Musculoskeletal

Stress Fractures

Stress fractures are tiny cracks in a bone caused by repetitive force or overuse, often from jumping or running long distances. They can also develop from normal use of a bone that has been weakened by osteoporosis. Stress fractures most commonly occur in the weight-bearing bones of the lower leg and foot.

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Symptoms

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Causes

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Treatments

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Prevention

Condition Overview

Understand key symptoms, causes, diagnosis options, and treatment pathways for Stress Fractures. This overview is intended for patient awareness and should be followed by specialist consultation.

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Symptoms

  • Pain that develops gradually and worsens with activity
  • Pain that diminishes with rest
  • Swelling on the outside of the ankle or foot
  • Bruising
  • Tenderness to touch at the fracture site

Causes

  • Repetitive force exceeding bone's ability to remodel
  • Sudden increase in training
  • Change in surface or footwear
  • Bone weakened by osteoporosis or nutritional deficiency
  • Female athlete triad

Diagnosis

  • Physical examination (point tenderness)
  • X-rays (often normal early)
  • MRI (most sensitive — shows early stress fractures)
  • Bone scan

Treatment

  • Rest from weight-bearing activity
  • Protective footwear or crutches
  • Gradual return to activity (6–8 weeks)
  • Surgery (for high-risk fractures, e.g., navicular, fifth metatarsal)

Risk Factors

  • Running and high-impact sports
  • Female sex (lower bone density)
  • Rapid increase in training
  • Osteoporosis or low bone density
  • Nutritional deficiencies
  • Female athlete triad

Prevention

  • Gradual training progression
  • Adequate calcium and vitamin D
  • Cross-training
  • Proper footwear
  • Addressing nutritional deficiencies

Prevalence

Represent 1–20% of all sports medicine injuries; tibial stress fractures account for about 50% of all stress fractures.