Stress Fracture

What is it? A stress fracture is a small crack, or break in a bone These fractures are most commonly found in the long bones of the lower extremity and the bones of the foot and ankle

How does it develop? Stress fractures are typically overuse injuries and can be caused by Running Jumping Contact sports Stress fractures can also be caused by osteoporosis

Examination Some signs and symptoms of stress fractures: Positive Patrick’s or FABER’s Test Pain reproduced with weight bearing Pain with heel strike Pain described as aching or deep aching Pain subsides with rest, but increases with activity Positive Fulcrum Test Radiographs may or may not show the fracture

Examination FABER’s Test Patient is in supine with the suspected leg bent with the foot resting on he opposite knee The bent leg is lowered towards the table A positive test is pain

Examination Fulcrum Test Done with the patient in sitting, the examiner elevates the suspected leg, lays their arm between the leg and the table, and provides force through the knee A positive test is when there is pain present

Treatment Education is key Instruct patient to discontinue activities that aggravate the pain Rest Ice Slowly return to activities

References Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2008.