Common stress fractures

Lower extremity stress fractures are common injuries most often associated with participation in sports involving running, jumping, or repetitive stress. The initial diagnosis can be made by identifying localized bone pain that increases with weight bearing or repetitive use. Plain film radiographs are frequently unrevealing. Confirmation of a stress fracture is best made using triple phase nuclear medicine bone scan or magnetic resonance imaging. Prevention of stress fractures is most effectively accomplished by increasing the level of exercise slowly, adequately warming up and stretching before exercise, and using cushioned insoles and appropriate footwear. Treatment involves rest of the injured bone, followed by a gradual return to the sport once free of pain. Recent evidence supports the use of air splinting to reduce pain and decrease the time until return to full participation or intensity of exercise.