Stress Fractures: A Fairly Common Issue For Active People

We tend to think of bone as a solid substance, however, it is in reality quite porous. If you were to look at a cross section of a bone you would notice a lot of ‘air' pockets. This is normal, but in someone with osteoporosis, these spaces will be more prevalent, making the bone weaker and more prone to breaks under stress.

Bone tissue is metabolically active just like other tissue such as skin, muscle, organs, etc. It has blood supply and nerve endings. It is constantly breaking down and rebuilding. If the process of breaking down is greater than the process of building then the bone will weaken over time. This can happen because of age, disease, malnutrition lack of vitamins, lack of resistance exercise, and when taking certain medications.

What Are Stress Fractures

We all know of fractures, where a bone simply breaks in half. But in addition to this, there is also something called a stress fracture. This is when a bone becomes damaged over time, usually by overuse. The bone may start to develop very tiny cracks, usually microscopic at first, but can progress to visible cracks. It is a very painful condition, but one which that is often ignored because there is no obvious injury. However, if not treated, primarily through rest, the fracture will most likely progress, even to the point where surgery may be required.


Stress fractures can happen when an athlete increases intensity or distance of an activity, changes surface density of where the activity is performed too suddenly, or has improper form.

If an athlete, or anyone stressing their skeletal system, does not allow for enough time for the bone to rebuild and strengthen it becomes weaker creating a cycle leading to injury.

This injury is very common in runners with the stress fracture occurring at the front of the lower leg. Sometimes called shin-splints, or anterior tibial stress syndrome. However, the injury can also occur in the foot bones, knee, femur, ankle, hip, lower back, and humerus.

Identification and Treatment

The injury begins with pain, swelling, and focal tenderness. It then progresses and becomes constant (at rest and while exercising) and more intense (sometimes even at night). Rest is very important to allow the tissue to heal. In addition, stretching and strengthening are important in preventing stress fractures.

Additional Information

  • Women have a higher chance of suffering stress fractures.
  • Osteoporosis is when bones become weaker over time, usually over several years. It cannot be prevented 100%, but the rate of progression can be limited through resistance exercises such as weight lifting.
  • When exercising, only bones under stress will strengthen. For example, by doing squats you will not strengthen the bones in your arms only in your legs.
  • Consuming foods rich in calcium will not prevent osteoporosis unless you are also consuming other vitamins, including vitamin D, and regularly performing weight resistance exercises.
  • Besides being involved in movement bones, also protect organs, and produce red blood cells in the bone marrow.
  • Bone can suffer from cancer, leukimia, in the bone marrow.
  • In young athletes, involved in high impact activities, bone growth may be stunted. This may resolve once the activity is stopped but not always.
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