What is a stress fracture?
A stress fracture is a microscopic fracture of the bone that is often not picked up on X-ray. If left untreated, a stress fracture can cause significant disability and develop into a full fracture, possibly even requiring surgery.
The majority of stress fractures occur in the lower limb, being particularly common in the hip, shins and foot at points where the most force passes through when weight bearing. Most stress fractures are overuse injuries and are common in long distance runners.
What are the symptoms?
As with many overuse injuries, the pain of a stress fracture starts gradually, beginning with pain during or after activity or sometimes the morning after. If activity continues without modification, the pain will gradually increase. Eventually most people are unable to maintain their usual activity level. Stress fractures are common in runners and military personnel who are required to march for long periods. A stress fracture will be more likely to occur in a person who has weaker bone strength, such as someone with osteoporosis, which is itself affected by many factors such as adequate calcium intake, vitamin D deficiency and a history of inactivity.
How are stress fractures treated and how long will it take to get better?
Stress fractures can easily be mistaken for other conditions such as shin splints. As the fracture is often too small to show up on X-ray, definitive diagnosis can be made using MRI, CT or bone scan.
After diagnosis, the most important part of treatment will be resting the area to allow the bone to heal before resuming activity. Stress fractures usually need at least 6 weeks to recover fully. Some areas of the body have poor blood supply, which makes healing more complicated. For example, stress fractures of the navicular bone of the foot may need to be kept still and placed in a boot or cast for a period of time to heal properly.
Other aspects of treatment will involve correcting any factors that contributed to the original injury. There is some evidence that unsupportive footwear is a risk factor, along with poor biomechanics and weak muscles that provide inadequate support to the skeletal system during activity. Speak to your physiotherapist if you suspect you may have a stress fracture or if you want to know more.
Running is a great way to stay in shape, manage stress, and increase your overall wellbeing. However, it's not without its drawbacks. While being a low-risk activity, there are a few injuries that commonly affect runners. As running is a repetitive impact activity, most running injuries develop slowly and can be challenging to get on top of. Here are three of the most common conditions faced by runners, all of which can be helped by your physiotherapist.
1. Runner's Knee:
Runner's knee (patellofemoral pain syndrome) is a persistent pain at the front or inside of the knee caused by the dysfunctional movement of the kneecap during movement. The kneecap sits in a small groove at the centre of the knee and glides smoothly up and down as the knee bends and straightens. If something causes the kneecap to move abnormally, such as muscle imbalance or poor footwear, the surface underneath can become damaged, irritated, and painful. The pain might be mild to start with, but left untreated, runner's knee can make running too painful to continue.
2. Shin Splints:
Shin splints (also known as medial tibial stress syndrome) is a common condition characterised by a recurring pain on the inside of the shin. While the cause of this condition is not always clear, it is usually due to repeated stress where the calf muscles attach to the tibia (shin bone). Why this becomes painful is likely due to a combination of factors that can be identified by your physiotherapist to help you get back on track as soon as possible.
3. Achilles Tendonitis/Tendinopathy:
The Achilles tendon is the thick tendon at the back of the ankle that attaches the calf muscles to the heel bone. The amount of force that this tendon can absorb is impressive. It is vital in providing the forward propulsive force needed for running. If the stresses placed on the tendon exceed its strength, the tissues begin to breakdown and become painful. Treatment is focused on helping the healthy tendon tissues to strengthen and adapt to new forces while allowing the damaged tissue to heal and regenerate.