Where Did This Stress Fracture Even Come From?

So you’ve been dealing with this aggravating ache in your lower leg for the past few weeks now. It happens as soon as you work on any type of jumping or leaps in your classes or practice, but now it has started to hurt while walking around at school. This could really be a problem for your upcoming competition next weekend. What are you going to do?

Does this sound familiar at all? Those aches and pains that don’t get better on their own in a week or two can be so frustrating. The longer you put off dealing with it though, the more problematic it could become! Putting your health first should be a priority as an athlete. When you don’t listen to your body, that’s when things like a stress fracture have the opportunity to develop. So where does a stress fracture even come from in the first place?

A stress fracture is a type of fracture that actually develops gradually over time progressing over days to even weeks. Unlike a fracture or broken bone that occurs in a single traumatic event, a stress fracture is characteristically the result of repetitive load or strain to the bone when the body doesn’t have the ability to handle that amount of stress. There can be many other factors that also play a role in the development of a stress fracture. Your nutrition can have a significant impact on your bone health and should be an important part of your healthcare team as an artistic athlete. During our evaluations at Graceful PT we always discuss basic nutritional habits and will refer out to a registered dietitian to best manage your care!

Other factors that may contribute to stress fractures include high training volume without proper recovery and rest, technique errors, poor quality floors, foot posture, strength imbalances, decreased mobility or flexibility, or poor fitting shoes. As you can tell there are many factors that could have contributed to your stress fracture, but many of which are preventable.  

The most common stress fracture in dancers is at the second metatarsal bone in the foot, but they may also occur in the spine as well as the tibia (shin bone) in dancers. Signs of a stress fracture include progressive pain during dance or an activity, tenderness that may be particularly point sensitive, and limping. A stress fracture will be diagnosed by a physician using imaging and their clinical evaluation. The treatment for a stress fracture is typically conservative where the bone will be offloaded by being placed in a boot or cast along with the possibility of crutches for support as well. This period of immobilization will be essential to allow for adequate healing of the bone. If you return too soon to your activity this may cause delayed healing or even the potential for a non-union of the bone which will set you back even further. 

After your stress fracture has gone through a period of rest to allow for sufficient healing your next step should be to work with a physical therapist, especially one who specializes in artistic athletes. We will evaluate your strength, mobility, posture, stability, and control to determine what deficits need to be addressed as well as figure out what may have led to developing the stress fracture in the first place. During your rehabilitation we will work to get you back to 110% while also focusing on preventative strategies to ensure development of a stress fracture can be avoided in the future. We don’t just treat symptoms, our goal is to help you determine WHY you began having pain in the first place and help you prevent this from happening again. When working with a physical therapist that specializes in artistic athletes, you’ll be sure that your healthcare provider understands your unique technique and demands as well looking out for your health and well-being as an athlete. 

Would you like us to help you return to dance or cheer without pain finally? Or maybe you don’t have an injury now, but you want to work on preventing injuries? We would absolutely be more than happy to work with you! Maybe you just have a couple questions. No problem at all, just reach out.

Send us an email at kristin@gracefulpt.com today. 

Originally posted March 13, 2023.

Albisetti, W. et al. Stress fractures of the base of the metatarsal bones in young trainee ballet dancers. International Orthopaedics (SICOT) (2010) 34:51–55.