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Stress Fractures
Geisinger Sports Medicine - Get Back in the Game
Mechanism of Injury
A stress fracture is a miniature crack of the bone due to unbalanced stresses in the body. In a healthy and efficient system, the body breaks down bone and gradually replaces it through nourishment and healthy lifestyle. The rebuilding process is continued through adequate sleep, healthy diet rich in calcium, and safety when exercising.
In athletes who are constantly required to meet high demands, the bone rebuilding process often gets interrupted. Something as seemingly insignificant as adding extra miles to a running routine can place elevated stress on the body. Failing to rest and rehydrate properly can also lead to muscle fatigue, which also forces the bones to absorb unexpected stress. When added stresses combine to weaken areas of bone, a stress fracture may occur over time. Long distance or sprint runners who over train often fall victim to stress fractures.
Athletes with a stress fracture may experience:
- Pain surrounding the affected bone area
- Increased pain during activity
- Pain when pressure is applied to affected area
- Swelling but no bruising
Women with bone mass and mineral density deficiencies due to hormonal imbalances or eating disorder problems are more prone to stress fractures.
Diagnosis & Testing
Physicians do not rely on X-rays as the stress fractures are usually so small they cannot be seen in the images. A physician can usually make a diagnosis based on activity history and physical examination. A bone scan is most often used for confirmation of a stress fracture diagnosis. During a bone scan, a substance is injected into the patient’s bloodstream and the patient is placed in a scanning machine. The fracture is identified when the substance collects around the fracture. An MRI test may also be helpful in diagnosis.
Treatment
Because a stress fracture affects only the bone, it can heal itself with proper immobilization. Crutches may be used for stress fractures in the legs. Returning to normal sports activities may take time, and patience is key for the healing process. Patients are encouraged to engage in non-weight bearing exercises (such as swimming) during the healing period. Your doctor will let you know when it is acceptable to return to certain impact activities. Bracing with a hard plastic boot or air cast may be recommended.
Surgical Management
Surgery may be recommended in cases of severe stress fractures using a process called pinning, which involves pinning the fracture site. Rehabilitation can take up to six months following a stress fracture surgery.
Rehabilitation
Stress fractures occur because the muscles surrounding the bone were not doing their job of absorbing impact. Physical therapy following a stress fracture will center around muscle strength training to relieve some of the stresses experienced by the bone. By building muscle strength, you are minimizing the risk of muscle fatigue and ensuring that the underlying bone is protected. For stress fractures in the lower legs, for example, the calves and shin muscles will be targeted. Rehabilitation is also very important element in healing for post-surgery patients as well.
Electrical stimulation therapy may be used to encourage healing and repair using electromagnetic currents.
At Geisinger Sports Medicine, we help athletes with stress fractures recover with the best techniques modern medicine has to offer. If you or your child sustains a stress fracture, contact us today for an appointment at our state-of-the-art facility.
Geisinger Sports Medicine Facility
1-866-414-4988
Orthopaedic Services-Woodbine Lane
Corner of Woodbine Lane & Route 11
Danville, PA 17822 MC 52-12
Geisinger Wyoming Valley Medical Center
1-800-921-1467
1000 East Mountain Blvd.
Wilkes-Barre, PA 18711
Geisinger Medical Center
1-800-275-6401
100 N. Academy Avenue
Danville, PA 17822