HEALTH & FITNESS
Stress Fractures
By Marc R. Rizzardo B.Sc. P.T., M.P.E., B.P.E., Dip. Sports Physio
Chief Therapist 2007 Pan Am Canadian Medical Team
Metrotown Orthopedic & Sports Physiotherapy Clinic, Burnaby, BC (www.metrotownphysio.com)
WHAT HAPPENS
There are several theories. The body constantly repairs itself every day from the stress put on it. If the cumulative strain put on the body exceeds its repair ability, you can develop a stress fracture.
CAUSES
It is more common in females than males due to different biomechanics and hormonal factors.
- Over training: too fast, too hard, and too far.
- Equipment problems: shoes and orthotic devices.
- General biomechanical problems: flat feet, high arches and other defects.
SIGNS AND SYMPTOMS
Usually a history of insidious onset of activity related pain that progressively worsens over time. There is localized bony tenderness and the site is often sensitive to vibration.
Confirmation of Clinical Diagnosis:
- X-rays are usually no help
- C/T scan or MRI is needed to confirm
TREATMENT - 2 PHASE PLAN
PHASE 1
- Modified rest (average 6-8 weeks)
- NO running!
- Continue flexibility, strength, and cross training exercises. For example, cycling, walking (once pain free), rowing, swimming, stair climbing, pool running (only if it's not a navicular stress fracture).
PHASE 2
- Once there are radiographic signs of healing OR you are totally pain free on normal activity, you can resume some running with days of relative rest.
- Gradually progress as able in a pain free manner.
COMPLICATIONS
- Mal-union
- Non-union
- Necrosis
- Reflex disturbance
M.D. INTERVENTION
- May need to cast leg with a removable cast.
- Occasionally operation is required (either fixing or removing)
- Anti-inflammatories
