Seven Risks and Four Signs of a Stress Fracture

A stress fracture, also known as a hairline fracture, is a small crack or severe bruise within a bone that is most often caused by overuse or an increase in repetitive actions creating microscopic damage to the bone over time.

Normally, after increased force through numerous activities, bones adapt by ‘remodeling’ with new bone tissue forming over time to replace old bone tissue. Hairline stress fractures are more likely when the breakdown happens faster than the new bone tissue can form.

The bones of the foot and leg are especially susceptible to hairline fractures. These bones absorb a lot of stress during running and jumping. Most affected within the foot are the second and third metatarsals – thin tubular-shaped bones in the middle of the foot – the point of impact when you push off your foot to run or jump. Other areas common to stress fractures are your:

  • Heel
  • Ankle bones
  • Navicular, a bone on the top inner side of the midfoot

How Do I Know if I Have a Stress Fracture?

The most common symptom of a stress fracture is pain, which can get worse over time, especially if you don’t stop the weight-bearing activity. Other symptoms include:

  • Bruising
  • Swelling
  • Tenderness

What are the Risk Factors of Developing a Stress Fracture?

High-impact sports or activities – Basketball, tennis, track and field, long-distance running, gymnastics, dance and ballet all are activities that increase the risk of hairline fractures.

Gender – Women, particularly those who have abnormal or absent menstrual periods, are at higher risk of developing stress fractures.

Foot issues – high or rigid arches or flat feet, often caused by problematic footwear can contribute to stress fractures.

Weakened bones – Osteoporosis and medications that affect bone density can put you at risk of hairline fractures during normal, everyday activities

Previous stress fractures – Once you’ve had a stress fracture, your chance of getting another increases.

Lack of nutrients – Lack of vitamin D or calcium or eating disorders can cause your bones to be more susceptible to hairline fractures.

Change in surface – Different playing surfaces, such as a tennis player moving from a grass court to a hard court, can cause undue stress to the bones of the feet and legs.

What to Do if You Think You Have a Stress Fracture

Seek treatment from a doctor as soon as possible if you think you have a hairline stress fracture. If you do have a hairline stress fracture, ignoring the pain can result in the bone breaking completely.

In the meantime, there are treatments you can do on your own.

  • Follow the RICE method:
    • Rest
    • Ice
    • Compression
    • Elevation
  • Nonsteroidal anti-inflammatory over-the-counter drugs such as ibuprofen and aspirin can help with pain and swelling.

A physician will determine whether you have a hairline stress fracture and may recommend crutches, protective footwear or a cast. Some stress fractures require surgery, using pins or screws to hold bones together during the healing process.

The key to avoiding chronic, long-term pain is to ensure your stress fracture heals properly and completely before gradually returning to exercise or use.