Anatomy, Biomechanics, Human, Injury and Rehab, Injury Management

Stress Fractures

You may have heard the term stress fracture being used before and wondered what makes it different from other types of fractures. In short stress fractures are not caused by a specific impact or trauma to the site of the injury but rather a repetitive overuse of that area forming micro trauma, inflammation and superficial cracks in the bone. Stress fractures form over time but can be prevented. Read on if you want to know how to prevent stress fractures forming.

How do stress fracture form?

As mentioned above stress fractures occur over time. Naturally our bodies go through a cycle of bone remodelling, where bone is reabsorbed by the body and new bone then laid down to replace it. When this process is disrupted then stress fractures can result.

Generally a sudden increase in activity is the main reason for the disruption in the remodelling process. This can be an increase in load, frequency, intensity or duration that doesn’t allow the body time to adapt. As a result the bone is reabosrned by the body quicker than bone is laid down causing bone weakness.

The majority of the time the bones affected are weight bearing such as the bones of the feet and lower leg but other bones can also be susceptible. In sport it can be common in high impact and endurance sports such as running, basketball, dance, gymnastics and tennis. In sports like rowing stress fractures can occur to the ribs due to tight muscles that repeatedly pull at the surface of the ribs.

Risk factors

  • Sport- certain sports as mentioned above can have a higher risk.
  • Sudden increase in activity- this includes increase in intensity, load, duration and not having enough recovery time.
  • Being female- abnormal menstrual cycles can affect bone density
  • Foot problems- flat feet, high or rigid arches can affect the ability of the foot to absorb impacts.
  • Worn footwear- footwear that doesn’t support the foot correctly can place undue strain on bony structures.
  • Weakened bones- osteoporosis is a condition that affects bone density. Certain medication can also have an affect.
  • Previous stress fractures- if you have had them before then unfortunately there is a higher chance of developing another one.
  • Lack of nutrition- not taking enough calories in can affect bone remodelling as well as deficiencies in Vitamin D and calcium.

How to reduce the risk

  • Eat a well balanced diet and get advice from a nutritionalist
  • Don’t restrict calories when increasing intensity and volume of exercise
  • Increase intensity of exercise gradually
  • Increase volume of exercise gradually
  • Make sure you have enough recovery time between training sessions
  • Replace equipment regularly and don’t let it get to worn
  • Look after you feet

If you suspect you have a stress fracture then seek medical advice from a doctor. Often stress fractures do not show up on x-ray when they initially occur so you may not initially get offered one. Once stress fractures start healing they become more apparent on x-ray.

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