A stress fracture is a partial or complete bone fracture that results from repeated application of stress lower than the stress required to fracture the bone in a single loading. Otherwise healthy athletes, especially runners, sustain stress injuries or fractures.

Stress fracture is a term used to describe bony or osseous injuries.They occur in athletes who are involved with repetitive activities, such as runners, track and field athletes, dancers, and anyone who is involved with a degree of training and running.

Stress fractures or stress injuries present with pain over the overlying bone. Initially, the pain is resolve with rest. However, with repetitive activities and stress on the bones, the pain becomes unremittent or constant.

Stress fractures are diagnosed based upon clinical suspicious, a good history, and imaging. X-ray imaging is okay for identifying the late stages of stress fracture but is not ideal.

Bone scanning can be used. However, it lacks the specificity for determining the location and the severity of illness.

Ultrasounds, in particular MSK ultrasound, can identify some of the bony reaction that can occur. However, MRI is considered the standard for evaluating the severity and grade of an osseous or stress injury.

The mainstay for treatment of stress fractures is immobilization, activity modification, and pain control. In some instances, the stress fracture may not heal adequately.

In that case, it may go on to nonunion. In those cases, there may be an indication for ultrasound or low-intensity ultrasound as a bone stimulator to facilitate union or healing of the bone. In some cases, surgery may even be indicated for treatment of nonunion stress fractures nt of stress fractures, please consult with your local family physician, orthopedic surgeon, or sports medicine specialists.  Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. 

Presenter: Dr. Patrick Ling, Sports Medicine Physician, Saskatoon, SK

Now Health Network Local Practitioners: Orthopedic Surgeon