Stress Fractures — What Athletes Need to Know

Stress fractures are among the most common sports injuries, occurring when muscle fatigue sets in. Fatigued muscles cannot effectively absorb added shock, so any overload is transferred to the bone. This can cause a tiny crack — a stress fracture — to develop.

Stress Fractures — What Athletes Need to Know

If you’re an athlete, you may end up facing this sports injury sooner or later if you aren’t careful — or even if you are.

What Causes Stress Fractures?

Often, these sports injuries result from increasing the intensity or amount of physical activity too quickly. Using improper equipment, like the wrong shoes for your sport, and getting active on an unfamiliar surface may also contribute to the development of a stress fracture.

Which Athletes Are Most Susceptible to Stress Fractures?

The weight-bearing bones of the lower leg are most often affected by these sports injuries. Research shows that athletes whose sports involve the foot repeatedly striking the ground — like basketball players, track and field enthusiasts, tennis players and gymnasts — are more likely to develop stress fractures.

What Are the Risk Factors for Developing Stress Fractures?

Anyone who participates in repetitive sports activities can suffer a stress fracture, but female athletes seem to be at a greater risk. Menstrual disturbances, decreased bone density and caloric restriction may be to blame. Muscle weakness and leg-length differences can also increase an athlete’s risk.

How Is a Stress Fracture Diagnosed?

A thorough medical history and physical examination are necessary for diagnosis. A stress fracture may be suspected for pain that occurs during physical activity and subsides with rest. X-rays are typically ordered for confirmation, but since these sports injuries may not appear on regular X-rays for several weeks, a CT scan or MRI may be recommended.

How Are Stress Fractures Treated?

Rest from the physical activity that led to the stress fracture is essential for the sports injury to heal. Most athletes need to take a six-to-eight-week break from their usual workout and training. Some may also need to wear braces or shoe inserts to encourage proper healing. A gradual return to sports is advised, as resuming activities too soon can cause the injury to worsen or lead to chronic problems.

Can Stress Fractures Be Prevented?

Not every stress fracture is preventable, but sports medicine physicians recommend that athletes follow these practices to avoid injury:

  • Gradually build up time and intensity when participating in new sports activities.
  • Cross-train, engaging in more than one sport and adding exercises to boost muscle strength and flexibility.
  • Eat a healthy diet, incorporating foods rich in calcium and vitamin D
  • Stop sports activity immediately and rest when any pain or swelling occurs, and see a sports medicine physician if symptoms persist.

When athletes recognize the symptoms of stress fractures early and follow the recommended treatment plan, recovering and returning to sports is much less of a challenge.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.
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About Robert Engelen, DO

Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School. Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.