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Stress fractures occur due to the repetitive jarring of a bone. The most common sites for this type of fracture are the metatarsal bones in the feet, in the lumbar region of the spine, in the thigh bone which is the neck of the femur and in the lower leg bones known as the tibia or fibula. In most cases a stress fracture is considered a sports injury since most occur during sports related activities. This type of injury can be caused by chronic wear and tear that has resulted from repetitive motion that creates stress in susceptible tissues. It will also occur when an athlete is using a faulty training method or has structural abnormalities that stress certain parts of the body more than others. In some cases even a weakness of tendons, ligaments or muscles can account for sports injuries such as a stress fracture.
When a stress fracture occurs a small crack will appear in the bone. Runners as especially prone to this type of fracture in the bones of the the mid-foot. The most likely bone to fracture in runners is the metatarsal bone of the three middle toes. In most cases the metatarsal bone of the big toe is somewhat immune due to its strength and large size while the metatarsal bone of the little toe is protected since the greatest force from pushing off into a run is exerted on the big toe and one beside it. Those who have high arches, use running shoes that have inadequate shock absorbtion and often increase the amount of intensity of their workouts are at greater risk for stress factors. In cases of post-menopausal women stress fractures may become a risk due to the possibility of osteoporosis.
Symptoms of a stress fracture will include tenderness and pain in the area of the fracture. Often this will be noticed after a long and intense workout. Once the exercise has stopped the pain may disappear within seconds only to return when the workout begins again. In this case the pain will last longer after the workout is stopped. In most cases a doctor will be able to make a diagnoses based on the history of the symptoms and an examination of the affected area. Even though some stress fractures may not show up on x-ray until they begin to heal, this is best possible way to diagnose this problem. The one thing concerning a stress factor that can be seen on x-ray is the callus or tissue that tends to form around the fracture within two to three weeks after the injury occurs. In some cases a radionuclide bone scan will be done to help confirm the diagnosis.
The best way to prevent stress fractures is to always warm up prior to any strenuous exercise. Be sure the shoes you are wearing have the proper padding to absorb and support any shock to the body that is created by repetitive strenuous exercise. Never try to run until a stress fracture has completely healed although it is acceptable to substituted other exercises that will not aggravate the fracture. If you are a runner, when the stress fracture is heals you should begin by running on grass or other soft surfaces to help prevent a reoccurrence. In rare cases a cast may be necessary for a stress fracture to properly mend. Although most stress fractures will take between 3 and 12 weeks to heal, the cast will be removed within only a week or two to prevent the muscles from becoming atrophied.
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