Stress fracture

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Stress fracture
X-ray of a stress fracture of the second metatarsal bone
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Pain in the affected area, swelling, tenderness
Complications	N/A
Onset	Gradual
Duration	Weeks to months
Types	N/A
Causes	Repetitive mechanical stress
Risks	Athletes, military recruits, osteoporosis
Diagnosis	Physical examination, X-ray, MRI
Differential diagnosis	Tendonitis, arthritis, bone tumor
Prevention	Gradual increase in activity, proper footwear
Treatment	Rest, ice, compression, elevation, physical therapy
Medication	N/A
Prognosis	Good with proper treatment
Frequency	Common in athletes and military recruits
Deaths	N/A

Stress Fractures

Stress fractures are small breaks or cracks in the bones, typically resulting from repeated pressure or stress on the bone over time. Unlike acute fractures that occur due to a single, severe impact, stress fractures develop gradually as a result of overuse and repetitive force. They are common in weight-bearing bones of the lower leg and foot, often affecting athletes and individuals engaged in high-impact sports.

X-ray showing a stress fracture.

Causes

Stress fractures are primarily caused by:

• Repetitive activity
• Increased physical activity without proper conditioning
• Impact on hard surfaces
• Poor equipment, such as worn-out shoes

Risk Factors

Factors that increase the risk of stress fractures include:

• Participation in high-impact sports like running, basketball, and gymnastics
• Conditions such as osteoporosis that weaken bones
• A sudden increase in physical activity intensity or duration
• Improper footwear

Symptoms

Symptoms of a stress fracture include:

• Pain that worsens with activity and improves with rest
• Swelling at the site of the fracture
• Tenderness to touch at the fracture site
• Possible bruising

Diagnosis

Diagnosis of a stress fracture involves:

• Medical history and physical examination
• Imaging tests such as X-rays, although early stress fractures may not always be visible. MRI or bone scan may be recommended for a more accurate diagnosis.

[[File:Occult stress fracture of the talus on 1 month follow-up T1 MRI.jpg|left|thumb|Occult stress fracture of the talus on 1 month follow-up T1 MRI]]

Treatment

The primary treatment for stress fractures is rest and avoidance of the activity that caused the injury. Additional treatments include:

• Protective footwear or braces
• Physical therapy to strengthen surrounding muscles
• Gradual return to activity following a period of rest

Prevention

Prevention strategies for stress fractures include:

• Gradually increasing the intensity and duration of physical activity
• Using appropriate and well-fitting footwear
• Cross-training to avoid repetitive stress on one area of the body
• Ensuring adequate nutrition, particularly calcium and vitamin D intake

See Also

• Bone fracture
• Osteoporosis
• Sports medicine
• Physical therapy

References

• American Academy of Orthopaedic Surgeons. (2021). Stress Fractures.
• National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2020). Stress Fractures.

External Links

• American Academy of Orthopaedic Surgeons: Stress Fractures
• National Institute of Arthritis and Musculoskeletal and Skin Diseases: Stress Fractures

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