Don’t stress out about stress fractures


By Daniel Skulavick - Contributing columnist



A stress fracture, also known as a fatigue-induced fracture, consists of one or more small cracks in the bone. It is associated with a pattern of overuse, commonly seen in the lower extremity in athletes.

Causes: Repetitive motion is one the mechanisms that result in a stress fracture. The muscles become fatigued and are unable to absorb ground force, which is transmitted to the bone. This overload results in stress fractures over a period. High impact sporting activities that result in this injury include: 1. Track and field activities, 2. Basketball, 3. Tennis, and 4. Gymnastics

Symptoms: The main symptom is pain in the extremities which worsens with activity and subsides with rest.

Diagnosis: A thorough history and medical examination should lead to the suspicion of an underlying stress fracture. As with any bone injury, the confirmatory diagnostic test is an X-ray. In some cases, a CAT scan or MRI is requested if the X-ray is not conclusive.

Treatment: The pain stimulus is the body’s natural mechanism to protect itself from severe self-inflicted injury. The rule of thumb for immediate treatment is:

• Rest

• Ice

• Compression

• Elevation

Rest (and limited weight bearing) is an important aspect of stress reduction on the bone and surrounding joints. Shoe inserts also help with shock absorption.

If something is tingling, numb or hurting, it is time to stop what you are doing and seek medical attention. If a stress fracture is ignored, the condition can get worse and escalate to a more serious injury. A stress fracture is an early sign of bone destruction, and it must be treated quickly and proactively. It is generally associated with dull, aching pain in a general area. As it progresses, the pain can escalate to sharp, piercing pain in a localized area. Ignoring a stress fracture will lead to further bone deterioration. This can result in long-term consequences ranging from increased recovery time to joint deformity.

If you are participating in ongoing, repetitive activity or a high impact sport, it is important to rest periodically from the task and do the following: Massage the limbs and joints, stretch the muscles, and relieve the pressure by reducing weight-bearing on the affected joints

Anti-inflammatory and analgesic medication can help with pain relief. A physician may recommend prescription medication for pain relief and refer patients to physical therapy.

Recovery from stress fractures is a gradual process. Bone fragments need time to heal. The primary objective of physical therapy during the healing process is to prevent further injury. Once the healing process is complete, it is even more important to seek the counsel of a physical therapist. The therapist will design an exercise program geared towards gradual, progressive recovery of full function of the bones, muscles, and joints. Physical therapy is an excellent choice for non-surgical treatment for mild to moderate cases of stress fractures. Some of the techniques used by physical therapists include:

• Cold compress to reduce swelling

• Strengthening the limbs and joints

• Bracing with splints to reduce load on the affected joints

• Ergonomically designed footwear

• Psychosocial rehabilitation for the professional athlete, looking for a speedy, successful and complete recovery

If you or someone you know has a recent stress fracture, give us a call. We’ll be sure to take the stress away.

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By Daniel Skulavick

Contributing columnist

Dr. Dan Skulavick is the physical therapist at Advanced Physical Therapy in the Food Lion Shopping Center.

Dr. Dan Skulavick is the physical therapist at Advanced Physical Therapy in the Food Lion Shopping Center.

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