One of the most dreaded running injuries, stress fractures can sideline runners for weeks or months. Stress fractures often result when the athlete makes the mistake of doing too much, too soon; these cracks or fractures in bones typically occur when tendons or ligaments that attach to the bone are repeatedly overloaded by new training stress before they've adapted. Stress fractures tend to occur in runners' pelvic areas, legs or feet.
Stress Reaction Versus Stress Fracture
A stress reaction is the precursor to a stress fracture. While at the stress-reaction stage, the bone structure is breaking down and becoming weaker, but does not actually contain any fracture.
A stress fracture means the structure of the bone has been compromised by a crack or fracture.
More: Common Running Injuries
What Causes Stress Fractures
Stress fractures can occur from abnormal force on normal bone (most common in athletes), and with normal force on abnormal or osteopenic bone (more common in older patients or young, very thin females). Routine x-rays rarely show a stress-fracture injury. A bone scan or MRI is needed to confirm the diagnosis. A bone-density scan may be needed if concern for osteopenia exists.
As long as the bone quality is normal, the following phases will help you get through a stress-fracture diagnosis.
Phase 1: Injury Period (Usually 4 to 6 weeks)
This period begins at the time of diagnosis, not at the time the athlete started feeling pain. The athlete must stay below their pain threshold throughout this phase. To accomplish this, weight-bearing status is variable for each patient, but can range from being on crutches to use of a special walking boot to being able to swim, aqua jog or even ride a bike. This may be a trial to see what causes pain, but you must be honest! Don't do anything that causes pain, and if you experience pain when walking, you might need to try crutches or a walking boot. Here are more rules to follow:
- Don't take medications to mask pain.
- Understand the way you interact with family, colleagues and training partners. It's not their fault that you are hurt. Be aware of displaced anger.
- Use this time to attend physical therapy, seek chiropractic treatments, and/or massage therapy to assist in the healing process.
- Yoga (stretching) and core strengthening are essential to the safe return to your pre-stress fracture activities when the time comes. They will also help you maintain your level of fitness while healing.