Stress Fractures occur due to excess loading of the bone. Bones respond to activity, they become stronger with loading by becoming more dense i.e. stronger. However, if there is not a sufficient period of rest allowed after activity then the bone can become weaker and lead to a Stress Fracture.
A Stress Response Injury is a prelude to a Stress Fracture. No fracture is present but there may be local swelling, pain and tenderness to touch the bone. Often the bone is painful on exercise but eases once the activity stops. If this situation continues to occur it will lead to a Stress Fracture.
Stress Fractures and Stress Response Injuries are very common in Runners, Ballet Dancers, Walkers and any activity on hard surfaces. Symptoms are usually gradual and can be managed with rest and pain relief medication.
Stress Fractures and Stress Response Injuries are most common in the Metatarsals (Toes), Calcaneus (Heel), Tibia (Shin) and Pubic Ramus (Pelvis/Groin).
A thorough History and Physical Examination by your Chartered Physiotherapist will determine the likelihood of a Stress Fracture or Stress Response Injury. If such an injury is likely, an x-ray or MRI would be requested to confirm.
Treatment for a Stress Fracture or Stress Injury includes rest, activity modification and biomechanical corrections. A protective boot may need to be worn if the injury is in the foot, this will offload the bone and aid in its healing. Biomechanical corrections such as increasing mobility and strength in the lower limbs and core can help the injured bone from being excessively overloaded. In cases involving the foot Temporary Orthoses may be considered to re-direct the forces away from the injured site.
MyPhysio’s thoughts on Stress Fracture and Stress Response
Often clients come to MyPhysio self diagnosing with Plantar Fasciitis, Patellar Tendinopathy or Groin Strain when in fact they may have a Stress Fracture or Stress Response Injury. Of course, treatment is very different and this will be clarified after a thorough examination.
MyPhysio owner, John Flynn, has worked in the Royal Air Force as a civilian Chartered Physiotherapist. Stress Fractures were common in the Calcaneus (Heel) and Pubic Ramus (Pelvis/Groin). This was due to the high levels of activity. A well-thought-out rehabilitation programme is required for a successful return to a normal lifestyle post-Stress Fracture or Stress Response Injuries.
If you have any queries regarding Stress Fractures or Stress Response Injuries, please ‘Ask the Expert’.