What Are Stress Fractures?
A stress fracture is an overuse injury. Most commonly found in the lower leg bones or the lower back, stress fractures occur when muscles become fatigued and are unable to absorb shock. The muscle eventually transfers the load to the bone, causing tiny cracks in the bone called stress fractures.
What to Look Out For
Stress fracture symptoms typically worsen with time and workload. While at first, the symptoms may seem subtle, tenderness, pain and stiffness can become apparent. Swelling may also be present, particularly if the injury is not given adequate time to rest.
How Do We Diagnose Stress Fractures?
Risk factors are very carefully considered in the diagnostic process. Often stress fractures are so minuscule that they will not show up on medical imaging scans for weeks or sometimes not at all. For this reason, often health professionals will treat stress fracture symptoms with caution.
The most common imaging test used to detect stress fractures is an MRI, which will identify ‘hot spots’. An MRI uses radio waves and a strong magnetic field to produce detailed images of your internal structures. An MRI usually can visualise stress fractures within the first week of injury and can visualise lower-grade stress injuries (stress reactions). The reason X-rays aren’t typically used to diagnose stress fractures is that they are often not apparent on regular X-rays for a number of weeks, meaning making an accurate diagnosis can take months. Occasionally a CT scan can be used.
Common Causes of Stress Fractures
Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface, improper equipment, a change in technique (for example a cricket bowling action being changed and subsequently greater stress is being placed on a part of the body).
Bone adapts gradually to increased loads through remodelling, a normal process that speeds up when the load on the bone increases. During remodelling, bone tissue is destroyed (resorption), then rebuilt.
Bones subjected to an unaccustomed force without enough time for recovery resorb cells faster than your body can replace them, which makes you more susceptible to stress fractures.
Treatment Options for Stress Fractures
The majority of stress fractures will heal with a conservative and patient approach. But first and foremost, given that the fracture is an overuse injury, the most immediate course of action that needs to be taken, is to stop the activity that is causing the problem. A period of rest is almost always required and a general time frame, to begin with, is 6-8 weeks of rest.
Additional measures such as shoe-wearer modification may be prescribed. A stiff shoe insert or boot-walker can be part of the treatment. And in certain cases, your doctor may recommend a cast or crutches. Calcium and vitamin D supplements often are prescribed.
Most stress fractures will heal with the conservative measures outlined above, but there are instances when surgery is needed. The most common situation that requires surgery is when the bone fails to heal, which is called a nonunion. Surgery would usually include placing screws to secure the bone. Sometimes this surgery also includes placing fresh bone into the area that is slow to heal. This process is called bone grafting.
If you want any more information or have any questions in regards to stress fractures, please do not hesitate to contact our Melbourne CBD or Reservoir teams to arrange an appointment on (03) 9470 1010.