Are Female Athletes Prone to Stress Fractures?

female athelete sitting on floor with injury

YES, it's true. Studies show that female athletes are more prone to stress fractures than male athletes due partially to a decrease in bone density called "female athlete triad." Basically, a combination of things, phenomenon, and conditions can happen to women, resulting in a loss of bone and weakening of the bones - extremes in dieting or exercise, eating disorders, menstrual dysfunction, and premature osteoporosis. As bone mass decreases, the chance for stress fracture increases.

There are also several other ways people can get fractures. These types of fractures commonly occur when people change their workout or lifestyle activities – running on a paved street instead of a mountain dirt road or increasing the intensity of your workouts. A stress fracture is a small crack in a bone, or severe bruising within a bone. Most stress fractures are caused by overuse and repetitive activity and are common in runners and athletes who participate in running sports, football, and basketball. Even for the nonathlete, a sudden increase in activity can cause a stress fracture.

Think about the amount of impact that your foot endures daily. Your forefoot has 14 bones, multiple tendons, nerves, and muscles. It withstands continual pounding every day. Whether you’re standing or walking, the small size of your foot absorbs shock and carries all that weight.

Your foot pain may be due to overuse, an injury, or chronic swelling or inflammation – most often referred to as arthritis. The most common form of arthritis associated with foot pain is rheumatoid arthritis (a systemic immune disease of the body). With rheumatoid arthritis, the soft tissues that stabilize and lubricate the small joints in the foot or toes may be inflamed and painful, opening the door for unwelcome changes in the bone.

Conditions that decrease bone strength and density, such as osteoporosis, and certain long-term medications can make you more likely to experience a stress fracture-even when you are performing normal everyday activities. For example, stress fractures are more common when Vitamin D is at a low level or absent from the body.

You can try to refrain from high impact activities for a period to recover from a fracture. Resuming activity too quickly however can delay the healing process and potentially increase the risk for a complete fracture. If a complete fracture occurs, it will take much longer to recover and return to normal.

Treatment will vary depending on the location of the stress fracture and its severity. Most of these fractures are treated non-surgically. As a last resort, some stress fractures require surgery to heal properly.

The goal of treatment is to relieve pain and allow the fracture to heal so that you can return to your activities.

In most cases, the surgical solution involves supporting the bones by inserting some type of device within the bone. This is called internal fixation. Pins, screws, and/or plates are most often used to hold the small bones of the foot and ankle together during the healing process. Typically, research studies have shown that bone takes around 6-8 weeks to heal however that number is different for each person depending on their age/comorbidities/medical conditions among other things.

How to minimize the risk of stress fractures:

Exercises such as back bridges, standing hip flexors and leg lifts help to improve flexibility in the hip and glutes; Tai-Chi, to strengthen legs; Weight-bearing exercises to increase or maintain bone density; and dance classes, hiking, aerobics, or fast walking. Remember, no sudden intense or long workouts. Always wear proper exercise/athletic shoes on less than hard surfaces.

Try to avoid or correct anything that alters the mechanics of how your foot absorbs impact as it strikes the ground. For example, if you have a condition such as a blister, bunion, or tendonitis, it can affect how you put weight on your foot when you walk or run and may require an area of bone to handle more weight and pressure than usual.

The most common symptom of a stress fracture in the foot or ankle is pain. The pain usually develops gradually and worsens during activity that requires placing extra weight on the body. Other symptoms may include:

● Pain that diminishes during rest
● Pain that occurs and intensifies during normal, daily activities
● Swelling on the top of the foot or on the outside of the ankle
● Tenderness to touch at the site of the fracture
● Possible bruising

Following your doctor's treatment plan will help you return to activities faster and prevent further damage to the bone. Ask your primary doctor for a referral to see our podiatrist or orthopedic specialist. Or call The Orthopaedic, Sports, Spine and Pain Center (OSSP): (714) 861-4888 which specializes in this type of orthopedic surgery.