Overview
Stress fractures of the hip once most commonly affected military personnel who marched and ran day after day. Today, stress fractures of the hip are more common in athletes, especially distance runners.
There are two types of stress fractures. Insufficiency fractures are breaks in abnormal bone under normal force. Fatigue fractures are breaks in normal bone that has been put under extreme force. Fatigue fractures are usually caused by new, strenuous, very repetitive activities, such as marching or distance running. Most stress fractures of the hip are fatigue fractures. The stress fractures this article refers to are fatigue fractures.
Where do stress fractures occur?
Most stress fractures occur in the weightbearing bones of the lower leg and the foot. More than 50 percent of all stress fractures occur in the lower leg.
What causes a stress fracture?
Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface (a tennis player who has switched surfaces from a soft clay court to a hard court); improper equipment (a runner using worn or less flexible shoes); and increased physical stress (a basketball player who has had a substantial increase in playing time).
What are the symptoms of a stress fracture?
Pain with activity is the most common complaint with a stress fracture. This pain subsides with rest.
How are stress fractures diagnosed?
It is very important that during the medical examination the doctor evaluates the patient's risk factors for stress fracture.
X-rays are commonly used to determine stress fracture. Sometimes, the stress fracture cannot be seen on regular x-rays or will not show up for several weeks after the pain starts. Occasionally, a computed topography (CT) scan or magnetic resonance imaging (MRI) will be necessary.
How are stress fractures treated?
The most important treatment is rest. Individuals need to rest from the activity that caused the stress fracture, and engage in a pain-free activity during the six to eight weeks it takes most stress fractures to heal.
If the activity that caused the stress fracture is resumed too quickly, larger, harder-to-heal stress fractures can develop. Re-injury also could lead to chronic problems where the stress fracture might never heal properly.
In addition to rest, shoe inserts or braces may be used to help these injuries heal.
Prevention
Here are some tips developed by the American Academy of Orthopaedic Surgeons to help prevent stress fractures:
- 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 an orthopaedic surgeon.
- 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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