Introduction
Stress fractures are one of the most common sports injuries. Overcoming a stress fracture can be difficult as they occur by causing tiny cracks in the affected bones. A repetitive force, often from overuse, is repeated jumps and running longer distances. Stress fractures can also result from the frequent use of a bone that has already been weakened by a condition such as osteoporosis.
Stress fractures are typically found in weight-bearing bones of the lower limbs. Athletes involved in contact sports and military recruits who carry heavy packs over long distances are at the highest risk. However, any individual can sustain a stress fracture due to simply implementing a new exercise program by over-exertion.
What Is a Stress Fracture?
A stress fracture is a repetitive stress injury that occurs when muscles become fatigued and cannot absorb added shock. The fatigued muscle thus transfers the overload of stress to the underlying bones causing tiny cracks called stress fractures.
Activities that Make Individuals More Prone to Develop Stress Fractures:
Studies indicate that tennis, track and field, gymnastics, and basketball athletes are highly susceptible to stress fractures. The repetitive stress injury caused due to the foot striking the ground can cause trauma, resulting in tiny cracks developing within the bone. Sufficient rest between workouts or competitions is an absolute necessity, and an athlete who neglects proper resting periods can develop stress fractures.
What Are the Causes Behind Stress Fractures?
Stress fractures result from increased intensity or duration of activity at a faster pace than the body can handle. An impact of an unfamiliar surface, improper equipment, and increased physical stress may result in this condition.
Where Are the Common Sites of Occurrence of Stress Fractures?
Mainly stress fractures occur in the weight-bearing bones of the lower limbs. Stress fractures in the lower extremities account for nearly fifty- percent of the reported cases.
Are Women More Predisposed to Stress Fractures?
Stress fractures affect people of all ages and genders. Those who participate in activities like running or other repetitively strenuous tasks are more predisposed. Studies conducted, however, have indicated that female athletes experience more incidences of stress fractures when compared to their male counterparts.
This condition is referred to as "the female athlete triad," which consists of the following three disorders;
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Bulimia or Anorexia: These are eating disorders primarily seen in women in their late teens to early thirties.
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Amenorrhea: Infrequent menstrual cycles.
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Osteoporosis: Calcium metabolism in females occurs at a higher rate than in males, leading to the early onset of this condition.
What Are the Symptoms Seen In the Case of Stress Fractures?
Pain while performing activities are the most common symptom associated with a stress fracture which eventually subsides with rest. However, more extreme cases may report increased pain even on rest and medication.
Risk for Developing Stress Fractures:
Factors that can increase the risks of a stress fracture include the following;
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Certain Sports: Stress fractures are more typically seen in people involved in sports such as running, basketball, tennis, dancing, or gymnastics.
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Increased Activity: Stress fractures often occur in individuals who suddenly switch from a sedentary lifestyle to an active lifestyle. It may also be seen in cases where there is a rapid increase in intensity, duration, frequency, or a combination of the three during training sessions.
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Sexual Predilection: Women, especially those who exhibit the female triad, as mentioned earlier, are at increased risk of developing stress fractures.
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Foot Anatomy: People who are flat-footed or have rigid arches are more likely to have stress fractures. Wearing worn-out footwear may also contribute to the condition.
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Weakened Bones: Pathological conditions such as osteoporosis can weaken the bones and make it easier for the cracks to develop, resulting in stress fractures.
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History of Stress Fractures: If an individual has a previous history of stress fractures, they are at an elevated risk of developing more in the future.
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Malnutrition: Eating disorders such as anorexia or bulimia and the lack of vitamin D and calcium salts in the diet can make bones more brittle and likely to develop stress fractures in the foreseeable future.
Complications Arising From Stress Fractures:
Some stress fractures do not heal properly, and this may result in other chronic problems. If the underlying causes of the condition are not addressed, the patient may be at increased risk of stress fractures.
If the activity responsible for a stress fracture is resumed too quickly, it may result in more extensive and harder-to-heal fractures. Re-injury also could lead to chronic problems, and the stress fracture may never heal properly.
How Can Stress Fractures Be Diagnosed?
The physician must evaluate the patient's risk factors for developing stress fractures in the first place during the medical examination. X-rays are typically used to determine stress fractures. However, some stress fractures cannot be visualized by regular X-rays. These fractures may not appear for several weeks after the pain initially starts. Additional medical imaging such as computed tomography (CT) scan or magnetic resonance imaging (MRI) is necessary. This is to rule out other probable causes for the pain, such as ligament or tendon injuries.
What Are the Treatment and Management Protocols for Stress Fractures?
The importance of rest in treating stress fractures cannot be emphasized enough. Individuals need to refrain from the activities that caused the fracture in the first place, and engaging in a pain-free activity during the resting phase is advisable. Six to eight weeks is required for most stress fractures to heal completely. In addition to rest, shoe inserts, orthotics, or braces are used to heal the injuries.
How Can Stress Fractures Be Prevented?
As suggested by the American Academy of Orthopedic Surgeons, the following means to prevent stress fracture incidences can be helpful;
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Setting Incremental Goals: For example, to run five miles a day, individuals should gradually build up their mileage weekly instead of overexerting themselves from day one.
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Cross-training: This involves alternating activities that accomplish the same fitness goals. This can help prevent micro-injuries that ultimately lead to stress fractures. For instance, running and cycling on alternate days is advisable instead of running every day to meet cardiovascular goals. Strength training and flexibility exercises should also be incorporated to achieve maximum benefit.
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Healthy Diet: The importance of a properly balanced diet, especially for athletes and exercise trainees, are instrumental in maintaining the body composition against repetitive wear and tear.
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Using Proper Equipment: The individuals must refrain from using inappropriate or damaged equipment, such as old tennis rackets, worn-out running shoes, etc.
Recognizing the symptoms early and consequent prompt treatment can help individuals return to sports at their original playing level.
Conclusion
Overcoming a stress fracture can be difficult as they occur by causing tiny cracks in the affected bones. However, more extreme cases may report increased pain even on rest and medication. Individuals need to refrain from the activities that caused the fracture in the first place, and engaging in a pain-free activity during the resting phase is advisable.
