A stress fracture, also known as a hairline fracture, refers to a type of broken bone where only a small crack or bruising on the bone occurs. You may have heard of an athlete with a stress fracture, especially those who engage in repetitive movements like running and jumping that stress bones and joints. People with osteoarthritis, the most common type of arthritis, are also at greater risk for stress fractures. Unlike what you would normally think of with a broken bone, a stress fracture may not require a cast or even look like a clean break on an X-ray. Instead, stress fractures caused by overuse or repetitive force can create microscopic damage to bones that worsens with time. The legs and feet are common places where stress fractures occur because of the amount of stress they absorb when running, jumping, and other weight-bearing activities. What might seem like slight pain and tenderness after working out can develop into something more serious like a stress fracture. Here are signs of a stress fracture to keep an eye out for and what you can do to reduce your risk.
What Can Cause a Stress Fracture?
Athletes who run track and field or play basketball are more susceptible to a stress fracture, especially in the lower legs and feet. The repetitive pressure while going for a run or playing on a hard court can lead to wear and tear on your bones and joints. Other sports with high-impact activities that can lead to a stress fracture include tennis, dance, and gymnastics. In addition to athletes and certain sports, stress fractures can also be caused by a sudden increase in activity. If you suddenly change your workout routine or dramatically increase the intensity of a training session, you could risk a stress fracture.
Your bones and their supportive tissues and structures can adapt to a gradual increase in activity and intensity. However, too much at once can put too much pressure on your bones, and that unaccustomed force can make your bones more susceptible to a stress fracture. People with high arches or flat feet are also at greater risk for developing a stress fracture, especially when you don’t wear the right supportive shoes to help with a foot problem. People who have experienced a stress fracture in the past are also more likely to have one again in the future. Improper technique or equipment from amateurs to professionals can also lead to a stress fracture.
5 Signs & Symptoms of a Stress Fracture
Here are five examples of signs of a stress fracture that can develop over time, especially with weight-bearing activities.
Increased Pain with Activity
You may notice an increase in pain with certain activities, especially those that require repetitive movements or load-bearing activities. Pain from a stress fracture will typically get worse when you move around and put pressure on the area, like going for a run with a stress fracture in your foot. Over time, the microscopic cracks in the bones of your foot or leg can start to get worse during activity.
Pain Relief with Rest
If you have a stress fracture, you may notice that the pain you experienced in the area goes away as soon as you rest. Taking weight off the affected area will help reduce pressure on the area where the hairline cracks occur. The pain from a stress fracture can lessen when you take a break from repetitive movements or overloading activities like running.
Pain Gets Worse Over Time
When you continue to engage in activities that lead to a stress fracture, the tiny cracks in the bones can get worse. This can also cause an increase in your pain and discomfort over time, too. If left untreated, pain from a hairline fracture may gradually become so uncomfortable that you cannot even participate in regular activities like walking or going up and down steps without increased pain.
Swelling and Tenderness in the Area
A stress fracture can also lead to swelling and tenderness in the area. While you might not notice the pain of a stress fracture at first, you might experience some tenderness in the area that increases with certain activities and lessens when you rest. As pain gradually increases, you may also experience swelling around the painful area, like a swollen ankle around a hairline fracture in the joint.
Decreased Mobility in the Area
If you develop a stress fracture, you may experience worsening pain and other symptoms from everyday activities like walking around, especially on hard surfaces or for long distances. Stress fractures to lower extremities like your feet, ankles, and legs can lead to decreased mobility and keep you from going about your day like you normally would.
When to See a Doctor About a Stress Fracture
Talk to your doctor if you start to experience pain while participating in an activity you regularly enjoy. If you have a history of osteoarthritis and notice a gradual increase in pain, especially in a specific spot like your foot, ankle, or lower leg, then let your doctor know. Sometimes a diet lacking in certain nutrients can put you at greater risk for a stress fracture. Your doctor will want to know about your medical history and ask questions about your diet, what medications you may be taking, and other common risk factors for a stress fracture. Talk to your doctor about your regular activities and habits, like if you play tennis every weekend or go for a run every morning. They will also want to know where your pain occurs and if it gets worse with certain activities or better after periods of rest.
To diagnose a stress fracture, your doctor will perform a physical examination to inspect the area where you experience pain. They will check for tenderness in the area by applying gentle pressure to see if you experience any pain. Your doctor will likely want to run some diagnostic imaging tests to confirm the diagnosis. An X-ray may not detect a tiny hairline fracture or one that develops from a sudden injury. It can actually take weeks for a hairline fracture to become large enough to show up on X-rays, which is why you may get other tests done instead. An MRI offers the best option for diagnosing a stress fracture. MRI scans offer highly detailed images of not only your bones but also soft tissues like muscles, tendons, and cartilage. Your doctor will be able to detect a stress fracture with an MRI sooner and can also determine its severity, too. A bone scan may also be recommended to help rule out other potential abnormalities or issues with your bones.
Treatment Options for a Stress Fracture
The sooner you start treating a stress fracture, the better your chances are for a full recovery. Plus, treating a stress fracture as soon as possible will help prevent the tiny crack from turning into a full break or causing damage to nearby soft tissues. A complete bone break will require a lot longer time to heal and may require more complicated treatments. Here are your treatment options for a stress fracture.
The RICE method offers a great at-home remedy for pain and discomfort. RICE stands for rest, ice, compression, and elevation. Resting after any activity is key to letting your body recover effectively. If you experience pain from an activity, especially if you have not noticed pain before, then you want to make sure you give your body additional time to rest before you participate in that activity again. You can also ice the area where you notice pain, tenderness, and swelling. A cold compress will help reduce swelling and inflammation while also providing a temporary numbing effect to soothe your discomfort. You may want to wrap your foot in a soft bandage for added compression that will help ease swelling, too. Finally, elevating your affected foot or lower leg so that it rests above your heart will also help reduce blood flow to the area and allow swelling and inflammation to go down.
From proper footwear to a splint or brace, assistive devices can help provide you with additional support while you heal from a stress fracture. You may need to wear a walking boot or use crutches to help reduce the weight-bearing load on the area where the stress fracture occurred. An orthopedic doctor can talk to you about your options for assistive devices, including stiff-soled shoes or orthotic inserts to support your arches and ensure better stability. Orthotics and insoles can also help reduce your risk for stress fractures by lessening shock and fatigue on your feet.
Low Impact Exercises
While healing from a stress fracture, you do not want to skip exercise altogether. Staying in shape and keeping your muscles strong will help provide your legs and feet with better support going forward. You can engage in low-impact activities like yoga or swimming that keep your muscles warm and flexible while you recover. Check with your doctor about what low-impact exercises would work best for you to avoid putting too much stress on a particular area while you heal. Cross-training with low-impact activities can also introduce you to other ways to exercise that do not put you at risk for a repeated stress fracture.
In rare cases, your doctor may recommend surgery for a stress fracture. Professional athletes may also elect for surgical treatment to allow them to return to their sport as soon as possible. A potential surgery for a stress fracture may include using fasteners like pins or screws to hold the bone together while it heals.
Physical therapy offers a wide range of benefits for healing from a stress fracture, whether or not you end up getting surgery. A physical therapist can introduce you to low-impact stretches and activities that will keep you in shape while you recover. Physical therapy can also help you improve your technique and prevent future stress fractures. A physical therapist can also help you slowly reintroduce more activity into your routine and show you how to modify certain activities while you heal. Your physical therapist will set goals for your treatment that will include removing stress from the injured area and pain management. Physical therapy will teach you about activity modification and help you safely initiate a return to regular activity when it is appropriate for you. Physical therapy is about more than just stretches and exercises; your physical therapist may also utilize manual therapy and soft tissue mobilization to help with pain and improve your range of motion.
How to Prevent a Stress Fracture
One of the most important things you can do while recovering from a stress fracture is to avoid high-impact activities that caused it in the first place. Even once you return to these activities, you want to make sure you do so with proper form and good support. Going forward, make sure to incorporate changes to your exercise regimen gradually to avoid overloading your legs and feet. Wear proper footwear and make sure your shoes fit well and provide enough support and shock absorption. You also want to engage in cross-training activities that will still keep you in shape while also reducing the load on your body. Focus on getting the proper nutrition, so your body has the nutrients it needs to maintain healthy bones, muscles, and joints.
If you are worried about a stress fracture, talk to one of our doctors at AICA Orthopedics near you. With multiple locations across the metro Atlanta area, you can get quality, comprehensive care at a location near you. Our teams of doctors include orthopedic surgeons, chiropractors, and physical therapists, all in one location with access to state-of-the-art equipment and diagnostic imaging tools like X-rays and MRIs in-house. Find an AICA Orthopedics location near you and get started with our personalized treatment plans today.