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Stress fractures, caused by excessive and cumulative stress on bones, are often suffered by athletes, dancers, and soldiers. They can be difficult to detect on an X-ray and require other scanning methods. Prevention includes modifying exercise programs, changing shoes, and increasing bone density through dietary supplements.
Many of us are familiar with bone fractures caused by trauma, such as a simple or compound fracture of the leg. However, there is another form of bone damage that rarely shows up on an X-ray but can still be extremely painful and debilitating. Because it is mainly caused by excessive and cumulative stress on the bone, this form of injury is commonly called a stress fracture. Athletes, dancers, and soldiers are especially susceptible, as their job descriptions include excessive standing, marching, and running. Some sources also refer to this type of fracture as a fatigue or march fracture.
While any bone can potentially receive a stress fracture, most cases requiring treatment occur in the lower legs and feet. Every time a person runs, dances, or performs any other stressful movement, the shock must be absorbed by the body. Ideally, the leg muscles should absorb much of the impact before it’s transferred to the tibia (lower leg) or metatarsal bones (feet). As the muscle tires, however, more and more shock is absorbed directly by the bones. Over time this constant pressure and shock can cause a crack in the bone itself, even if it doesn’t result in a complete break. This crack is considered a stress fracture.
Because a stress fracture rarely appears on a plain x-ray, other scanning methods, such as a CT scan or MRI, are usually recommended. For many sufferers, the only clue to such a fracture is extreme pain in the affected area. Some small stress fractures will eventually heal as the bone works to repair itself, so a few weeks of rest and some over-the-counter pain relievers should be enough. Other forms are more severe and may require a cast or air cast for support and protection. The patient is often asked to stay off the affected limb for several months.
A stress fracture can be prevented by modifying an exercise program or a change in technique or body mechanics. Runners should change their shoes periodically to maintain adequate shock absorption. Dietary supplements such as calcium and vitamin D should be used to increase bone density and strength. Some athletes and dancers find that a gradual increase in exercise can reduce their chances of developing a stress fracture. As bones adjust to the controlled increases in shock, they get stronger and are less likely to break under unusual pressure.
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