Fatigue fractures are more common in athletes and mainly relate to bones subject to repeated loading.
WHAT IS A FATIGUE FRACTURE?
A fatigue fracture is usually a fracture caused by constant bone loading during intense exercise.
WHAT CAUSES FATIGUE FRACTURES?
Fatigue fractures are often the result of a sudden increase in physical activity. The increase may be related to the frequency, intensity or duration of an athlete’s workouts. It can also be caused by the impact of a new playing field, unknown to the athlete (e.g. rough terrain) or even new sport footwear.
WHERE ARE FATIGUE FRACTURES USUALLY LOCATED?
The majority of these fractures concern the lower extremities and especially the tibia and the foot.
WHAT ATHLETIC ACTIVITIES CAUSE FATIGUE FRACTURES?
Studies have shown that athletes involved in tennis, basketball, track and gymnastics are more likely to experience fatigue fractures. In all of these activities, repeated foot loading when striking the ground can cause fatigue fractures. In addition, without a sufficient rest period between workouts, the risk of fatigue fracture increases.
ARE WOMEN MOST VUNERABLE TO FATIGUE FRACTURES?
Fatigue fractures can be diagnosed at any age or gender and involve athletes – and especially female athletes – who engage in repetitive sports activities. This is attributed to a situation called the “Female athlete triad” and includes:
Eating Disorders (Bulimia or Anorexia)
WHAT ARE THE SYMPTOMS OF A FATIGUE FRACTURE?
Pain during exercise is the most common symptom and subsides during rest periods.
HOW ARE FATIGUE FRACTURES DIAGNOSED?
The suspicion of a fracture during the examination is evaluated by the Orthopedist. Radiological examination diagnoses the fracture and determines its type. In some cases the fracture may not initially be diagnosed and may require re-examination a few weeks later. Rarely, computed tomography (CT scan) or magnetic resonance imaging (MRI) will be required.
HOW ARE THE FATIGUE FRACTURES TREATED?
The treatment is usually conservative and is based on resting and avoiding the certain activities that caused the fracture. Failure to treat the fracture in a timely manner will lead to pseudoarticulation with concomitant pain and chronic disability. In addition to rest, and depending on the fracture, shoe inserts or splints are used.
Below are some helpful tips for preventing fatigue fractures.
Realistic and gradual goals must be set in any new sporting activity. For example, instead of running five kilometers a day, split the distance into a week.
Alternative activities that achieve the same goals for the patient’s physical condition help avoiding fatigue fractures. Add strength training and range of motion exercises into your “mixed” training schedule.
A healthy diet rich in calcium and vitamin D
Use of appropriate equipment (old and worn footwear)
If pain or edema occurs, immediately stop activity and rest for a few days. If the pain does not subside, despite rest, refer to an Orthopedist.
Early diagnosis and treatment of a fatigue fracture can allow the patient to return to pre-injury activities.