Stress Fractures (Pediatric)

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What are stress fractures?

Stress fractures are injuries to a bone caused by repeated pressure or tension. There are two types of stress fractures:

  • "Fatigue” stress fractures occur when a healthy bone sustains abnormal stress and partially breaks. They are the most common type of stress fractures observed in active children and teens.
  • “Insufficiency” stress fractures occur when a bone that has been weakened by disease partially breaks under normal stress.

Who is affected by stress fractures?

Stress fractures are more common in females. A recent study found that 4 percent of all adolescent girls develop a stress fracture. Stress fractures are most common in those who play high-impact sports, such as running, basketball, cheerleading, and gymnastics.

What causes stress fractures?

Most fatigue stress fractures are caused by too much pressure applied too quickly and frequently for the bone to fully heal during a rest period. With continued stress, the weakened bone fractures.

Risk factors are:

  • alignment abnormalities
  • change in the playing or running surface
  • improper nutrition
  • inappropriate shoes
  • inflexible or weak muscles
  • personal or family history of low bone density
  • not enough rest between activities
  • training errors, such as a rapid increase in intensity/duration

In addition, females with irregular menstrual cycles have an increased risk of stress fractures and poor bone health.

What are the symptoms of stress fractures?

Stress fractures often occur in the bones of the lower leg or foot. Those suffering from stress fractures usually experience a gradual increase in localized pain, starting with pain after activity that progresses to pain during activity and weight-bearing. Pain typically resolves with rest. In more advanced cases, patients may have pain during inactivity and/or at night.

How are stress fractures diagnosed?

Our doctors take your child's medical history and do a physical examination. To confirm diagnosis, we may also use X-rays, bone scans, or MRIs.

What is the treatment for stress fractures?

Stress fractures must fully heal before your child returns to activity. To protect the injured bone, our doctors may place your child on crutches or use other equipment to take stress off the bone, such as a walking boot. Physical therapy may help to treat the underlying factors that contributed to the injury and allow your child to return to full activity slowly and safely.