STRESS FRACTURE SYNOPSIS

How Stress Fractures Develop

1. Casual event

2. Pain after exercise only and relieved by short rest

3. Pain tolerable during exercise but more marked after exertion and relieved by longer rest

4. Pain intolerable during and after exercise and partially relieved by long rest

5. Constant pain not relieved by rest

Signs of Stress Fractures

1. Point tenderness of bone (except well-shielded femur)

2. Soft-tissue swelling

3. Palpation of callus (with time)

4. Alteration of gait

5. Muscular atrophy, especially anterior tibial and gastrocnemius-soleus groups

6. Full and painless range of motion of adjacent joints

7. Painless resisted active movement of joint

Treatment of Stress Fractures

1. Rest from running

2. Relieve symptomatic inflammation with ice and anti-inflammatory agent

3. Maintain strength (especially foot dorsum and plantar flexors)

4. Maintain cardiovascular fitness with swimming and/or biking

5. Orthotics tailored to need

6. When asymptomatic, gradually reintroduce running

Source: The Physician and Sportsmedicine