OrthoNow/Upstate Orthopedics Provides Injury Information


April 03, 2012 at 5:47 AM

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OrthoNow is the presenting sponsor of the 2012 Mountain Goat Training Runs and will beoffering advice and explanations on various running injuries leading up to the Mountain Goat Run. 

This week's information was put together by Dr. Robert Sherman, Orthopedic Surgeon/ Upstate Orthopedics and addresses stress fractures.
 

What is a stress fracture? 

A small crack or fracture of the bone. Usually it starts very small and can get larger over time.
 

What causes a stress fracture?  

Most often they occur when a person increases their activities or training. A stress fracture occurs when muscles become fatigued and are unable to absorb shock and repeated impacts. Over time the fatigued muscle transfers this stress to the bone, resulting in a small crack (a small break in the bone). Prolonged and continuous activity can cause this small crack to propagate and get larger resulting in pain, especially with activity. Factors such as limb length inequalities, overall muscle weakness, and over exertion may predispose to developing a stress fracture.  
 

Where do stress fractures occur?

A stress fracture can occur in any bone. The most frequent site is in the tibia (the shin bone) and in the foot. The type of activity performed helps to dictate where a stress fracture may occur. For instance in long distance runners, the tibia is most common; in sprinters, it is the foot; and in rowers, it is the ribs and/or arms.
 

How do stress fractures present?

Usually a person complains of pain in one specific spot over the bone. Initially this starts with just activity. But this may progress to even pain with rest.   A person may have some swelling over that spot. The Hop Test, or pain that occurs when the patient hops on one leg, may be positive.
 

How is the diagnosis made?

Initially only about 15% of stress fractures will be visible on an X-ray. Over time, as the stress fracture either propagates or heals, up to 50% can be seen on X-ray. Often other diagnostic tools are used to make the diagnosis. These include a bone scan and/or MRI. MRI is the best tool to make the diagnosis.

Therefore, if you are having significant pain, especially made worse with activity, it is important that you see your doctor or an orthopedic surgeon. Based on your examination, the appropriate studies can be ordered.
 

What is the treatment of a stress fracture?

The most important and earliest treatment is rest. Avoidance of the activity that precipitated the injury while maintaining low impact fitness. In severe cases, crutches and limited weight bearing may be necessary. In certain circumstances, especially with stress fractures around the hip, surgery might be indicated.

Once the stress fracture has healed, activity can be started again. A gradual return to activity is recommended, starting with low impact weight bearing and progressing to participation in running and sports.

It is important that these are recognized early and appropriate treatment is initiated.
 

What can happen if I ignore the pain?

If the symptoms are ignored and activity is continued there is risk that the fracture may propagate. This can lead to a full fracture or break of the bone. And in one of the worse case scenarios it can displace, resulting in a gap between the bones. This may require surgery to fix and a prolonged recovery.

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Posted by Helen on
Beth - Sorry to hear that Lailah! Please give yourself a rest and have your hubby and son dote on you! On our first failmy hike today with Erin I sprained my ankle pretty bad. It was such a nice day too! Take care of yourself and hope to see more of your posts soon!!
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