Stress Fractures

What Is a Stress Fracture?

A stress fracture is a tiny crack in a bone.

What Causes Stress Fractures?

Stress fractures usually happen from repeating the same movement over and over (such as when someone trains for a sport). They also can happen from everyday activities in people whose bones are weak due to poor nutrition or a medical condition.

What Are the Signs & Symptoms of a Stress Fracture?

Someone with a stress fracture might notice:

• pain when exercising that may or may not go away after rest
• tenderness
• mild swelling and redness

The lower leg and the foot are the most common areas to get a stress fracture. But they also can happen in other areas, such as the arm, spine, or ribs.

How Are Stress Fractures Diagnosed?

To diagnose a stress fracture, a health care provider first asks about general health and activities (such as sports). Then they'll do an exam to check for tenderness, swelling, or redness. X-rays are usually done.

Some stress fractures don't show up on an X-ray until a few weeks after the bone starts hurting. Sometimes an MRI scan or a bone scan is needed.

How Are Stress Fractures Treated?

The most important parts of treatment for a stress fracture are:

• resting the injured area
• taking a break from sports

Sometimes a child or teen with a stress fracture will need a cast, splint, brace, or boot. Rarely, surgery is needed.

Kids who have pain from a stress fracture can:

• Place a cold compress or ice wrapped in a towel on the area for about 15 minutes three times a day.
• Take pain medicine as recommended by the health care provider.

Nutritional or psychological counseling can help if a stress fracture happens because of poor nutrition or an eating disorder.

What Can Kids Do While Healing From a Stress Fracture?

Ask the health care provider if your child can exercise a part of the body that does not have the stress fracture. For example, a child who has a stress fracture in the foot might be able to do exercises with their arms and shoulders. This can help kids stay active during healing.

After a few weeks, your health care provider may give your child the OK to slowly start to increase activity. The provider may recommend physical therapy to help your child safely return to sports.

Can Stress Fractures Be Prevented?

Parents can help prevent stress fractures by making sure that kids:

• Eat a healthy diet that includes plenty of calcium and vitamin D.
• Know that the risks of smoking include slowed healing of broken bones.

Kids who are very active or play sports should:

• Always warm up before practices and meets.
• Start any new activity or exercise slowly.
• Slowly increase how long and how hard they train.
• Stop any activity or exercise if pain or swelling starts.
• Use the right sports equipment, especially supportive shoes in good condition.

What Else Should I Know?

If found early and treated correctly, most stress fractures heal well. But if someone goes back to activities too soon, tiny stress fractures can become larger and harder to heal.

Help your child or teen follow the doctor's directions so that they can get back to activities and sports as soon as possible.