Stress fractures and how to avoid them

Any bone that is subjected to repetitive impact can suffer a stress fracture (also called fatigue fractures). The bones most frequently involved are those of the lower limbs (feet and shins) and the pelvis, but stress fractures can also occur in the spine and upper limbs in people who overload those areas of the body.

 

 

Most frequent forms of stress fractures

 

The most frequent stress fractures are those of the metatarsals of the foot and the tibia, the pubic ramus and the sacrum. They may also appear in other bones of the foot such as the scaphoid or calcaneus, and also in the fibula and femur neck or femoral shaft.

 

How to avoid stress fractures

 

Stress fractures are injuries caused by an imbalance between the load or impact on certain bones, and rest and recovery measures taken afterwards. Some factors that may cause them are also nutritional deficiencies in vitamin D or minerals, or amenorrhoea.

Stress fractures are most common in athletes and can be prevented by strengthening the muscles correctly, with for example, with physiotherapy, the use of insoles (if there are biomechanical alterations), and above all, correct form and not overloading.

 

Symptoms of stress fractures

 

The main symptom of stress fractures is pain, although it sometimes does not appear strongly enough to cause the person affected to cease their damaging activity. This is one of the main problems of the injury. It can go unnoticed by those suffering, their coaches and even their physiotherapists or medical specialists in orthopaedic surgery.

This injury is sometimes related to the muscles or tendons. To diagnose it, it is necessary to perform radiological tests - scintigraphy is the most sensitive, but the resonance enables better measurement of the degree and track of the injury.

If it is not detected in time or training is not reduced the injury ends up progressing and getting worse.

 

Treatment for stress fractures

 

The majority of stress fractures heal with rest, avoiding weight or impact, but allowing mobility in a swimming pool or on a bicycle in most cases (metatarsus, tibia, and calcaneus). Some bones are more complicated and require immobilisation or even surgery (tarsal scaphoid, femoral neck). All fractures recover completely after the correct treatment.

The most important thing is to emphasise the need for early diagnosis when a fracture is suspected or there are early symptoms.