How Are Stress Fractures Different From A Fracture, And, How Are They Best Treated?

July 1, 2009— -- Question: How are stress fractures different from a fracture and how are they best treated?

Answer: Most of us think of bones as a rigid structure, where in actuality the bone has some elasticity and some bend to it. In other words, with repetitive stress such as running and jumping, there's a little give and a little bend to the bone. If you do that often enough and continually, you can actually develop microscopic breaks in the bone -- at least in part of the bone -- and those are termed stress fractures, where it's a microscopic fracturing of the bone.

In other words, if you looked at the bone, you wouldn't see a crack. You would have to look at it under a microscope, as opposed to a complete fracture or a traumatic fracture, the difference would be in say, taking a branch from a tree and bending it multiple times without breaking it. Just small bends until you start seeing a little cracking of the bark or the wood on one side, as opposed to taking a pencil and snapping it in half as you would with a complete fracture. A lot of it has to do with the amount of trauma and the amount of bending of the bone involved. And if there's a high enough amount of stress and it's loaded abruptly or suddenly it will fracture or you'll sustain a complete fracture.

Stress fractures are overuse injuries -- microscopic fractures, so they come on slowly or gradually over time. We treat them differently. With stress fractures -- rest, protection of the bone, stopping the inciting activity, most commonly running, will allow it to heal, and it takes about six or eight weeks. As opposed to a complete fracture where you have to reset the bone, you have to hold it together with a cast, or more frequently with surgery. We use metal plates and screws or a metal rod to hold the bones together. Again, it will still take about six or eight weeks to heal, but those require some type of stabilization, either surgical or casting for a complete fracture.