Stress Fracture

What is a Stress Fracture?

Stress fractures are tiny cracks that appear in your bones. These injuries are common in the bones in the lower body because these bones are responsible for distributing and bearing your bodyweight. Feet are particularly vulnerable to stress fractures because they are responsible for absorbing your bodyweight during normal activities—such as walking, running or jumping.
The most common area affected by stress fractures in the lower body is the tibia—or shinbone. Also called “shin splints”, this pain is usually felt during physical activity. In reality, shin splints are not stress fractures—they are the result of muscle pulling away from bone. When they first appear, patients are advised to stop training altogether because muscle shin splints can actually cause stress fractures.

Symptoms & Causes of Stress Fractures

Stress fractures are usually the result of an overuse injury and are most commonly experienced in runners and other athletes. Stress fractures occur over time due repetitive forces that occur on weight-bearing bones and supporting muscles. This constant repetition eventually causes small cracks to form in the bone.
Because stress fractures so small, they typically don’t cause any pain at first. However, over time—with enough repetitive motion—pain can develop in the affected area. While repetition and overuse are the most common causes of stress fractures, there are other factors that contribute to their development. Some of these causes include:

  • Biomechanical problems
  • Inflexible or weak muscles
  • Training on the wrong surfaces
  • Wearing improper or ill-fitting footwear
  • Family history of osteoporosis

Diagnosis & Treatment of Stress Fractures

To diagnose a stress fracture, your podiatrist will discuss your medical history and gather information about your symptoms. Then, he or she will perform a physical examination where they will check for areas of tenderness and pain. Once located, your podiatrist may recommend imaging tests—like x-rays or an ultrasound—to help confirm the diagnosis.
The treatment depends on the severity of your stress fracture. For mild stress fractures, your doctor will probably recommend non-surgical treatment. Some of these treatments include:

  • Activity modification
  • Protective footwear
  • Better-fitting footwear
  • Casting
  • Padding
  • Custom orthotics

When a stress fracture does not respond to the above methods, surgery may be recommended. Surgery usually involves inserting some type of fastener—like pins, screws, and/or plates—to support the bones in the foot or shin.