Stress Fractures a Lockdown Epidemic?

Stress Fractures a Lockdown Epidemic?

March 6, 2022

Lockdowns with reduced activity and overall lack of sunlight has meant that children may have become less resilient to activity and potentially Vitamin D deficient reducing bone strength.

Stress fractures most commonly occur in the lower limbs in children who are involved in sports that involve running and jumping.  They usually occur when there is a sudden increase in training demand, such as training more frequently, for increased time, or increased intensity.

This increase in training puts outpaces bones ability to accommodate for the intensity of the higher level of activity.

Factors such as being female, having a lower than normal Body Mass Index (BMI), abnormal periods and low bone density can put children and adolescents more at risk of developing a stress reaction. Tight muscles, particularly calf muscles, reduces the ability to absorb forces when running and jumping and can also put children at risk of a stress reaction.

A stress fracture is diagnosed after considering a patients history (for example activity level/ training schedule and pain history) and clinical findings.

Plain radiology is important to rule out other causes, check alignment and may show established bony changes consistent with overactivity

In some cases imaging such as a bone scan or MRI may be indicated and the Vitamin D level may need to be checked

A complete history and examination is required to identify risk factors for stress fractures and evaluate lower limb alignment, foot posture and flexibility. Appropriate investigations performed and the diagnosis made excluding other causes of leg and foot pain.

A careful and gradual rehabilitation program will be prescribed.  Your child must be pain free to  progress throughout each phase of the rehabilitation program

For more details see the fact sheet on stress fractures on the website