Stress Fractures: Symptoms, Causes, and Treatment

Stress fractures are small cracks that appear in the bone due to overload, that is, due to intense and/or repeated exercise.

This injury can appear in any area of ​​the body, but luckily there are different risk factors that we must have present to prevent this affectation, and we can follow some general advice so that this kind of problem does not affect us. affect.

In this article we will talk about stress fractures and we will see what symptoms they generate, what their causes and risk factors are, how they are diagnosed and treated, and how to prevent their appearance.

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What are stress fractures?

Stress fractures are small cracks that appear after repeated stress or trauma. In other words, this type of injury, which can be more or less serious, occurs when performing a gesture or action repeatedly, for example, running long distances or jumping constantly.

This type of fracture can appear in any part of the body, but taking into account the definition and the type of wear requiring this injury, is most often seen in the lower extremities, either the lower leg or the foot.

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Causes

As we have already seen, stress fractures are caused by physical overload, and this tends to show when the intensity of exercise is increased without the body being prepared and without allowing time for adaptation.

The body adapts to the change of exercise or sports practice through a process called remodeling: this consists of the balance between the destruction of bone tissue and the formation of new tissue. When remodeling occurs inappropriately, resulting in more destruction, a stress fracture is more likely to develop.

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Risk factor's

The characteristics of this type of fracture make it more common if certain conditions are met. So let's see what factors increase the risk of this injury.

1. the type of sport

The appearance of the fracture due to repetition of the movement causes it to be observed more frequently in subjects who practice high-impact sports, where long races are made, as in athletics, or where continuous jumps are made, as in dance or gymnastics.

2. To be a woman

An increased risk of presenting stress fractures has been observed in women, especially those who show an abnormal menstrual cycle or amenorrhea, that is, absence of menstruation.

3. Alterations in the shape of the feet

As we have already seen, the feet are one of the areas with the highest risk of being affected, more so if the shape is not adequate. For example, this occurs in subjects who do not have the arch of the sole of the foot (flat feet) or have a very pronounced arch. Likewise, wearing the wrong footwear that does not protect the foot well also increases the possibility of injury.

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4. over-activity

It is common for this type of injury to appear in subjects who led a sedentary life and suddenly they begin to practice exercise, doing it in an accelerated way and with an increase in intensity disproportionate If the level of exercise and the time are not adapted to your physical condition, this means a body overload.

5. Bone damage

A bone problem, such as osteoporosis, with weaker and worn bonesincreases the risk of developing a stress fracture.

6. inadequate diet

A lack of nutrients (such as low levels of vitamin D or calcium, which are nutrients linked to the state of the bones) increases the possibility of showing this type of fracture.

7. weakened area

If there are parts of the body where we have suffered an injury or damage before, it is more likely that these will suffer before and we can suffer this type of fracture.

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Symptoms

The most common symptom is pain in the area of ​​the body where the damage is located when we play sports or force the area. The discomfort tends to decrease or disappear when we stop exercising. In this way, we notice a more sensitive part of the body, being able to also observe swelling and redness of the area.

The pain usually decreases when we stop practicing sports, but if we do nothing to remedy it and we continue loading the area, the pain may persist and remain after finishing the treatment. exercise.

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types of fracture

The type of fracture is classified according to the area and ease of improvement. Thus, we will have lower risk areas with a faster recovery, requiring less rest time: the femur, the ulna, the tibia and the 1st to 4th metatarsals (long bones of the foot that connect the ankle with the fingers).

On the other hand, the areas at greatest risk of fracture are: the neck of the femur, the anterior diaphysis of the tibia (central part), the medial malleolus (part of the tibia and fibula that protrudes into the ankle), lateral process of the talus (bone that has the function of transmitting the weight of the body to the foot), navicular (located on the dorsal part of the foot above the arch), fifth metatarsal and sesamoid bones of the foot (bone embedded in a tendon).

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Diagnosis

Now that we know the symptoms and causes of stress fractures, it will be easier to understand what process the professional follows to make the diagnosis. To rule out other conditions and make sure it is a stress fracture, it is usual to ask about the type of sport you do and the days of the week you do it; as well questions are asked about possible previous injuries, and an inspection is usually done noting possible swelling or redness of the skin.

Subsequently, if there is suspicion of a fracture, an X-ray is usually performed or, if more precision is needed, an MRI is chosen. In this way, pain and external signs can be contrasted with the internal state of the bones and muscles.

Treatment

The type of treatment selected will depend on the area where the ailment is located and the intensity of pain or severity of the fracture. Normally, the affectation fades after 6 or 8 weeks after immobilizing the area and/or keeping it at rest. That is, the pain is usually relieved by stopping the exercise that caused the injury and reducing the overload of the affected area. Likewise, rest can also be complemented by applying ice to the area where it hurts, 2 to 3 times a day.

Despite noticing improvement after 6 to 8 weeks, it is recommended not to practice sports until after 12 to 16 weeks, and the reactivation must be gradual, progressive, without overloading the area again.

In cases of complications in the injury, adequate treatment has not been carried out, the cause has not been repaired caused the fracture and the pain remains chronic, surgery may be necessary to intervene the injury and relieve the pain. For this reason it is so important to go to the doctor when we notice that the pain persists and follow the treatment prescribed by the professional, to avoid surgical intervention that will require more time of rest.

Prevention

Visits the complications that this type of fracture can entail and the possibility of preventing them by carrying out a correct sports practice and not overloading, we will try to follow some guidelines to prevent the injury from appearing or spreading. chronicle.

1. Do not overload the body

As we already know, this fracture is mainly produced by overloading a part of the body, and for this reason we will try to stop in time and not force it. We better than anyone know our body and the different sensations we can have. Thus, if we feel more tired than usual, it is better to rest for a short period of time, preventively, than to continue forcing and end up needing a longer recovery time.

2. Gradually increase the intensity

The body needs an adaptation time; as we saw, destruction and formation of new bone tissue must be balanced. In this way, we will increase the intensity of the exercise, either by increasing the time or the weight, gradually so that the body can progressively get used to it and there is no maladjustment.

3. Avoid hard or very irregular surfaces

To reduce the impact it is better to avoid hard surfaces. It has been scientifically proven (Newton's third law) that hard surfaces, such as asphalt, they return the same intensity of force as the one we exert on them.

4. Wear proper footwear

It is important that the footwear is comfortable, suitable for the exercise we do and is in good condition (not worn or broken), in this way we better protect the foot and avoid overloading. If we need some type of corrector (such as templates) we must use it systematically, to reduce the risk of damage.

5. work the whole body

To prevent the overload of an area of ​​the body, it can help us to carry out a balanced training, in which we will work the different parts of the body without focusing only on one. A) Yes, we will achieve a better general condition of the body and reduce the possibility of injury due to continuous exercise focused on one area.

6. Follow a good diet

It has been proven that a good diet, where the necessary nutrients are consumed (as we have already seen, calcium and vitamin D are essential for the good condition of the bones) reduces the risk of stress fracture by making the body stronger.