Stress fractures were first described in 1855 by a Prussian military physician. He observed signs and symptoms of stress fractures in soldiers' feet resulting from their long marches. Stress fractures are now commonly experienced by all athletes, but especially among athletes competing in sports requiring significant running, such as soccer.
Causes of Stress Fractures
For soccer players, lower extremity stress fractures are obviously most common. These injuries occur as a result of repeated overload of the bone without adequate recovery time. This occurrence creates an imbalance between normal bone formation and resorption. When this imbalance happens, a microfracture gradually grows into a true stress fracture. Unlike a true fracture, a stress fracture does not usually result in displacement of the bone and an inability to bear weight. Pain over the affected bone, local swelling and warmth are the normal symptoms.
Diagnosis and Treatment
Your physician can diagnose a stress fracture with a plain X-ray or a bone scan test. Treatment usually involves rest, crutches and sometimes casting. Unfortunately, recovery can take from six weeks to four months or more depending on the boney location of the stress fracture. Certain high risk stress fractures, such as the "dreaded black line" stress fracture of the tibia/shin and the Jones fracture of the fifth metatarsal, heal poorly and often are treated with surgery.
As with most injuries, preventing stress fractures from occurring is the goal. Training should always follow a hard/easy pattern allowing for a 24-hour recovery period after hard training. Appropriate shoe wear and soft training surfaces also are helpful. Allowing for post season recovery and variation in sports are recommended.
Peter H. Edwards, Jr., M.D. is an orthopedic sports medicine specialist at the Ohio Orthopedic Center of Excellence in Columbus, Ohio. He specializes in lower extremity sports medicine with an emphasis on soccer injuries.