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Stress Fracture – Symptoms, Causes, Treatment

Written by Dr.Mary

What are Stress Fractures?

These are tiny cracks or breaks in the bone. They are caused by the repeated applying of force usually from overuse – for instance jumping up and down repeatedly or long distance running. These fractures can arise also just from normal use especially if the bone is weakened by conditions such as osteoporosis.

These fractures are more common in bones that are weight-bearing in the lower foot or leg. Field or track athletes are predominantly vulnerable to these type fractures, but almost anyone may experience one of these fractures. If an individual is beginning a new exercise program, they can be at risk especially if they start doing too much too soon.

Stress Fracture Symptoms

The symptoms of stress fractures consist of:

  • Pain
  • Swelling
  • Increased pain and swelling with activity
  • Tenderness in one specific spot
  • Decreased pain and swelling with rest
  • Onset of pain earlier with each succeeding workout
  • Pain continues at rest due to progression of damage

In the beginning these fractures are hardly noticeable. But notice the pain. Self-care and treatment that is proper can stop the fracture from getting worse.

If there is pain that persists or is severe even at rest, contact your physician.

Stress Fracture Causes

Stress fractures are the result of repetitive use of a force that is greater than the bones of the lower legs or feet can normally endure. This causes a discrepancy between the resorption and the growth of the bone, each of which happen all the time. The repetitive force encourages the turnover of cells of then bone, but new bone cells are added when an individual is at rest.

When the bones are submitted to uncommon force without the time to recover, bone cells are resorbed faster than they can be replaced. And the result is bone fatigue. Repetitive, continued force creates tiny cracks in the bones that are fatigued. These progress until they become stress fractures.

Those aspects that can escalate the risk of these type fractures can include:


These type fractures are most common in individuals who take part in sports such as field and track, tennis, gymnastics, or basketball.

Increased activity

These type fractures occur often in individuals who rapidly shift from a lifestyle that is sedate to an active training program – for instance a military recruit exposed to extreme exercises or an athlete who quickly increases the duration, frequency or intensity of sessions of training.


Those females who have atypical or absent menstrual periods are at a greater risk of suffering from these type fractures.

Problems with feet

Individuals who have rigid, high arches or flat feet are most apt to get stress fractures

Bones weakened

Problems such as osteoporosis weaken the bones as well as make it that much easier for these type of fractures to happen.

There are cases where stress fractures do not heal correctly. This can lead to pain that is chronic. If the underlying causes are not managed, the individual can be at a much greater risk for more stress fractures.

Stress Fracture Treatment

Even though physicians may often diagnose a stress fracture from physical exam and medical history alone, imaging tests are still often required in order to confirm that diagnosis.

Imaging tests include:



In most incidents, these fractures are not obvious on X-rays that are regular and taken shortly after the beginning of symptoms and signs. It normally takes several weeks – and often longer than a month – for the indication of fractures due to stress to begin to show up on x-rays.

Bone scans

Several hours before a bone scan, the individual is given a small dose of radioactive matter thru an intravenous line. This material collects in areas where bones are repairing – showing up on the bone scan as white spots that are very bright. But, most types of problems with the bone look alike on these scans, so these test are not very precise for stress fractures.


MRI’s use radio waves as well as a strong magnetic field to create images of internal structures that are very detailed. MRI’s normally can envision these type fractures in the first week of an injury and this test is the best to differentiate between soft tissue damages and stress fractures.

Treatment depends on the fracture location as well as how fast the individual needs to start activity again. These include:


When needed, use Tylenol as a pain reliever. There is research that proposes that other pain relievers such as Advil, Aleve or Motrin interfere with healing bone.


In order to decrease the weight-bearing load of the bone while healing, the individual might need to wear a walking brace or boot or use crutches. In cases that are severe, the physician may want to immobilize the bone with a cast or splint.


It is very unusual, but at times surgery is necessary to ensure total healing of some stress fractures, particularly the ones that occur in areas with blood supply that is poor.

The bone needs time to heal. Some cases can take many months or even longer, so in the meantime the individuals should:


Stay off the limb that is involved or as directed by your primary care physician until there is clearance to endure full weight on the limb.


In order to relieve pain as well as reduce any swelling, your primary care physician might advise the application of ice packs to the area that is injured – use up to 3 or 4 times a day for ten minutes each time.

Slowly resume activity

When your physician releases the individual for activity, progress slowly from non-weight bearing actions – for instance swimming – to normal activities. Activities which are high impact, for instance running, need to be started on a slow basis, with very cautious development of distance and time.

Very easy measures can aid in preventing more stress fractures.

Any changes should be made slowly

Beginning any new program for exercise should be slow and progress slowly using proper shoes. Make certain the shoes also fit well and are appropriate for the activity. If the individual has flat feet, speak with an expert about using arch supports in the shoes.

Get proper nutrition

In order to keep bones strong, make certain the diet has lots of calcium as well as other nutrients.

Cross train

It is best to add low-impact actions to the exercise routine in order to avoid repeatedly stressing any part of the body.

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