The old childhood taunt begins with “sticks and stones may break my bones,” but some fractures develop as the result of more than just blunt force from a solid object. Whereas physical trauma is commonly thought of as the reason for most broken bones, accumulation of forces over a period of time can also cause a fracture.
Stress Fracture Basics
Instead of a bone fracture that happens due to an isolated incident, stress fractures are injuries that can develop over time from athletic activities, such as those featuring running and jumping. These fractures are hairline surface cracks that typically develop in response to cumulative forces from these activities that add up in time. This typically takes place when the remodeling process is not given enough time to replace fatigued, resorbed cells, which leads to the bone tissue not being as strong as it otherwise would.
Bones undergo a cycle of constant remodeling to more efficiently bear the physical forces that come with walking, running, and other movements. This remodeling process entails resorbing old bone cells and then replacing them with new ones. An active lifestyle and proper nutrition can help to promote this remodeling process and provide the essential nutrients to ensure strong, healthy tissue.
These bone fractures produce pain that increases over time, worsens during and immediately after activity, and improves with rest. The location of the fracture is often quite tender and there can be swelling present as well.
Essentially, stress fractures happen when bones are subjected to forces they are not used to and without having ample time to recover before additional stress is placed upon them. The repetitive application of tremendous force loads can lead to imbalance between the resorption and bone growth processes.
Repetitive forces can actually be a good thing—bones not subjected to a safe amount of force do not remodel correctly and can atrophy—but failing to provide bones with adequate rest increases the likelihood an individual will sustain a stress fracture. Additionally, muscle tissue can help by absorbing some of the excess force, but not when they are fatigued themselves.
Stress Fracture Treatment and Prevention
The best form of treatment for a stress fracture is to keep weight off the bone until it is fully healed. Depending on the severity of the case, this may require a brace or walking boot or even the use of crutches. This is rather rare, but surgery can sometimes be used for stress fractures, particularly when they develop in areas that have a poor blood supply.
Home care for a stress fracture is centered on rest, ice, and slowly resuming activities over time. Rest allows your body the opportunity to perform natural healing functions and ice reduces the levels of pain and swelling. It is important to ease back into physical activities, when we determine it is safe for you to do so. Gradually resuming your activities will help reduce your risk of re-injury.
Fortunately, there are steps that can be taken to prevent or lower the risk of suffering a stress fracture. These include:
- Wearing proper footwear. Shoes should always be activity-appropriate, fit properly, and offer ample cushioning and arch support to assist in the distribution of forces.
- Make gradual changes. Whether you are just starting a workout program or have decided to ramp up your existing routine, do so gradually. It is better to start at a light level and slowly progress instead of trying to do too much and ending up with a stress fracture or other injury.
- Cross-train. Not only will incorporating low-impact activities into your workout regimen lower your risk of injury, it will also lead to greater overall levels of fitness.
- Eat well. Proper nutrition is essential for making sure that your bones are strong. Eat lots of foods that contain calcium and other minerals and vitamins.