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Stress Fractures

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What is a Stress Fracture?

A stress fracture is a break in a bone cause by repetitive stress. The break, or small crack develops in the outer shell of the bone. A stress fracture may occur in any bone. However, stress fractures are very common in the metatarsal bones of the foot. Metatarsal stress fracture may not become apparent on x-rays until a few weeks after the injury.

A stress fracture develops in the outer shell of the bone. Without proper treatment, a stress fracture may progress to a "through and through" (overt) fracture of the bone.

Stress fractures are common sports injuries. They are often called fatigue fractures.

Symptoms of a Stress Fracture?

The most common symptoms of a stress fracture are:

  • Sharp pain in the forefoot, aggravated by walking.
  • Tenderness to pressure on the top surface of a metatarsal bone.
  • Diffuse swelling of the skin over the forefoot.
  • Bruising or redness of forefoot .

Stress fractures are usually preceded by inflammation of connective tissue covering the surface of bone.

What Causes a Stress Fracture?

A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. The fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture.

Other causes of a stress fracture are:

  • Osteoporosis
  • Foot deformity (bunion, hammer toe)
  • Abnormal foot structure or mechanics (flatfoot)
  • Increased levels of activity, especially without proper conditioning
    • Runners who increase their training too rapidly often develop stress fractures.
  • Obesity
  • Wearing worn or improper shoes

Can a Stress Fracture be Treated?

Yes a stress fracture can be treated. Rest and pain medication are the most common treatments. Stress fractures take about 6 to 8 weeks to heal. It is important to rest the stress fracture. If strenuous activity is resumed too quickly, larger, harder-to-heal stress fractures can develop. Reinjury also could lead to chronic problems where the stress fracture might never heal properly.

Tips to Prevent Stress Fractures

  • Slowly increase any new sports activity.
  • Do not immediately start running five miles a day; instead gradually build up your mileage on a weekly basis.
  • Eat a balanced, healthy diet.
  • Do not wear old or worn running shoes.
  • If pain or swelling occurs, immediately stop the activity and rest for a few days. If continued pain persists, see an orthopedic surgeon.

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