Musculoskeletal injuries: Stress fractures

Stress fractures are one of the most common sports injuries. Overcoming them can be difficult but is certainly possible. They are classified as an overuse injury. Fatigued muscles become unable to absorb shock and transfer the overload to the bone causing tiny cracks. It is estimated that more than half of them occur in the bones of the foot and the lower leg.

Causes
 
A sudden increase in the intensity or a duration of an activity doesn’t allow the bone sufficient time to adapt. The excessive force causes rapid destruction (resorption) of bone tissue coupled with insufficient remodelling making you more susceptible to such fractures.
 
An unfamiliar surface such as a runner used to a treadmill hitting the tarmac, increased physical stress such as increased playing time of a volleyball player, or improper equipment, usually footwear, are other common culprits.
 
Risk factors
 
The likelihood of stress fractures is higher in:

• Sports such as gymnastics, basketball, tennis, and track and field.
• People with foot problems such as flat feet or high arches.
• Conditions such as osteoporosis which weaken the bones.
• Nutritional insufficiencies such as vitamin D and calcium.
• Women, particularly those with abnormalities in their menstrual cycle.
• People who suddenly increase the duration, intensity or frequency of activities stressing the bones.
• Cases where there is a history of stress fractures.

 
Symptoms and diagnosis
 
Initially, stress fractures can be barely noticeable as the cracks in the bone are only minor but the pain tends to worsen over time. Swelling in the area is possible and the pain tends to subside with rest.
 
X-rays may or may not be able to detect a stress fracture, so a computed topography (CT) scan or magnetic resonance imaging (MRI) may be required.
 
Treatment
 
It is essential to contact a doctor if the pain becomes severe or persists even at rest.
 
In general, rest is the best treatment route coupled with discontinuing the activity that caused the problem. If the activity that caused the fracture is resumed too quickly, re-injury and further complications are very likely. 
 
Prevention (is indeed better than cure in this case)
 
By embracing the following best-practices, the likelihood of stress fractures can be significantly reduced:

• Change activity levels and type gradually to allow all of the body’s systems sufficient time to adapt.
• Use proper equipment and footwear to minimise the stress on the foot and lower leg bones.
• Do a variety of activities that aim at meeting your goals to prevent repetitive stress scenarios.
• Eat, drink and sleep healthy to ensure you provide enough nutrients and opportunity for the body to utilise them for maintaining healthy bones.

 
Last but not least, be in touch with your body. Knowing the symptoms and risk factors and being acutely aware of how you feel, can help you spot potential issues before they materialise.