The differential diagnosis varies based on location, but commonly includes tendinopathy, compartment syndrome, and nerve or artery entrapment syndrome. Stress fractures should be considered in patients who present with tenderness or edema after a recent increase in activity or repeated activity with limited rest. These injuries occur more commonly in lower extremities than in upper extremities. This takes a minimum of 12 weeks.Stress fractures are common injuries in athletes and military recruits. An early diagnosis is crucial to ensure the athlete's well-being and a safe return to sport. The location and status of the stress fracture are more important in prognosis than the choice of treatment. Young athletes are particularly receptive to changing their technique, but it usually becomes more difficult with age. An adjustment in technique can alter the load, thereby decreasing the risk of injury. We know that the injury can occur as a result of repetitive and monotonous loading. This may involve supplement use.įor some athletes it can be a good idea to adjust their sporting technique. Measures should be taken to ensure that nutritional values are met by making adjustments to the athlete's diet. Low levels of calcium and vitamin D affect bone density and may increase the risk of a stress fracture. In some cases, the athlete should be examined for any nutritional deficiencies with blood tests. For example, cycling, swimming, and general strength training. In the meantime, the athlete can stay fit by performing alternative, pain-free, exercises. The athlete should not participate in the sport that caused the injury for at least 12 weeks, even if the pain subsides within this period. This condition should be suspected if a young athlete experiences low back pain. If an injury is still suspected, even though the X-ray is normal, a different imaging diagnostic tool, like MRI, should be used to confirm the diagnosis. If the pain has only recently started, the changes in the bone tissue may not yet show up on an X-ray. It is difficult for a doctor or physiotherapist to diagnose a stress fracture with a clinical examination. This may seem strange, but it is possible to have a stress fracture even when no pain or discomfort is present. The pain may be localised to one side, but sometimes it also spreads down into the buttocks. In 95% of cases of a stress fracture in the spine it will be located in the lowest part of the back.īack pain that worsens during activity, especially when the athlete stretches and rotates the back. For example, a right-handed tennis player might suffer a stress fracture on their left side. A stress fracture can also occur on the opposite side from where the main activity takes place. These sports involve a lot of bending backwards, forwards and rotation of the spine. The injury is most common in sports such as wrestling, dance, gymnastics, tennis, rowing, weightlifting, diving and javelin. Youth in growth are particularly prone to this injury as their bone structure is not yet fully developed. As mentioned above, stress fractures are most likely caused by monotonous and repetitive loading of the back. It was previously thought that the condition was inherited or present at birth congenital, but this belief has been disregarded. Up to 50% of young people with back pain have a stress fracture in the lower back. It is also three times more common in men than women. It is important to detect the injury early to prevent a complete fracture.Īround 5-8% of the population is estimated to sustain this type of injury. The term describes a weak point or an area in the bone structure where bone tissue breaks down faster than it can repair itself. It is not the same as a «normal» fracture where the bone breaks in two. A stress fracture is a type of overuse injury that can occur in young athletes who perform a lot of monotonous and repetitive movements.
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