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Stress Fractures (Bone Stress Injuries)

What is it?

A stress fracture is a tiny crack in the bone that generally occurs due to repetitive or excessive loading (Patel, Roth, & Kapil, 2011). Most people complain of localised pain that worsens with activity and settles with rest however as a fracture progresses pain may continue even when activity ceases (Astur et al., 2016).

The most common locations for a stress fracture include:
• Shin (tibia)
• Foot (navicular and metatarsals)
• Outside bone of leg (Fibular)
• Thigh bone (Femur)
• Pelvis
• Spine
(Aweid, Aweid, Talibi, & Porter, 2013)

How does it occur?

Repetitive, high intensity training is thought to be the major factor that contributes to stress fractures with the most at risk populations being athletes, military recruits and recreational runners (Patel et al., 2011).

The typical progression of disorder is as follows:
Excessive load  overactivity of cells that break down bone  stress reaction (bone microfractures)  continued activity (stress/load)  stress fracture  break/fracture (if activity continues after stress reaction) (Patel et al., 2011).

How is it best managed?

Enhance Physiotherapy are experts in managing stress injuries due to their experience within the defence force and at elite sporting teams. Management includes:
• Activity modification
• Muscular endurance
• Strengthening program
• Biomechanical stress-relieving measures (if applicable)
• Cross training to maintain cardiovascular fitness
(Astur et al., 2016)

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