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Stress Fractures: Causes, Symptoms, Prevention and Treatment

By Brad Walker
Flexibility Expert
Updated: June 18, 2008
Stress fractures occur when repetitive stresses are applied to a weakened bone. This is a chronic injury, which means that it does not happen from a one-time event, but over an extended period. Improper equipment (worn or improper shoes), muscle imbalances, or improper running and walking gait can all cause stress fractures.

The muscles are designed to act as shock absorbers during impact activities. They take the stress off the skeletal system and the internal organs. When the muscles become fatigued due to a workload that is more than they can handle they will no longer be able to work as shock absorbers. The load is then transferred to the bones. The force is transferred through the bone until it reaches a weak area where it causes a small crack. Over time, that develops into a stress fracture. This process is known as the fatigue theory.

When the human body is subjected to a slight increase in workload it will adapt by getting stronger. The bones, tendons and muscles will all change to handle the increase. If the workload is increased too quickly the body is unable to adapt quick enough and the stress is transferred to the foundation of the body (the skeletal system.) If there is a weakness in any part of the skeletal system this increase in stress will cause it to succumb to the pressure and crack. This process is known as the overload theory.
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Symptoms of stress fractures are fairly focused. Pain usually increases with weight bearing activities and diminishes with rest. Pain is most severe at the beginning of the activity then subsides in the middle of the activity and increases in severity near the end. The pain continues as a dull throb after the activity. Swelling and point tenderness around the site of the fracture may also occur. The pain will gradually get worse and may occur earlier in the workout over time. If left untreated the pain may become unbearable.

Prevention and Treatment

Due to the extended recovery time (6-10 weeks), preventing stress fractures is of major importance. Gradually increasing workloads at a rate of no more than 10% a week and varying the training by using cross training techniques will help to off set the overload and repetition often associated with stress fractures.

Warming up properly and preparing the body for the workout will help to keep the muscles from fatiguing as quickly. This will also prevent injuries to the muscles and tendons, which could lead to further weakening of the bones. Injuries to the muscles, tendons or ligaments that support the skeletal system could lead to excess, and awkward, pressure on the bones.
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