Overuse Symptoms of Low Back
Stress Fractures
Stress fractures are tiny cracks in a bone. Stress fractures are caused by the repetitive
application of force, often by overuse — such as repeatedly jumping up and down or
running long distances. Stress fractures can also arise from normal use of a bone that's
been weakened by a condition such as osteoporosis.
Stress fractures are most common in the weight-bearing bones of the lower leg and foot.
Track and field athletes are particularly susceptible to stress fractures, but anyone can
experience a stress fracture. If you're starting a new exercise program, for example, you
may be at risk if you do too much too soon.
Stress Reaction (Marrow Edema)
A stress reaction is the lowest grade of the three levels of bone injury. A stress reaction is
essentially the early stages of a stress fracture. This occurs when the stresses affecting the
bone occur at a faster rate than the rate at which the bone is able to rebuild itself.
These stresses typically occur from repetitive impacts to the bone like those seen in crosscountry runners or a gymnast. A stress reaction will initially present as localized (a specific
spot) pain over the bone.
These injuries are hard to diagnose because they do not show up on normal x-rays. Instead,
to “see” a stress reaction, the athlete must undergo a bone scan which will show increased
bone building in the area of the reaction. If diagnosed, the athlete will typically be advised
to stop activity and rest. The first thing that comes to mind when one thinks of a bone
injury is a broken bone, or a fracture.
A fracture typically occurs in one of two ways.
First, a fracture can occur from a high stress or trauma to the bone from an outside force
such as being hit by another object or colliding into another object. The second way a
fracture can occur is when a stress reaction is left untreated and eventually develops into a
stress fracture.
Fractures can usually be diagnosed using an x-ray, but sometimes an MRI may be
necessary. Treatment for fractures can vary greatly; in some cases, the bones must be put
back into place, or set. This can be done by setting the bones and applying an external cast
or by surgically joining the bones using plates, pins, and/or screws. In some cases however,
the bone may not need a cast or surgery and rest is the main form of treatment.
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While a broken bone can be a traumatic injury, bone injuries typically heal faster than soft
tissue injuries like muscle, tendon and ligament damage. This is because bones are very
well vascularized; they have excellent blood flow.
The more blood that gets to the injury site, the faster the injury will heal. By utilizing
proper treatment methods during the healing process, this can result in faster healing
times.
Pars stress fractures occur in young athletes involved in repetitive bending and
straightening of the spine. They are generally self-limited and get better with rest followed
by rehabilitation. A specific stretching and spinal stabilization program is important to
allow the athlete to successfully return to his or her sport.
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When participating in any new sports activity, set incremental goals. For example, do not immediately set out to run
five miles a day; instead, gradually build up your mileage on a weekly basis.
Cross-training -- alternating activities that accomplish the same fitness goals -- can help to prevent injuries like stress
fractures. Instead of running every day to meet cardiovascular goals, run on even days and bike on odd days. Add some
strength training and flexibility exercises to the mix for the most benefit.
Maintain a healthy diet. Make sure you incorporate calcium- and Vitamin D-rich foods in your meals.
Use the proper equipment. Do not wear old or worn running shoes.
If pain or swelling occurs, immediately stop the activity and rest for a few days. If continued pain persists, see your
local Sports Doctor.
It is important to remember that if you recognize the symptoms early and treat them appropriately, you can return to
sports at your normal playing level.
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