Stress Fracture 101: How Little Bone Cracks Can Be a Big Deal

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A stress fracture happens slowly, as a bone absorbs impact after impact without getting the rest it needs to rebuild. These small stresses add up, eventually creating a small but painful crack called a stress fracture.

Stress fractures are most commonly seen in athletes who train too hard, too quickly, says Dr. Brad Homan, Medical Director of Sports Medicine at AdventHealth Celebration. Stress fractures almost always happen in the weight-bearing bones of the legs and feet.

Bones are like muscles — regular activity is good for them. As they undergo increasing stress, bones break down and, in time, rebuild stronger. When the stress comes too frequently, like when a marathon runner overtrains, the bone is repeatedly breaking down without building up afterward.

The result can be a stress fracture, a painful condition that, if ignored, can eventually become a complete break. They are preventable, though.

Paying attention to the signs of an impending stress fracture can save you some pain and ensure your training isn’t interrupted.

It’s important to note that, while most stress fractures are caused by overuse, they can also be a sign of low bone density. As Dr. Homan explains, women who have gone through menopause should pay special attention to potential stress fractures.

Before the Fracture

An overstressed bone will send out warning signs before it cracks. Repeated pain during exercise is often a sign that a bone should be given more time to heal. This is called a “stress reaction.”

“As a general rule, if you’re training and you start noticing pain in a certain bone that lasts for more than a week, you should probably back off,” Dr. Homan says.
If pain continues for a few weeks and you suspect a stress fracture has occurred, it’s worth going to the doctor. Though most stress fractures don’t require surgery, a doctor should verify that it’s healing correctly.

Rest, followed by slowly increasing activity, is the most common treatment for stress fractures.

“You just need to give your body a chance to accommodate the stress you’re putting on it,” he says.

Female athletes, in particular, should pay attention to stress fractures, Dr. Homan said. Overtraining can throw off a woman’s hormone balance, which may affect her menstrual cycle and long-term bone health.

Nutrition is another key part of preventing stress fractures. A healthy diet should provide enough calcium, but someone who is lactose intolerant may benefit from a calcium supplement and vitamin D, which helps the body absorb calcium.

Though stress fractures are most commonly seen in athletes, they can also be a sign of bone density issues.

A Sign of Osteoporosis?

A person who gets a stress fracture from regular activity, like walking, should have their bone density evaluated. They may suffer from bone loss, called osteopenia, which can be a precursor to osteoporosis. A bone density test, called a DEXA scan, can provide answers.

Spotting bone loss early can prevent it from progressing to osteoporosis through the use of targeted exercise and, when appropriate, medication.

A Stressful Injury

The bottom line in preventing stress fractures is to listen to your bones; if you’re in recurring pain, change up your routine. Substituting swimming or biking for running is one way to cope with or prevent a stress fracture while staying active.

At the AdventHealth Orthopedic Institute, we understand exercise is a big part of being healthy in body, mind and spirit. We know healing means getting you back to normal as fast and safely as we can.

For more information, visit our website or call us at Call855-303-3627 to schedule an appointment.

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