Stress fractures can occur in all age groups. Stress fractures are prevalent in the older population due to decreased bone density. However, stress fractures can occur at any age due to decreased skeletal maturity, decreased strength/endurance, and overuse.
Four common areas where stress fractures occur are in the lumbar spine, tibia (shin bone), the fifth metatarsal in the foot, and the medial elbow. Using physical therapy we can treat these conditions.
Lumbar Spine
Young athletes performing athletic activities that consist of increased amount of contact (compression on the lumbar spine) and hyper extension of the back are more prone to have lumbar stress injuries than athletes performing other activities. This is primarily due to the lack of core stability in young athletes, the repetitiveness of the movement, and the athlete’s body being unprepared to handle the rigorous activities of the sport. Our older population can develop these types of stress fractures as well due to decreased bone density and disc height.
Tibia (Shin Bone) and Foot
Stress fractures can occur in the tibia and foot due to increased weight bearing pressure during running, prolonged walking, jumping activities, or prolonged standing. This can occur in any active person or athlete. However, some factors such as not being skeletally mature, flat feet, decreased training, or training too hard too soon can increase the risk of these types of stress fractures. Good shoe wear and a gradual increase in sports specific training or work activities can reduce the risk of these types of stress fractures.
Medial Elbow
Medial elbow stress fractures can occur in young athletes who perform overhead throwing activities. This is common with young pitchers who are not skeletally mature. Often, such athletes are throwing too many pitches with improper throwing mechanics. Most young pitchers need good core stability, upper/lower body flexibility/strength, cardiovascular endurance, and proper instruction to maximize their throwing mechanics. Most pitchers are often put on a pitch count to decrease the chances of obtaining a stress fracture.