What is a stress fracture?

James Dallis, MD

Orthopedic Surgery

When most of us think about broken bones, we think about large cracks in the bone or it being forcibly moved out of its usual place. However, there are bone fractures that are far less obvious but can still result in serious pain and discomfort.

Orthopedic surgeon James Dallis, MD, spoke with us on stress fractures, including what symptoms to look for and how these subtle bone breaks are treated.

What is a stress fracture? What causes it?

“Stress fractures are fatigue-induced bone injuries that are caused by repeated stress over time,” said Dr. Dallis.

Our bones exist in a constant state of breaking down and replenishing themselves. Every time you run or jump, your bones might break down a little, but then they rebuild as you rest and recover. If your bone breaks down faster than you can rebuild it through rest, a stress reaction or stress fracture might result.

A loss of bone density, due to osteoporosis or aging, can make stress fractures more likely as the bone needs longer to heal itself.

What are some symptoms of a stress fracture?

“Stress reactions can happen before the fracture itself, and stress fractures tend to have less obvious symptoms than more significant bone breaks,” said Dr. Dallis.

Symptoms of stress fracture to watch for include:

• Pain that begins during a physical activity and worsens while the activity is in progress
• Tenderness to even a light touch near or on the affected area
• Pain that doesn’t get better after stopping movement or may even worsen while resting
• Swelling and inflammation in the affected area

When diagnosing a stress fracture, X-rays or a CT scan may be used to decide how severe the injury is.

How is a stress fracture treated?

“Treatment for a stress fracture is aimed at making sure the bone has the time it needs to heal,” said Dr. Dallis. “Resting from the activities that cause pain, potentially utilizing a boot or crutches to take pressure off when moving around and, in rare cases, surgery to insert plates or screws may be needed.”

Is it okay to walk on a stress fracture?

Whether or not it’s safe to walk on a stress fracture depends on how severe the fracture is, where it’s located and how bad your symptoms are. Speak with your doctor on what movements are safest and which you’ll need to avoid while healing.

How long does it take a stress fracture to heal?

“Stress injuries take three weeks to heal on average,” said Dr. Dallis. “In the event of a fracture, healing could take three to four months or even longer.”

How can you prevent stress fractures?

“Improving nutrition is a good first step toward preventing bone density loss and weakness,” said Dr. Dallis. “Make sure you’re taking in the right amount of calcium and vitamin D, both important for building up your bone health.”

Other ways to prevent stress fractures include:

• Work on improving flexibility and strength of muscles and joints
• Replace sneakers and shoes as they wear out
• Choose supportive shoes, sneakers and sandals
• Mix and match exercises, including lower-impact and strength training
• Allow plenty of time for recovery
• Get at least 7 hours of sleep per night
• Make sure you take a break of 1–2 weeks between sport seasons
• Train on softer surfaces
• Stop activities for a few days if you begin to feel pain

If you’re showing symptoms of a stress fracture, schedule an appointment with your doctor right away.