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Stress fractures are generally caused by an imbalance of stress/load causing the bone to break itself down more quickly than it is able to build itself back up. These fractures are often seen in adults who have taken up a fitness regime without adequate conditioning or in children participating in many physical activities without enough rest. Elite athletes may also suffer these fractures because their total training/competition volume is very heavy. Certain types of arthritis and/or other pathologies within the bone itself can drastically reduce the amount of repetitive stress a bone can tolerate.
In most situations, a patient presenting with a stress fracture will note a gradually increasing amount of pain. Typically pain is first reported to occur at rest and progressively occurs during and throughout their chosen activity. Treatment involves identifying the source of excessive loading and modifying contributing factors such as training load, rest, abnormal gait mechanics and bone density. Imaging may be requested to confirm this diagnosis and often a period of activity reduction is required.
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