Stress Fractures in Young Athletes

Teen girl holding ice pack on shinCompetitive sports can give some young athletes an edge over their peers. When fun, teamwork, and good sportsmanship are the top goals, sports can improve young kids’ physical and emotional health, self-esteem, and even their relationship skills. Unfortunately, young athletes must also compensate for still-growing bones, tendons, and muscles. Sometimes sports injuries happen.

The most common type of sports injury is an overuse injury such as a stress fracture. Overuse injuries are becoming more common in young athletes Playing sports year-round without time off doesn’t give young bodies enough time to rest and recover.

How stress fractures happen

Stress fractures happen when muscles are too tired to take on the impact of exercise, and the bones absorb the added stress. When those bones become too strained, they develop a tiny break known as a stress fracture.

 

Most stress fractures affect the bones in the lower leg. Stress fractures are also common in the feet.

These are the most common causes of stress fractures:

  • Increasing the frequency or intensity of exercise too quickly
  • Suddenly changing the workout surface
  • Getting sudden and significantly more playing time
  • Using or wearing gear that doesn’t offer enough support, such as shoes that are worn out
  • Insufficient periods of rest between practice or events

Stress fractures can happen during any number of sports, but they tend to be most frequent in young athletes who participate in sports that involve running and jumping, such as basketball, gymnastics, and track and field. These sports involve repetitive movements that strain the muscles and bones. This increases the risk for a stress fracture.

Preventing stress fractures

Parents and coaches can do many things to help reduce the risk for stress fractures in growing bones. Make sure that your young athletes follow these guidelines:

  • Eat a balanced, nutritious diet rich in calcium and vitamin D for strong, healthy bones.
  • Participate in conditioning practice for sports.
  • Do cross-training (alternating types of physical activities).
  • Stick to sports that are age-appropriate.
  • Always warm up before practice or games and cool down afterward.
  • Get a complete physical exam before participating in sports.
  • Wear athletic shoes (and any other needed gear) that are appropriate for the sport and that offer plenty of protection and cushioning.
  • See a healthcare provider for any persistent pain or limp.
  • Drink plenty of fluids and stay hydrated for practices and games.
  • Don’t resume sports or exercise too quickly after a stress fracture or other injury.

Also, make sure that your child’s coach is aware of the signs of stress fracture. This may be milder in nature than a more severe sports injury. Pain, particularly pain that gets better when the child is allowed to rest, is the most common symptom of a stress fracture.

Stress fractures typically heal with rest alone, but injured athletes may need to take off from their sport for as long as 6 to 8 weeks to properly recover. If your child complains of any pain that persists during sports, schedule a visit with your child’s healthcare provider.

Stress Fractures

What are stress fractures?

Anatomy of the foot
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A stress fracture is a very small, fine break in the bone caused by continuous overuse. Stress fractures often occur in the foot after training for basketball, running, and other sports. While stress fractures can occur in many bones that are subjected to repetitive activities, the bones of the legs and feet are at greatest risk. The bones in the midfoot (metatarsals) in runners are especially vulnerable to stress fractures.

What are the symptoms of a foot stress fracture?

A stress fracture may not cause obvious swelling. But symptoms can occur a bit differently in each person. Symptoms may include:

  • Pain in the front of the foot, often after long or intense bouts of exercise
  • Pain that goes away after exercise, then returns when exercise is continued

The symptoms of stress fractures can be like other health conditions. Always see your doctor for a diagnosis.

How is a stress fracture diagnosed?

Diagnosis of a stress fracture usually is confirmed with a complete health history and a physical exam. X-rays often cannot see stress fractures because they are so fine. So a bone scan or an MRI may be done. Once calluses form around the fracture, an X-ray can confirm a stress fracture.

Treatment for a stress fracture

Treatment is aimed at relieving pain and giving the fracture time to heal, usually around 6 to 8 weeks. Specific treatment for a stress fracture will depend on:

  • Your age, overall health, and health history
  • How serious your injury is
  • How well you are able to handle certain medicines, procedures, and therapies
  • How long your injury is expected to last
  • Your opinion or preference

Treatment may include:

  • Rest
  • Protection of the fracture site with reduced weight bearing
  • Cold packs
  • Medicine such as ibuprofen
  • Shock-absorbing shoes to use during exercise
  • Running on soft surfaces, such as grass
  • Physical therapy
  • Switching to a less stressful activity, such as swimming or biking
  • Wearing a brace or cast