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Dr. Andrew Blackman, St. Luke's Hospital



Women more likely to develop stress fractures

For many women living an active lifestyle, the balance between healthy exercise and overuse can be delicate. Minor aches and pains are normal after typical exercise, however, persistent localized pain with activity may be a sign that you are overdoing it. One cause for this type of pain with activity is a stress fracture.

Stress fractures can occur when bone remodeling is imbalanced. Bones constantly remodel in response to normal loading, but this remodeling process can become abnormal with overuse. Muscle weakness or fatigue can also put increased stress on the nearby bones. In these situations, the bone is susceptible to developing small cracks, known as stress fractures.

Stress fractures are most common in the foot, ankle and lower leg but can occur throughout the body depending on the activities being performed. Running, dance and gymnastics are high risk activities for developing stress fractures.

Studies have shown that women have a higher risk of developing stress fractures than men, likely due to hormonal differences, decreased bone density and higher rates of inadequate nutrition.

Athletes are at highest risk of stress fractures after changes in intensity, frequency or duration of their workouts. A change in training surface or footwear can also put an athlete at risk. For women specifically, irregular menstrual cycles and weight less than 75 percent of ideal body weight are associated with increased risk of stress fractures.

If you are concerned that you may have developed a stress fracture, contact your doctor. Diagnosis can be made with an X-ray, CT scan or MRI. Treatment with rest and/or immobilization is typically successful, although surgery may be required in some cases.

Early treatment results in better outcomes, but prevention is the best management strategy. The best ways to lower your risk for stress fractures include maintaining a healthy weight, avoiding abrupt changes in training, wearing appropriate athletic shoes and using menstrual irregularity as a warning flag.

Dr. Andrew Blackman specializes in orthopedic surgery and sports medicine at St. Luke's Hospital. If you experience joint or persistent pain, connect with a physician by calling 314-205-6060, or register to attend a free hip or knee pain class by visiting our Wellness Programs and Screenings page.

This article was published in the St. Louis Post-Dispatch on October 30, 2014.