Definition

A stress fracture is a tiny crack in the bone. They are most common in the lower leg and foot.

Stress Fractures of the Tibia and Fibula Copyright © Nucleus Medical Media, Inc.

Causes

This fracture is caused by repeated stress or overuse from:

• Increasing the amount or intensity of an activity too quickly
• Changing to a new playing surface
• Not wearing the right shoes or wearing old shoes for a sport

Risk Factors

Stress fractures are more common in women. Things that may raise the risk of this fracture are:

• A sudden increase in activity
• Not getting enough rest between physical activities
• Playing sports that involve running and jumping, such as track and field, tennis, gymnastics, and basketball
• Having female athlete triad
• Bone disorders, such as osteoporosis and Paget disease
• Low levels of vitamin D and calcium
• Smoking
• Alcohol use disorder

Symptoms

Symptoms may be:

• Pain that is worse with activity and better with rest
• Swelling

Diagnosis

The doctor will ask about symptoms and past health. They will also ask about regular activities. A physical exam will be done. The doctor may suspect a stress fracture based on symptoms. Images may be taken if pain is severe or fracture is not healing as expected. Tests may be:

• X-rays
• MRI scan
• CT scan
• Bone scan

Treatment

It can take 6 to 8 weeks for a stress fracture to heal. The goals of treatment are to manage pain and support the bone as it heals. Options may be:

• Walking boot, crutches or a cane to keep weight off of a foot or leg stress fracture.
• Limiting activity that is causing pain or stress.
• Medicine to ease pain and swelling.
• Exercises to help with muscle strength and range of motion will be needed.

Prevention

To lower the chance of a stress fracture:

• Slowly increase the amount and intensity of activities over time.
• Wear the right shoes for sports.
• Eat a diet that contains foods with vitamin D and calcium.