Definition
A stress fracture is a tiny crack in the bone. They are most common in the lower leg and foot.
Stress Fractures of the Tibia and Fibula |
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Causes
This fracture is caused by repeated stress or overuse from:
- Increasing the amount or intensity of an activity too quickly
- Changing to a new playing surface
- Not wearing the right shoes or wearing old shoes for a sport
Risk Factors
Stress fractures are more common in women. Things that may raise the risk of this fracture are:
- A sudden increase in activity
- Not getting enough rest between physical activities
- Playing sports that involve running and jumping, such as track and field, tennis, gymnastics, and basketball
- Having female athlete triad
- Bone disorders, such as osteoporosis and Paget disease
- Low levels of vitamin D and calcium
- Smoking
- Alcohol use disorder
Diagnosis
The doctor will ask about symptoms and past health. They will also ask about regular activities. A physical exam will be done. The doctor may suspect a stress fracture based on symptoms. Images may be taken if pain is severe or fracture is not healing as expected. Tests may be:
Treatment
It can take 6 to 8 weeks for a stress fracture to heal. The goals of treatment are to manage pain and support the bone as it heals. Options may be:
- Walking boot, crutches or a cane to keep weight off of a foot or leg stress fracture.
- Limiting activity that is causing pain or stress.
- Medicine to ease pain and swelling.
- Exercises to help with muscle strength and range of motion will be needed.
Prevention
To lower the chance of a stress fracture:
- Slowly increase the amount and intensity of activities over time.
- Wear the right shoes for sports.
- Eat a diet that contains foods with vitamin D and calcium.
RESOURCES
American Orthopaedic Society for Sports Medicine http://www.sportsmed.org
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
CANADIAN RESOURCES
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
References
Femoral stress fracture. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/femoral-stress-fracture. Accessed September 30, 2020.
Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00112. Accessed September 30, 2020.
Stress fractures of the foot and ankle. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/stress-fractures-of-the-foot-and-ankle. Accessed September 30, 2020.
Tibial plateau fracture. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tibial-plateau-fracture. Accessed September 30, 2020.
Welck MJ, Hayes T, et al. Stress fractures of the foot and ankle. Injury 2017 Aug;48(8):1722.
Revision Information
- Reviewer: EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
- Review Date: 01/2021
- Update Date: 09/08/2020