Too Much Too Soon

Continued...

Causes and Risks

Training errors are often the cause of stress fractures. Among them are a rapid increase in distance, running too many hills, running on a hard or uneven surface and wearing worn-out shoes with inadequate cushioning and support.

Of course, not everyone in an aerobics class will get a stress fracture. Clearly; some people are more susceptible to stress fractures than others.

One important risk is low bone density; caused by a lack of weight-bearing activity; malnutrition and lack of the female hormones estrogen and progesterone. Any woman with a history of an eating disorder; particularly anorexia, may have lowered bone density.

A woman who has had amenorrhea (cessation of menstrual periods) may also be at higher risk for fractures because of the low levels of female hormones. Amenorrhea can be treated by replacing the hormones with medication. See "A Crucial Period" for more information about amenorrhea.

Biomechanical imbalances, such as having one leg longer than the other; may unevenly distribute the load to the bone and also increase stress fracture risk. If you suspect you have a stress fracture, consult your sports medicine physician for an evaluation.

Symptoms

The symptoms of a stress fracture, like the fracture itself, do not usually appear suddenly You'll feel a dull, deep, aching pain at the end of an activity - after a day of heavy walking or at the end of an aerobics class, for example.

By the next day, the pain is usually gone or much diminished. However; the aching returns the next time you're active. If you continue activity the pain will crescendo. It is generally localized in an area about the size of a half dollar and may feel tender to the touch. Typically it does not extend up or down the length of a muscle or tendon, like tendinitis.

If a physical therapist or trainer is treating you with ultrasound, the pain will get dramatically worse when the sound waves cross the stress fracture. Tendinitis can coexist with a stress fracture, so the physical examination and symptoms of these overuse injuries can overlap. In some cases there may be a swelling or prominence of the bone over the stress-fracture site.

How is a stress fracture diagnosed?

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Table of Contents

Foreword: Billie Jean King

Comments by Barb Harris
Editor in Chief,
Shape Magazine

General Health
Nutrition
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Common Medical Problems
Dental Health
Emergency!
Infectious Disease
Sexual Health
Emotional Well-Being
Eating Disorders
Alcohol & Other Drugs
Environmental Health
Prevention