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Preventing stress fractures

Alternating your activities and not overdoing exercise can help you avoid fractures.

If you're thinking about jumping into a sport, you might want to ease into it instead—for the sake of your bones.

Overdoing exercise may result in painful cracks called stress fractures, one of the most common sports injuries, according to the American Academy of Orthopaedic Surgeons (AAOS). But whether you take to the court, track, field or gym, you can reduce your risk of stress fractures by taking proper precautions.

Cause and effect

Stress fractures happen when muscles are overtired and can no longer absorb the shock of repeated impacts, according to the AAOS. When that happens, the muscles transfer the stress to the bones, which can lead to small fractures.

Risk factors for stress fractures include:

  • Sports that involve running and jumping.
  • Rapidly increasing a physical training program.
  • Being in poor physical condition before starting an exercise program.
  • Running on irregular or angled surfaces.
  • Wearing improper footwear for the sport or exercise.

Most stress fractures occur in the weight-bearing bones of the lower leg and foot, according to the AAOS.

The most common symptom is pain directly over the area where the fracture is. The pain develops gradually, worsens with weight-bearing activity (such as walking) and improves with rest. Often, tenderness and swelling occur along with the pain.

Steps to take

If you suspect a stress fracture, stop whatever activity you're doing and rest with an ice pack on the painful area. It's important to see your doctor too; ignoring the pain could result in the bone breaking entirely, according to the AAOS.

Since stress fractures don't show up well on x-rays early on, a bone scan may be needed to help determine the cause of your symptoms. As part of the procedure, you will be given a dose of a mildly radioactive substance called technetium through an intravenous line. This substance occurs naturally in your body and has a role in bone formation. After a few hours, a scanner is used to detect the amount of technetium absorbed by the bones. If a bone is repairing a stress fracture, it will absorb more of the substance than other bones will, and the fractured bone will stand out on the scan.

Treatment and prevention

In most cases, stress fractures heal on their own with plenty of rest—usually several weeks—from the activity that caused the stress fracture.

If you resume the activity that caused your injury too quickly, it could cause larger stress fractures that take longer to heal. Repeated injuries also could lead to chronic problems and prevent the fracture from ever healing completely.

However, you may still be able to take part in other activities. If running caused a foot fracture, for instance, swimming could be substituted for a while to help maintain exercise while putting less pressure on the foot.

Some stress fractures require other treatment in addition to rest. Options include:

  • Protective footwear, such as a stiff-soled shoe, wooden-soled sandal or removable brace.
  • A cast or crutches.
  • Surgery to insert a screw into the bone and help ensure proper healing.

The best treatment, of course, is prevention. Here are some tips from the AAOS and other experts to help prevent stress fractures:

  • Slowly increase any new sports activity—don't do too much too soon. Gradually increase time, speed and distance.
  • Eat a healthful diet with plenty of calcium- and vitamin D-rich foods to help build bone strength.
  • Always stretch and warm up before exercising. Stretch gently—don't bounce.
  • Alternate activities. For instance, you might switch jogging with swimming or cycling.
  • Use the proper equipment for whatever sport or exercise you do. Don't wear old or worn running shoes; select shoes that fit well and provide shock absorption and stability.
  • Use the softest exercise surface possible. Run on flat, smooth surfaces and avoid running on hard surfaces such as asphalt and concrete.

reviewed 7/22/2019

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