclusion:
A stress fracture of the leg is a term given for the fracture of the lower leg or foot due to repetitive stress or trauma while playing or doing an activity in a daily routine. These fractures can cause swelling and pain, which gradually worsen if neglected for a long period of time. It can be easily diagnosed by imaging tests such as bone scans and an MRI. Once diagnosed, it can be easily treated by taking proper rest and pain medication and not putting excessive pressure or weight on the foot.
