A stress fracture is a partial or complete bone fracture that results from repeated application of stress lower than the stress required to fracture the bone in a single loading. Otherwise healthy athletes, especially runners, sustain stress injuries or fractures.
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A femoral neck stress fracture is essentially a hairline fracture or crack in the bone at the femoral neck of the hip joint.
That occurs as a result of fatigue of the bone when placed under extreme pressure or stress or it can happen after repeated activity load on a bone that is unprepared. Imagine if you will, a paper clip that’s bent back and forth many times and then snaps. Three to five times the load for a runner’s body is placed through the femoral neck when running. Fifteen percent of runners experience stress fractures of which ten percent are femoral neck stress fractures. In treating this condition, often seeing a local massage therapist for muscle tension, a local personal trainer for muscle strength and a physiotherapist for release and conditioning is a good option.
This type of fracture results in a deep ache experience at the hip, which radiates into the groin and the lower back. Pain often comes on initially just after activity and then as it progresses over weeks, perhaps the pain will be felt during activity such as running and then it will be experienced during activities of daily living and then the runner will be limping following activity unable to walk and then may even experience pain during sleep.
Because of the anatomy of the hip, not treating this problem can lead to very serious outcomes. The hip, if you will, is a ball and socket joint with the femoral head serving as the ball and a sort of a cup shaped acetabulum, which is part of the pelvis, being the socket that it fits in. The femoral neck is where the blood supply runs to the femoral head.
A stress fracture at this site if untreated can go on to a full fracture at the femoral head which can disrupt the blood supply to the femoral head and lead to bony death which is called a vascular necrosis, which can have catastrophic consequences requiring hip replacement in otherwise healthy young adults.
Often a change in training intensity, frequency or duration can result in this type of stress fracture is particularly worsened by doing hill work or running on hard surfaces when the body is not accustomed to doing so. Gender and age are also predisposing factors to this injury. So women and people in older age groups are disproportionally affected.
If a femoral neck stress fracture is suspected, medical treatment should be sought right away, not only to get a proper history and physical, but also to have the appropriate imaging done. An x-ray as well as a bone scan, possibly an MRI will be necessary to confirm the diagnosis.
Once the diagnosis is known, the treatment is actually fairly conservative and it’s simple. Stop running, it means being non-weight bearing that is on crutches for six to eight weeks, and to follow the healing progress. Local Physiotherapists
Local Practitioners: Sports Medicine Physician