Stress fractures are small cracks that appear in the bone due to overload, that is, from performing intense and/or repeated exercise.
This injury can appear in any area of the body, but luckily there are different risk factors that we must keep in mind to prevent this condition, and we can follow some general advice so that this type of problem does not affect us.
In this article we will talk about stress fractures and we will see what symptoms they generate, what their causes and risk factors are, how they are diagnosed and treated, and how to prevent their appearance.
Stress fractures are small cracks that appear after repeated overuse or trauma That is, this type of injury, which can be more or less serious, occurs when repeatedly performing a gesture or action, for example running long distances or jumping constantly.
This type of fracture can appear in any part of the body, but taking into account the definition and type of wear that this injury requires, it is most frequently seen in the lower extremities, whether the lower leg or the foot.
Causes
As we have already seen, stress fractures occur due to physical overload, and this tends to appear when the intensity of the exercise is increased without the body being prepared and without allowing time for adaptation.
The body adapts to the change in exercise or sports practice through a process called remodeling: This consists of the balance between the destruction of bone tissue and the formation of new tissue. When remodeling occurs inadequately, resulting in greater destruction, a stress fracture is more likely to develop.
Risk factor’s
The characteristics of this type of fracture make it more common if certain conditions are met. Let’s see what factors increase the risk of this injury appearing.
1. The type of sport
The appearance of fracture due to repetition of movement makes it more frequently observed in subjects who practice high-impact sports where long races are carried out, as in athletics, or where continuous jumps are made, as in dance or gymnastics.
A higher risk of developing a stress fracture has been observed in women, especially those who show an abnormal menstrual cycle or amenorrhea, that is, the absence of menstruation.
3. Alterations in the shape of the feet
As we have already seen, the feet are one of the areas most at risk of being affected, especially if the shape is not appropriate. For example, This occurs in subjects who do not have the arch of the sole of the foot (flat feet) or have it very pronounced Likewise, wearing inappropriate footwear that does not protect the foot well also increases the possibility of injury.
4. Over-activity
It is common for this type of injury to appear in subjects who led a sedentary life and suddenly begin to exercise, doing so in an accelerated manner and with a disproportionate increase in intensity. If the level of exercise and the time do not adapt to your physical condition, this represents an overload of the body
5. Bone damage
A bone problem, such as osteoporosis, with weaker and worn bones increases the risk of developing a stress fracture.
6. Inadequate nutrition
A lack of nutrients (such as low levels of vitamin D or calcium, which are nutrients linked to the state of bones) increases the possibility of showing this type of fracture.
7. Weakened area
If there are parts of the body where we have previously suffered an injury or damage it is more likely that these will suffer sooner and we may suffer this type of fracture.
Symptoms
The most common symptom is pain in the area of the body where the damage is located when we play sports or force the area. The discomfort tends to decrease or disappear when we stop exercising. Thus, We notice a more sensitive part of the body, and may also observe swelling and redness in the area
The pain usually decreases when we stop practicing sports, but if we do nothing to remedy it and continue loading the area, the pain may persist and remain after finishing the exercise.
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Types of fracture
The type of fracture is classified according to the area and ease of improvement. Thus, we will have lower risk areas with a faster recovery, requiring less rest time: the femur, the ulna, the tibia and the 1st to 4th metatarsus (long bones of the foot that connect the ankle to the toes)
On the other hand, the areas with the highest risk of fracture are: the neck of the femur, anterior shaft of the tibia (central part), medial malleolus (part of the tibia and fibula that protrudes at the ankle), lateral process of the talus (bone that has the function of transmitting the weight of the body to the foot), navicular (located on the dorsal part of the foot above the arch), fifth metatarsal and sesamoid bones of the foot (bone embedded in a tendon).
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Diagnosis
Now that we know the symptoms and causes of a stress fracture, it will be easier to understand what process the professional follows to make the diagnosis. To rule out other conditions and make sure it is a stress fracture, it is common to ask about the type of sport you do and the days of the week you do it; also Ask about possible previous injuries, and an inspection is usually done, observing possible swelling or redness of the skin
Subsequently, if there is suspicion of a fracture, an x-ray is usually performed or, if greater precision is needed, an MRI is chosen. In this way, the pain and external signs can be contrasted with the internal state of the bones and muscles.
Treatment
The type of treatment selected will depend on the area where the pain is located and the intensity of pain or severity of the fracture. Normally, the involvement fades after 6 or 8 weeks after immobilizing the area and/or keeping it at rest That is, the pain is usually relieved by stopping the exercise that caused the injury and reducing the overload of the affected area. Likewise, you can also complement rest by applying ice to the area where it hurts, 2 to 3 times a day.
Despite noticing improvement after 6 to 8 weeks, It is recommended not to practice sports until 12 to 16 weeks have passed and the reactivation must be gradual, progressive, without overloading the area again.
In cases of complications in the injury, adequate treatment has not been carried out, the cause that caused the fracture has not been repaired and the pain remains chronic, it may be necessary to perform surgery to intervene in the injury and relieve the pain. For this reason, it is so important to go to the doctor when we notice that the pain persists and follow the treatment prescribed by the professional, to avoid surgical intervention that will require a longer period of rest.
You visit the complications that this type of fracture can entail and the possibility of preventing them by practicing correct sports and not overloading, we will try to follow some guidelines to prevent the injury from appearing or becoming chronic.
1. Do not overload the body
As we already know, this fracture occurs mainly by overloading a part of the body, and for this reason we will try to stop in time and not force it. We know our body and the different sensations we can have better than anyone So, if we feel more tired than usual, it is better to rest for a short period of time, preventively, than to continue pushing and end up needing a longer recovery time.
2. Increase the intensity gradually
The body needs time to adapt; as we saw, destruction and formation of new bone tissue must be balanced In this way, we will increase the intensity of the exercise, either by increasing the time or the weight, gradually so that the body can get used to it progressively and an imbalance does not occur.
3. Avoid hard or very irregular surfaces
To reduce the impact it is best to avoid hard surfaces. It has been scientifically proven (Newton’s third law) that hard surfaces, such as asphalt, they return to us the same intensity of force as the one we exert on them
4. Use appropriate footwear
It is important that the footwear is comfortable, suitable for the exercise we do and is in good condition (not worn or broken), in this way we better protect the foot and avoid overloads. If we need some type of corrector (such as templates) we must use it systematically to reduce the risk of damage.
5. Work the whole body
To prevent overloading of an area of the body, it can help us to carry out balanced training, in which we will work on the different parts of the body without focusing on just one. So, We will achieve a better general condition of the body and reduce the possibility of injury due to continuous exercise focused on one area
6. Follow a good diet
It has been proven that a good diet, where the necessary nutrients are consumed (as we have already seen, calcium and vitamin D are essential for the good condition of bones) reduces the risk of stress fracture by making the body stronger
