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Am Fam Physician. 2011;83(1):47

See related article on stress fractures

What is a stress fracture?

It is a fracture or break in the bone that is caused by repeated stress or pressure. Stress fractures are most common in the bones in your leg.

What causes it?

High-intensity exercise can put stress or pressure on your bones. Usually, the bone can heal itself. However, if you keep putting stress on the bone and it doesn't have time to heal, it can become weak. This can lead to a fracture.

Who is at risk?

Women are at slightly higher risk than men. People who participate in track and field, basketball, volleyball, soccer, or basketball are at higher risk of stress fractures. Also, people who run more than 25 miles per week are more likely to get stress fractures. People who smoke, drink more than 10 drinks per week, and get little exercise are also at risk.

What are the symptoms?

There is pain at the site of the fracture that gets worse with physical activity. Swelling and tenderness are also common.

How is it diagnosed?

Your doctor will ask about your risks and symptoms. He or she will examine you. You may also need an x-ray. If the x-ray is normal, your doctor may order other imaging tests to see if there is a stress fracture.

How is it treated?

You will need to limit the activities that caused your injury and that keep it from healing. Your doctor may recommend physical therapy and/or medicine for the pain. If the stress fracture is in your leg, your doctor may also recommend compression walking boots to help with the pain. The earlier you visit your doctor, the sooner you will be able to return to your activities.

Most stress fractures heal without problems, but some fractures, such as those in the hip or ankle, may not heal as well. If these cause problems, you may need surgery.

How can I prevent it?

Sometimes you can prevent a stress fracture by following a training program that slowly increases your training and allows time for your body to recover. Also, be sure your diet includes foods with calcium and vitamin D, such as milk and other dairy products, for bone strength.

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