Stress fractures

At first, you might barely notice the pain from a stress fracture. But it tends to become worse if you do more of an activity that puts stress on the cracked bone. The tender feeling often starts at a certain spot and gets better during rest. You also might have swelling around the painful area.

Call your doctor if you have ongoing pain. Get help as soon as possible if you feel pain even when resting or at night. When people with stress fractures get treatment early, they're more likely to recover faster. And they're less likely to have complications.

Stress fractures often happen when you increase the amount or intensity of an activity too fast.

Bone can adapt to greater amounts of stress, but it needs time to do so. During a lifelong process called remodeling, old bone tissue is destroyed and then rebuilt. This process speeds up when the weight-bearing load on the bone increases.

The risk of a stress fracture rises when a bone bears an unusual amount of force without enough time to recover. Bone tissue is destroyed faster than the body can replace it.

Factors that can raise your risk of stress fractures include:

• Specific sports. Stress fractures are more common in people who do activities that put a high level of repetitive stress on joints. These include track and field, cross-country running, basketball, tennis, dance and gymnastics.
• More activity. Stress fractures often happen in people who suddenly shift from an inactive lifestyle to a training routine. People who quickly raise the intensity, length or number of training sessions they do also put themselves at risk.
• Female sex. Athletes who were born female seem to have a higher risk of stress fractures than those born male. The higher risk may be linked to not getting enough nutrition to support training demands. This can result in irregular menstrual periods and a condition that involves thinning bones, called osteoporosis. Sometimes, eating disorders such as anorexia and bulimia also can play a role.
• Foot problems. People who have flat feet or high, rigid arches are more likely to get stress fractures. Worn footwear often contributes to the problem.
• Weakened bones. Conditions such as osteoporosis can weaken bones and make it easier for stress fractures to happen.
• Past stress fractures. Having had one or more stress fractures puts you at higher risk of having more.
• Lack of nutrients. Eating disorders and lack of vitamin D and calcium can make bones more likely to develop stress fractures.

Some stress fractures don't heal properly. That can cause long-term problems. It's important to not restart the activity that caused the stress fracture too soon. Doing so could put you at higher risk of larger stress fractures that may be harder to heal.

Simple steps can help you prevent stress fractures.

• Make changes slowly. Start any new exercise program slowly. Aim to make gradual progress over time. Don't build up the amount or intensity by more than 10% a week.
• Use proper shoes. Make sure your shoes fit well and suit your activity. Think about getting new running shoes if yours are old or worn. If you have flat feet, ask your doctor about arch supports for your shoes.
• Cross-train. Add low-impact activities to your exercise routine. These include biking and walking. They put less stress on bones than high-impact activities, such as running.
• Get proper nutrition. Make sure your diet includes enough calcium, vitamin D and other nutrients. These help bones stay strong.