Stress fractures are simply a consequence of being active. Our bone is a living tissue. It responds to stress by becoming harder and thicker. When the activity we perform exceeds the capacity of our bones ability to handle the stress, a fracture will occur.
Certain stress fractures are more common with various activities.
- The shoulder of a throwing growing athlete
- The elbow of a throwing growing athlete
- The tibia or shin of a runner
- The metatarsals of a runner.
- The hip of a runner
Stress fractures begin at a microscopic level. The tiny little scaffolds within the bone start to breakdown. And the lack of “rest” means the process is going to continue to progress.
Early in the stress fracture process many people are unaware that something potentially serious is happening. The pain is usually not severe. Runners will notice pain in their groin, shin or foot after a run. Throwers might see a drop in the number of pitches they can throw at a certain velocity. This might be the earliest stage of a stress fracture —something we refer to as a stress reaction. If caught at this stage, then healing will be faster than if a fracture is allowed to occur.
Later on, running, throwing or weight bearing exercises will become painful. At this stage the stress fracture has likely occurred.
Stress fractures of the hip are an urgent manner. See your physician immediately. Femoral neck stress fractures are rare, but they must be managed with urgency. If this fracture is allowed to displace there could be very serious long term consequences.
Stress fractures elsewhere need to be evaluated, but less emergently.
Most stress fractures, if caught early will heal uneventfully. Very few stress fractures will require surgery.
Getting back to your activities following a stress fracture is a reasonable goal. But you must give the fracture time to fully heal — and then you must return to your prior level of activity very slowly. Pushing it too hard, too fast will result in a recurrence of the fracture.