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Leg Stress Fracture, Fibula Injury

A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb shock and repeated impacts. Over time the fatigued muscle transfers this stress to the bone, resulting in a small crack (a stress fracture).

BODY PARTS INVOLVED

• Fibula (smaller bone in the lower leg).
• Soft tissue around the fracture site, including muscles, joints, nerves, tendons, ligaments, periosteum (covering to bone), blood vessels and connective tissue.

Causes

Fatigue of the fibula bone caused by repeated overload.

Signs & Symptoms

• Pain at the fracture site that lessens or disappears when the load is taken off the legs.
• Tenderness to the touch.
• Warmth over the site of the fractured fibula.

Treatment

The most important treatment for a stress fracture is rest. Individuals need to rest from the activity that caused the stress fracture, and engage in a pain-free activity during the six to eight weeks it takes most stress fractures to heal.

If the activity that caused the stress fracture is resumed too quickly, larger, more persistent stress fractures can develop. Re-injury also could lead to chronic problems where the stress fracture might never heal properly.

Physical therapy.

Working with a physical therapist during later stages of healing may be beneficial. The therapist can help you balance a slow increase in activity from non-weight-bearing activities - such as water exercise - to partial-weight-bearing exercises to a gradual return to impact activities. They also may instruct you in lower leg strength and stability exercises and can assess the need for arch supports (foot orthotics), which fit into your shoes.

MEDICATION

Your doctor may prescribe:

• Narcotic or synthetic narcotic pain relievers for severe pain.
• Stool softeners to prevent constipation due to inactivity.
• Acetaminophen or Ibuprofen (available without prescription) for mild pain after initial treatment.

Home Diet

During recovery,eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

• Heed early warnings of an impending fracture,such as leg pain during or after extended standing, walking or running. Reduce activities before a fracture occurs.
• Cross-training, or alternating exercises to prevent overloading any one area with the same repetitive stress.
• Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk products or calcium supplements.
• Starting any new exercise program slowly, and progressing gradually.
• Wearing cushioned insoles and footwear appropriate to your physical activity.

Any injury that does not respond to treatment in 1-2 weeks may be more serious. Always consult a physician for a thorough evaluation and diagnosis.