![]() ![]() Tuning forks have been advocated as an inexpensive alternative for identifying the presence of stress fractures. MRI appears to be the most accurate diagnostic test. A CT scan, MRI, or 3-phase bone scan may be more effective for early diagnosis. X-rays usually do not show evidence of new stress fractures, but can be used approximately three weeks after onset of pain when the bone begins to remodel. Changing habits or the environment like training surface or shoes.Going from one event to another without proper training for the second event.Going back to competition too soon after an injury or illness.Along with history of stress fractures, a narrow tibial shaft, high degree of hip external rotation, osteopenia, osteoporosis, and pes cavus are common predisposing factors for stress fractures Ĭommon causes in sport that result in stress fractures include Previous stress fractures have been identified as a risk factor. As the bones now experience larger stresses, this increases the risk of fracture. However, the muscles, usually those in the lower leg, become fatigued after running a long distance and lose their ability to absorb shock. Muscles and bones serve as shock absorbers. Each shock-a rapid acceleration and energy transfer-must be absorbed. In a runner, each stride normally exerts large forces at various points in the legs. Muscle fatigue can also play a role in the occurrence of stress fractures. Stress fractures are also commonly reported in soldiers who march long distances. They may also occur in athletes completing high volume, high impact training, such as running or jumping sports. Stress fractures commonly occur in sedentary people who suddenly undertake a burst of exercise (whose bones are not used to the task). Potential causes include overload caused by muscle contraction, amenorrhea, an altered stress distribution in the bone accompanying muscle fatigue, a change in ground reaction force (concrete to grass) or the performance of a rhythmically repetitive stress that leads up to a vibratory summation point. It occurs from repeated traumas, none of which is sufficient to cause a sudden break, but which, when added together, overwhelm the osteoblasts that remodel the bone. Over time, if enough stress is placed on the bone that it exhausts the capacity of the bone to remodel, a weakened site-a stress fracture-may appear on the bone. ( November 2020) ( Learn how and when to remove this template message)īones are constantly attempting to remodel and repair themselves, especially during a sport where extraordinary stress is applied to the bone. Unsourced material may be challenged and removed. Please help improve this article by adding citations to reliable sources in this section. This section needs additional citations for verification. Anterior tibial stress fractures elicit focal tenderness on the anterior tibial crest, while posterior medial stress fractures can be tender at the posterior tibial border. Pressure applied to the bone may reproduce symptoms and reveal crepitus in well-developed stress fractures. There is usually an area of localized tenderness on or near the bone and generalized swelling in the area. If pain is constantly present it may indicate a more serious bone injury. In cases of fibular stress fractures, pain occurs proximal to the lateral malleolus, that increases with activity and subsides with rest. Symptoms usually have a gradual onset, with complaints that include isolated pain along the shaft of the bone and during activity, decreased muscular strength and cramping. Stress fractures are typically discovered after a rapid increase in exercise. ![]() ![]() Treatment usually consists of rest followed by a gradual return to exercise over a period of months. Less common are stress fractures to the femur, pelvis, and sacrum. Stress fractures most frequently occur in weight-bearing bones of the lower extremities, such as the tibia and fibula (bones of the lower leg), metatarsal and navicular bones (bones of the foot). Stress fractures of the foot are sometimes called " march fractures" because of the injury's prevalence among heavily marching soldiers. Stress fractures can be described as small cracks in the bone, or hairline fractures. Because of this mechanism, stress fractures are common overuse injuries in athletes. Instead of resulting from a single severe impact, stress fractures are the result of accumulated injury from repeated submaximal loading, such as running or jumping. Stress fracture of the second metatarsal bone (below the knuckles of the second toe)Ī stress fracture is a fatigue-induced bone fracture caused by repeated stress over time. Hairline fracture, fissure fracture, march fracture, spontaneous fracture, fatigue fracture ![]()
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