Stressimurtuma

Stressimurtuma, commonly known as a stress fracture, is a small crack in a bone caused by repetitive submaximal loading that outpaces the bone’s remodeling process. Unlike acute fractures from a single injury, stressimurtuma results from accumulated microtrauma, often in athletes.

Common sites include the tibial shaft, metatarsal bones in the foot, the femur, and pelvic bones. Risk factors include sudden increases in training volume or intensity, running on hard surfaces, inadequate footwear, poor nutrition or bone health (osteoporosis, vitamin D deficiency), low energy availability, and female athlete triad. Overuse symptoms typically begin as localized, focal bone pain that worsens with weight-bearing and diminishes with rest; swelling and tenderness may be present but not always.

Diagnosis starts with clinical suspicion based on history and exam. Initial X-rays may be normal; MRI or bone scans are more sensitive in early stages. If a complete fracture is suspected, urgent imaging and immobilization are required.

Treatment emphasizes protection and gradual return to activity. Early management includes relative rest, reduced weight bearing or crutch-assisted ambulation, and switching to non-impact activities. Once pain-free during activity and imaging confirms healing, a structured, progressive loading program is started. Return to sport is gradual and individualized, often taking 4–12 weeks depending on site and healing, with a risk of refracture if resumed too soon.

Prevention focuses on gradual training progression, cross-training, proper footwear, adequate calcium and vitamin D, and addressing contributing factors such as menstrual irregularities or low energy availability in relevant populations.