Home > Blog > Physiotherapy > Conditions > Fractures > Lower Extremity Stress Fractures Physiotherapy

Lower Extremity Stress Fractures Physiotherapy

Lower extremity stress fractures are fractures of the bones in the lower legs (such as tibia and fibula) or feet (such as toes and the bones just before the toes ie the metatarsals) that occur with repeated activities.

Unfortunately, stress fractures are a relatively common injury, seen most often in athletes playing sports that require repetitive impacts (eg, running and jumping).

Stress fractures comprise 5% to 30% of all activity-related injuries of the lower extremities.

Female athletes are more likely to develop stress fractures in the legs and feet than male athletes. Although athletes and active or sporty individuals may be more susceptible to these types of injuries, however that being said, any individuals who

• walk
• march or
  
• spend much of their workday on hard floors (eg, concrete) also are at risk.

Our senior physiotherapists help people with lower extremity stress fractures

• recover strength
• recover movement
• recover flexibility
• and help them identify risk factors for future injury

What is Lower Extremity Stress Fractures?

Lower extremity stress fractures are fractures of the bones in the lower legs or feet.

Stress fractures are tiny cracks (but not full fractures nor breakage) that occur in bone, usually related to repetitive activities that impact the bone in a similar way over time.

These stresses lead to changes in the normal process of bone breakdown and reformation. Stress fractures are most common in the feet and legs, as these structures bear a person’s weight during

• walking
• running
• jumping

what does stress fractures feel like?

Stress fractures are characterized by a sharp pain in a very specific point over the top of the affected bone (area of the bone with stress fracture).

Lower extremity stress fractures generally hurt when you are walking, running, or jumping. Patients also report experiencing soreness and aching pain in the area after activity. Symptoms typically improve with rest.

Signs and Symptoms

Individuals who develop activity-related lower extremity stress fractures may experience:

• Pain during activity (eg, walking, running, jumping)
• Sharp pain over a specific point on the bone (eg, point tenderness)
• Aching pain after activity
• Swelling without bruising at the painful site
• Difficulty tolerating usual recreational / occupational demands

How Is It Diagnosed?

If you see our senior physiotherapists first, they will conduct a thorough evaluation that includes taking your health history.

We may ask whether you:

• Increased your activity significantly over the past weeks or months
• Noticed an increase in pain with activity that slowly subsides after activity
• Can touch a specific area on the bone that hurts
• Experienced any specific event that caused your pain (eg, falls, twist, collision)

We will perform gentle physical tests to help determine the likelihood that you have an activity-related lower extremity stress fracture.

We also may test for other contributing factors to your injury, such as

• the strength of your legs
• the flexibility of your muscles
• the stiffness (rigidity) of your joints
• and the quality of your footwear

To provide a definitive diagnosis, we may collaborate with an orthopedic physician or other health care provider who may order further tests, such as magnetic resonance imaging (MRI) or a bone scan, to confirm the diagnosis.

how our senior physiotherapists can help patients with stress fractures

Stress fractures are initially and typically treated by resting the leg as much as possible.

Stopping or modifying activities that increase stress on the legs (eg, running, jumping, or "cutting" in sports) for at least 3 weeks may be recommended to allow the bone to begin the healing process.

Based on your specific injury and condition, our senior physical therapist s can decide whether you should use a compressive brace, crutches, or a walking boot to protect your bone while it is healing.

Initial Treatment

Initial treatment may include muscle-strengthening exercises for the lower extremities and core, stretching exercises, and alternative cardiovascular training, such as swimming or aqua aerobics.

Shockwave therapy, radio-frequency Indiba physiotherapy or the use of a bone stimulator may be prescribed if the bone exhibits difficult or delayed healing.

During your rehabilitation, we also can design a specific treatment program for you to follow at home to help speed your recovery.

As You Start to Recover

Our overall goal is to return you to your normal daily tasks at home, at work, and in the community. Without proper physiotherapy treatment, stress fractures could progressively worsen to more serious problems such as

• chronic pain
• swelling (which leads to joint stiffness and other issues)
  
• weakness
• and more

which will further limit your ability to perform your usual activities.

We will design an individualized treatment program for you, based on your unique condition and goals.

Your physiotherapy treatments may include:

Range-of-motion exercises

Because you have been less mobile over the past few weeks, your range of motion may have decreased. We will teach you how to perform safe and effective exercises to restore full movement in the joints of your legs.

Muscle-strengthening exercises

Even short-term inactivity weakens the muscles of the legs, increasing the potential for new injuries.

Additionally, your stress fracture may have been related to some underlying weakness in the legs. We can determine which strengthening exercises are right for you based on the severity of your injury and where you are in your recovery.

Body awareness and balance training

Specialized training exercises help your muscles "learn" to respond to changes in your environment, such as uneven or unstable surfaces.

When you are able to put your full weight on your foot without pain, we may prescribe these training exercises to help you return stronger to your normal activities.

Functional training

When you can walk freely without pain, we may begin "progressing" your treatment program to include activities that you were doing before your injury. This program will begin with slow, progressive weight-bearing activities, such as hopping and light jogging.

We will create your own unique training program, based on

• your condition
• your goals and
  
• your activity levels

Activity-specific training

Depending on the requirements of your job or the type of sport you play, you might need additional rehabilitation tailored for your job or sport.

We can develop a program that takes into account all of these demands as well as your specific injury.

Orthotic therapy

In-shoe orthotics may be beneficial to support your return to activity with no pain as well as possibly prevent future stress fractures, if your foot posture or mechanics were a contributing factor to the development of the original stress fracture.