Stress Fractures

How is a stress fracture diagnosed?

Sometimes an expert physician can diagnose a stress fracture just on examination but more often the assessment leads to a high suspicion that needs to be confirmed with a scan. Scans can also be helpful in determining the severity of a stress injury which will influence how it is treated. Sport and Exercise Physicians are the only specialist medical doctors that have the training and experience to deal with all types of athletic stress injuries.

Whenever a fracture occurs with minimal trauma it raises questions about bone health in general- so a comprehensive medical workup is needed- and that is really where Sport and exercise physicians are specifically trained 4,5

While the treatment is generally some form of rest or immobilisation, an assessment of markers of bone health and metabolic as well as biomechanical contributors to the stress fracture need to be considered.

How do you treat a stress fracture?

All athletic bone stress injuries should be seen by a Medical professional. Often we need to investigate to see if there is an underlying medical cause such as a hormonal or nutrient problem that has led to the injury – and if a problem is identified that will also require treatment.

Not all stress fractures are the same. Some bones have a fantastic capacity to repair themselves and need less attention than others. Some can be extremely difficult to manage and repair and early expert care can prevent lifelong repercussions.

Your management plan will be based on your individual fracture, risk factors and the best available scientific evidence.

Just as with any other injury, the process of recovery starts with optimal loading, and gradual upgrade in activities with both stimulus and substrate for tissue healing and remodeling.

It requires regular review with a physio or allied health professional, with summative medical reviews at key milestones to ensure progress is being made 6

If there is a relative deficiency of energy after the body has used its energy on exercise and core functions, other bodily functions to do with reproduction, bone health, mental health and gut health can be compromised. Although loss of menstruation is a common feature of this energy deficiency, relative energy deficiency occurs in both men and women 4

Where do stress fractures commonly occur?

The most common sports for stress fractures occur in the bones of the feet (metatarsals, navicular, heel bone) and the shin (tibia and fibula). These are also the most common sites in people who do running sports but almost any bone can get a stress fracture depending on the activity. Fast bowlers commonly get stress fractures of their spine, rowers can get them in the ribs and tennis players can get them in the arm.

How long do stress fractures take to heal?

There is no set amount of rest for all stress fractures. Some heel very quickly and are very forgiving, others can take much longer. For serious athletes and even the every day person, it is sensible to see a Sports and Exercise Physician to work out the appropriate treatment for your specific type of stress injury.