Lower extremity stress fractures are a relatively common injury seen most often in athletes playing sports that require repetitive impacts (running and jumping). Female athletes are about one-third more likely to develop stress fractures in the legs and feet. While athletes may be more susceptible to these types of injuries, individuals who walk, march, or spend much of their workday on hard floors are also at risk. Our physical therapist at Progressive Physical Therapy have advance training and can help with recovery after a stress fracture as well as identify potential risk factors for prevention of future stress fractures.
What is a lower extremity stress fracture?
Stress fractures are tiny cracks that occur in bone, usually related to repetitive activities that impact the bone in a similar way over time. These stresses lead to change in the normal process of bone breakdown and reformation. Stress fractures are most common in the feet and legs as these structures bear weight during walking, running, and jumping.
How Does it Feel?
Stress fractures are characterized by a sharp pain in a very specific point over the top of a bone. Lower extremity stress fractures generally hurt when you are up walking, running, or jumping. You may also experience aching pain in the area after activity.
Signs and Symptoms
With activity-related lower extremity stress fractures, you may experience:
- Pain during activity (walking, running, or jumping)
- Sharp pain over a specific point on the bone (point tenderness)
- Swelling without bruising at the site of pain
- Aching pain after activity
How can a physical therapist help?
Stress fractures are treated by resting the leg as much as possible. Whatever activities you are participating in that increase force in the legs (running, jumping or “cutting” in sports) must be stopped for at least 3 weeks in order for the bone to begin the healing process. Your physical therapist can decide whether you should use a compressive brace, crutches, or a walking boot to protect your bone while it is healing. Your therapist can design a specific treatment program for you to follow at home to help speed your recovery. Initial treatment will focus on muscle-strengthening exercises using bands rather than heavy weights.
As You Start to Recover
Your physical therapist’s overall goal is to return you to your normal daily tasks at home, at work, and in the community. Without proper rehabilitation serious problems, such as chronic pain, swelling, weakness and more severe fracture, could arise further limiting your ability to perform your usual activities.
Your physical therapist will select from treatments including:
Range-of-motion exercises. Because you have been less mobile over the past few weeks, your range of motion may have decreased. A physical therapist teaches you how to perform safe and effective exercises to restore full movement in the joints of your legs.
Muscle-strengthening exercises. Even short-term inactivity weakens the muscles of the legs, increasing the potential for new injuries. Additionally, your stress fracture may have been related to some underlying weakness in the legs. Your physical therapist can determine which strengthening exercises are right for you based on the severity of your injury and where you are in your recovery.
Body awareness and balance training. Specialized training exercises help your muscles “learn” to respond to changes in your environment, such as uneven or unstable surfaces. When you are able to put full weight on your foot without pain, your physical therapist may prescribe these exercises to help you return to your normal activities. For instance, you might learn how to stand on 1 leg or stand on a wobble board, with or without your eyes closed, to challenge the muscles in your legs.
Functional training. When you can walk freely without pain, your physical therapist may begin “progressing” your treatment program to include activities that you were doing before your injury. This program will begin with slow, progressive weight-bearing activities, such as hopping and light jogging. Your physical therapist will create your own unique training program, based on the therapist’s examination of your legs, your goals, and your activity level and general health.
Activity-specific training. Depending on the requirements of your job or the type of sports you play, you might need additional rehabilitation tailored for your job or sport. Your physical therapist can develop a program that takes all of these demands as well as your specific injury into account.