Patient education: Stress fracture (The Basics)

What is a fracture? — 

This is a broken bone. A stress fracture is a small crack in the bone. Sometimes, it can grow larger or become a full break if it is not allowed to heal.

Stress fractures most often happen in the foot or shin bones, but they can happen to other bones as well.

Stress fractures are more likely to happen if a person:

●Had a stress fracture before

●Does an activity over and over, such as running, jumping, or dancing

●Starts a new activity, or increases the activity too quickly

●Has decreased muscle strength

●Has weak bones

●Has poor nutrition, with low levels of calcium and vitamin D

●Wears worn-out running, exercise, or hiking shoes

What are the symptoms of a stress fracture? — 

Symptoms depend on which bone gets cracked. Common symptoms can include:

●Pain at a specific place that gets worse with activity and gets better with rest at first – If the person continues to do the activity, the pain will likely get worse. The pain might also start happening with other activities, or when resting.

●Swelling

●Tenderness over a specific area of the bone

Is there a test for a stress fracture? — 

Yes. The doctor or nurse will ask about your symptoms and do an exam. They might take an X-ray. A stress fracture does not normally show up on an X-ray until after a few weeks.

They might also do other imaging tests, such as a CT, MRI, or ultrasound. These create pictures of the inside of the body. They can help your doctor figure out if you have a stress fracture or another problem.

How are stress fractures treated? — 

Treatment involves managing pain, helping the bone heal, and preventing further damage:

●If you were given a splint, brace, cast, or boot, follow all instructions for wearing it. This supports and protects the bone as it heals. Do not get a cast wet, unless the doctor says it is waterproof.

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do. To stay active while your fracture heals, you might be able to do exercises that are gentler on the painful area, such as water aerobics or riding a stationary bicycle. Ask your doctor or nurse how you can safely stay active.

●Prop the injured area on pillows, keeping it above the level of your heart. This might help lessen pain and swelling.

●The doctor might recommend you take an over-the-counter pain medicine such as acetaminophen (sample brand name: Tylenol).

●You might get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these.

●Ice can help with pain and swelling – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the splint, brace, cast, or boot. Ice for at least 6 hours after an injury. It might help to ice longer, even up to 2 days.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 1).

●Quit smoking, if you smoke. Your doctor or nurse can help. Broken bones take longer to heal if you smoke.

●You might need to work with a physical therapist (exercise expert) after your fracture heals. They will suggest exercises and stretches to strengthen your muscles and keep them from getting stiff.

How long do stress fractures take to heal? — 

Most take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

When should I call the doctor? — 

Call the doctor or nurse for advice if:

●You have more problems walking or moving the area with the stress fracture.

●The area over the fracture gets more swollen or starts to hurt more.

●The fracture isn't healing with treatment.

More on this topic

Patient education: Fractures in adults (The Basics)
Patient education: Fractures in children (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)

Patient education: Cast and splint care (Beyond the Basics)