In 331 BC – yes, over 2,300 years ago – Aristotle said, “Olympic victors are those who do not squander their powers by early and over-training.” Even though he may not have known about the medical implications of stress fractures, his insight warned against them. It just goes to show, this is not a new problem for athletes.
Stress fractures occur most often in the lower extremities (shins, feet, and femur) as a result of repetative stress on the affected bone. When the surrounding muscles become too fatigued, they can’t provide the right amount of protection, so the body’s exertion falls on the bone itself. Of all athletes, runners make up the highest population of those with stress fractures.
The symptoms appear as increased pain over time, first showing up only during athletic activity, and eventually becoming continuous pain as the fracture gets worse. They are sometimes difficult to diagnose in the beginning, so I usually ask several questions to rule out bone disease, eating disorders, and other leg pain resulting from poor running shoes or training methods. Once I can determine the location and severity of a stress fracture, I generate a treatment plan. This may include a cast and period of simple inactivity for low-risk patients, or invasive surgery to reset the bone with a rod or plates in high-risk patients. Usually, sitting still is the best way to get them to heal on their own.
Perhaps the most difficult part of treating stress fractures, however, is that they are typically the result of an underlying disease. An exercise addiction or eating disorder can often lead to these types of injuries, and in many cases, a high-performance athlete has a hard time hearing they need to rest or stop their training altogether for a long period of time. With many of my patients, though, I’ve noticed they are usually eager to avoid a chronic injury and will often buy into the process of healing.
If you’re looking for more information, take a look at the in-depth articles below from the American Academy of Orthopaedic Surgeons.
- More information on stress fractures: http://orthoinfo.aaos.org/topic.cfm?topic=a00112
- Foot and ankle stress fracture information: http://orthoinfo.aaos.org/topic.cfm?topic=A00379
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