How do stress fractures develop

You have a balance between osteoblastic activity and osteoclastic activity. Eventually osteoclastic activity wins out, and that is literally the breaking point.

Speculation was that Carlos Beltran might have a microfracture in his knee. What is the difference between a microfracture and a stress fracture? I almost see them being the same except maybe the location where they occur. You don't see too many stress fractures in the knees. Stress fractures are more an issue of overuse. A microfracture could be caused by trauma, like getting hit by something.

An MRI can generally give you an answer between a bone bruise [which Beltran was diagnosed with] and a microfracture without second-guessing. Yao Ming fractured the tarsal navicular bone of his left foot.

Which bone is that exactly? If you look at the foot from the side, it is the bone that sits at the top of the arch. It is a bone you could equate to a keystone of an arch—the stone that keeps an arch from falling in on itself. It carries a lot of weight. The bone is in the mid-tarsal region, where the heel bone and forefoot meet.

There is a lot of stress and force on that bone. One possible treatment for Yao is to let the fracture heal naturally. Can all fractures heal naturally? No—specifically, not in bones that do not have a good blood supply. Without a good blood supply you will not get the osteoblast cells.

These areas are "nonunions"—they will not heal—due to the poor blood supply. The tarsal navicular bone has poor blood supply. Yao injured the foot in May, and we are in July. They did another bone scan, and they can tell it is not healing.

So now they have to ask, what will be the difference if we let it rest another six months or should we do more aggressive treatments, like a bone bridge or a bone graft, where you take a different region of bone and insert it into the gap? How long does it take to recover from such injuries? Under the best conditions, say you were a relatively healthy and nonsmoking young person and you had no big competition in front of you, the textbook would say eight to 12 weeks.

A problem is that pros rush back to play. Sometimes they put titanium screws and plates in to take the stress, but the bones may not heal. Yao is at the crossroads of making a decision now. Do I let it heal by itself, or do I try another method? How do you treat a stress fracture? How long does it take for a stress fracture to heal?

Will I need surgery? Preventing stress fractures What is a stress fracture? Causes of a stress fracture in the foot and ankle Stress fractures generally occur by one of two ways: People with healthy bones overuse the foot and ankle by frequent, repetitive motion.

This is particularly the case in athletes who participate in high-impact sports such as running track and field, football, basketball, soccer, tennis, gymnastics or cheerleading. People who have very weak bones from a separate, underlying condition such as osteoporosis sustain a stress fracture in the foot even from fairly low-impact activities such as frequent walking.

This type of stress fracture is called an "insufficiency fracture" because it happens in a bone that does not have "sufficient" density or strength to withstand normal impact forces. Insufficiency fractures can sometimes affect younger, otherwise healthy women who exercise excessively, because such activity can lead to irregular or absent menstrual cycles, which in turn affects the strength of their bones. What bones in the foot and ankle are affected by a stress fracture?

The most commonly affected bones are: The metatarsals, which connect the toes to the midfoot. The calcaneus heel bone. The navicular, a bone near the ankle. Navicular stress fractures take a long time to heal. The bones that make up the ankle joint — particularly the tibia and fibula.

Examples of appropriate low-impact activity include: Swimming Cycling bicycle riding or spin classes The worst choices for resumed activity while you recover from a foot or ankle stress fracture are running or even walking on hard surfaces. Preventing stress fractures The following principles can help you lead a healthy lifestyle and avoid problems with stress fractures: Eat calcium-rich foods and ensure you get enough daily Vitamin D to help maintain bone density.

Wear good shoes. Do not wear old or stiff shoes, but instead try comfortable, well-padded, and supportive shoes. It is usually a good idea to wear shoes made specifically for the sport you would like to do. Avoid high heels whenever possible. Do not smoke. This can lead to problems with healing. It is actually the nicotine that creates the problem, so other gum and products containing nicotine will still prevent the bone from healing.

This means that you should alternate between activities. For example, you can switch up jogging with swimming or cycling during the week. Slowly ease into previous or new sports activities. Gradually increase the time, speed, and distance. In-person and virtual physician appointments. Book online. Urgent Ortho Care. Same-day in-person or virtual appointments. Get care. Departments and Services. Stress fractures often result from increasing the amount or intensity of an activity too quickly. Bone adapts gradually to increased loads through remodeling, a normal process that speeds up when the load on the bone increases.

During remodeling, bone tissue is destroyed resorption , then rebuilt. Bones subjected to unaccustomed force without enough time for recovery resorb cells faster than your body can replace them, which makes you more susceptible to stress fractures.

Some stress fractures don't heal properly, which can cause chronic problems. If underlying causes are not taken care of, you may be at higher risk of additional stress fractures.

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