Stress Fracture

(Fracture, Stress)

Definition

A stress fracture is a tiny crack in the bone from chronic overuse. Most stress fractures occur in the lower leg and foot. They can also occur in the hip and other areas.
Stress Fractures of the Tibia and Fibula
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Causes

A blow to the bone does not cause a stress fracture. Rather, it is typically caused by repeated stress or overuse. Some causes are:
  • Increasing the amount or intensity of an activity too quickly (most common)
  • Switching to a different playing or running surface
  • Wearing improper or old shoes
Stress fractures can worsen by continued physical stress. Smoking can also make stress fractures worse because it interferes with bone healing.

Risk Factors

Stress fractures are more common in women. Other factors that may increase your chance of a stress fracture include:
  • Sports that involve running and jumping, such as:
    • Tennis
    • Track, especially distance running
    • Gymnastics
    • Dance
    • Basketball
  • Absence or early stopping of menstrual cycle—amenorrhea
  • Reduced bone thickness or density—osteoporosis
  • Poor muscle strength or flexibility
  • Overweight or underweight
  • Poor physical condition

Symptoms

A stress fracture may cause:
  • Localized pain on the bone
  • Pain when pressure is applied directly over the fracture and the area around it
  • Pain when putting stress on the affected leg
  • Swelling and warmth at injury site

Diagnosis

You will be asked about your symptoms and medical history. The injured area will be examined for localized pain and swelling.Imaging tests to evaluate your bones include:
  • X-rays—stress fractures are very tiny and usually not seen on an x-ray until at least 2 weeks after symptoms begin
  • MRI scan
  • Bone scan

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