Do you have sudden hip, shin, toe, or foot pain every time you exercise? If it’s a deep soreness that you first noticed after a sudden increase in your activity level or a recent change in activities, you could have a stress fracture: a hairline crack in the bone.
Stress fractures are overuse injuries that tend to occur in the weight-bearing bones of the lower body. They may develop when you subject your bones to repeated stress and force—for example, when running, walking, or jumping and landing.
Over the course of a long workout or a series of workouts, your muscles can become fatigued. If you continue to push hard when your body is tired or overworked, the impact forces get transferred from muscle to bone.
Also, the cumulative effect of frequent, hard exercise can weaken bone. If you are training regularly but don’t allow enough time to rest within or between high-intensity workouts, your body may not be able to remodel stressed bone before you stress it again in your next session. The effect is a breaking down of bone faster than it can rebuild itself. (Similar to what happens to muscle if you don’t allow recovery time.) This constant stress makes the bone weaker and more likely to crack when subjected to impact forces.
The result: small, crack-like fractures in the bone result. Stress fractures don’t break the bone all the way through like the full, acute fractures associated with a fall or accidental blow. Rather, they are more like splinters in wood.
Long-distance runners—especially runners of road races like 10Ks and marathons—frequently develop stress fractures because they’re subjecting their muscle and bone to substantial force over time, often without sufficient rest and recovery. (And sometimes without replacing their running shoes often enough to keep up with their mileage.) The same is true for soldiers, who train to walk and run long distances in combat boots.
Though not as common, stress fractures can occur in the upper body (for example, in the ribs, wrists, or arm bones). If you are an athlete who uses your arms, shoulders, or trunk forcefully, or if you have a loss of bone density from age or osteoporosis, it is possible to experience a stress fracture above the waist. For example, it’s quite common for elderly people to develop stress fractures in their wrists.
However, stress fractures more commonly affect load-bearing bones of the lower body. In most active people, the legs and feet bear the brunt of the forces involved in playing sports, running, and other physical activities.
The bones most likely to sustain stress fractures are:
Those three areas are the most likely to be experience stress fractures.
However, it’s also relatively common to experience a stress fracture in the following areas of the foot:
Much less common but still possible—one may develop a stress fracture in these locations:
How do you know if you have a stress factor? It’s not possible for you to know for certain without visiting a doctor for imaging (e.g., X-ray, MRI, or bone scan). Stress fractures are often “invisible” injuries and don’t always show outward signs like swelling or bruising. Also, the symptoms can easily be confused with pain from other injuries such as a tendon tear, ligament sprain, or muscle strain.
If you have any of the following symptoms, however, you may have a stress fracture:
Some people describe the pain of a stress fracture as a deep soreness that gradually becomes debilitating or excruciating as you continue to move. The pain builds over time, eventually making the activity difficult if not impossible. When you rest, the pain subsides, but it will likely return when you resume activity.
The only real way to confirm a stress fracture is to see a doctor for imaging. Even then, diagnosis can be tricky because stress fractures are so thin they are not easy to see on X-rays until they’ve started healing. You may need to have additional imaging to confirm the injury.
What are the risk factors for developing stress fractures—and what are some of the causes?
High-impact sports and athletic activities are more likely to lead to stress fractures. Any physical activity that involves brisk walking, running, or jumping repeatedly on a hard surface can make you more prone to injury.
Examples:
If you or a loved one is sufferign from pain as mentioned in this post, feel free to Coastal Orthopedics in Corpus Christi, Texas today at (361) 994-1166
Article written by: Rob Williams, MD