Stress Fractures

Stress Fractures are tiny crack formations in a bone. When muscles are fatigued, they are unable to reduce the shock of repeated impacts. These fatigued muscles then transfer the stress directly to the bone creating small cracks or fractures. Stress Fractures could be so fine that they are often missed in an x-ray or MRI; sometimes called Hairline Fractures. Stress Fractures often develop due to the repeated application of force and overuse from high impact sports where jumping, running etc. is continually used in the sport, such as tennis, basketball, distance running etc. Stress Fractures also occur from normal wear and tear of the bone when the bone has been weakened by a condition such as osteoporosis. In such cases, merely hitting the knee at the edge of a table could cause a Hairline Fracture. A Stress Fracture is one of the most common sport related injury and injury in the elderly suffering from osteoporosis.

Cause or Possible Risk Factors

  • Most stress fractures occur in the weight bearing bones of the lower leg and the foot. More than 50 percent of all stress fractures occur in the lower leg
  • Repetitive application of a greater amount of force than the bones of the feet and lower legs normally bear
  • Muscle fatigue can also play a role in the occurrence of stress fractures
  • People with weak bones or nutritional deficiencies and can happen in the foot, leg, spine, arm, ribs, and other bony locations
  • Previous stress fractures
  • Increasing the frequency, intensity or length of workouts, such as adding miles to a running regimen or practicing a sport more than normally accustomed to
  • Wearing worn-out shoes, shoes that don't fit well, or shoes that aren't designed for the activity
  • Stress fractures seem to be more common in women, especially in women who do not have regular menstrual cycles
  • Acute event, such as a car crash or a fall


  • Pain with activity is the most common complaint with a stress fracture
  • Pain that develops gradually, increases with weight-bearing activity, and diminishes with rest
  • Swelling on the top of the foot or the outside of the ankle
  • Tenderness to touch at the site of the fracture
  • Possible bruising
  • Decreased swelling and pain with rest
  • Earlier onset of pain with each successive workout
  • Continued pain at rest as the damage progresses

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