A stress fracture is an injury to a bone caused by repeated stress to that bone. There are two types of stress fractures.

• A “fatigue” stress fracture is when a healthy bone sustains abnormal stress and partially breaks.
• An “insufficiency” stress fracture is when a bone that has been weakened by disease partially breaks under normal stress.

Fatigue stress fractures are the most common type of stress fracture seen in active children and teens.

What Causes a Fatigue Stress Fracture?

It is believed that most “fatigue” stress fractures are caused by too much stress applied too quickly for the bone to fully heal. With continued stress, the weakened bone may break (fracture).

What Are Known Risk Factors?

Risk factors vary depending on age, gender and type of activity. In general, risk factors include:

• Poor / improper nutrition
• Too much activity or increasing activity too quickly after time off
• Improper rest
• Combination of these risk factors
• Females with irregular menstrual cycles are at an increased risk of a stress fracture

Your doctor and physical therapist will find which risk factor(s) may have played a role in your injury.

How Is It Diagnosed?

A plain X-ray, bone scan or magnetic resonance imaging (MRI) is used to diagnose a stress fracture.

How Is It Treated?

It is important to allow the stress fracture to fully heal before returning to activity. To protect the injured bone, your doctor may place your child on crutches or use other tools, such as a walking boot, to help the stress fracture heal.

Physical therapy (PT) plays an important role in helping to treat the underlying factors that may have played a role in the injury. The goal of PT is to help your child return to their previous activities slowly and safely.

When Is Surgery Needed?

Surgery is needed only in rare circumstances. Your doctor will talk with you about your child’s unique needs.

What Should My Child NOT Do?

Your child should avoid:

• Activities that cause or increase their pain
• Running, jumping and any other high-impact activities

It is important that your child follows the guidelines set forth by your doctor.