You know you have a good workout because you feel it. But what if that muscle soreness isn’t actually muscle soreness, but something more serious? A stress fracture is a small crack in a bone that can feel a lot like muscle soreness, but requires very different treatment.
“Treating a fracture like a sore muscle can make things much worse,” says Dr. Cory Messerschmidt, a board-certified, fellowship trained orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists, who specializes in sports medicine. “Getting it checked out early helps you start on the road to recovery as soon as possible.”
If you’re hurting after exercise or daily life, here’s how to tell whether it’s just soreness or if you broke a bone.
Read More: Head Off Sports Injuries Before They Happen
Stress Fractures and Muscle Pain: Overuse Injuries
Anytime you exercise, you cause your bones and muscles to experience microtrauma. Rest helps your body recover from these tiny injuries. If you don’t get rest, these tiny bits of trauma build up until you have an overuse injury. Muscle soreness and stress fractures can both be overuse injuries.
When you begin working out more often, for longer periods of time or with greater intensity, you increase the risk of stress fractures and other overuse injuries.
“Though muscle pains often occur due to overuse,” Dr. Messerschmidt says, “there are other causes.”
Other reasons your muscles may ache include:
- Chronic health conditions, such as lupus or fibromyalgia
- Infections, such as Lyme disease or the flu
- Injury or trauma
What Muscle Soreness Feels Like
Put simply, sore muscles hurt. The pain often appears during exercise or immediately afterward. In some cases, it can kick in 24 hours later. When it takes this long to feel the pain, it’s known as delayed onset muscle soreness (DOMS).
Whether you have DOMS or other muscle soreness, you may feel pain in more than one place. That's because when you exercise, you work multiple muscles and joints at the same time. So, your legs, back and shoulders may all hurt, especially if it’s been a while since you exercised.
Wherever your soreness settles, it may cause the following:
- Difficulty moving the affected limb
- Pain
- Stiffness
Read More: Contusions, Sprains and Fractures: What's the Difference?
Managing Sore Muscles
Usually, muscle soreness lessens with each passing day and goes away after a few days. DOMS, however, can last up to a week, according to the National Academy of Sports Medicine.
To manage the pain, you can take a few simple steps.
- Get a massage — A gentle massage can help ease muscle aches brought on by overuse.
- Rest — Avoid using the hurting limb to give it time to recover.
- Take medicine — Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help relieve pain.
- Use ice and heat — When soreness starts, apply ice to the injured body part. This helps reduce swelling, pain and inflammation. After a couple of days, apply heat to your aching limb. It can feel good and speed up the healing process.
If these steps don’t help, you have severe pain or your pain doesn’t improve after a few days, contact your healthcare provider. It may be a stress fracture or other issue.
Risk Factors for Stress Fracture
“Anyone can break a bone,” Dr. Messerschmidt says, “but certain factors increase the likelihood that you’ll develop a stress fracture.”
These include:
- Previous injury — A stress fracture in the past increases the likelihood of one in the future.
- Race — White people have weaker bones and lower bone density, which leads to more fractures.
- Sex — Females are more vulnerable to stress fractures. The risk is highest among female athletes who participate in gymnastics, cross country and track, according to the American Academy of Orthopaedic Surgeons. You’re also at higher risk if you don’t eat enough calories and have menstrual dysfunction and impaired bone health, a combination called the female athlete triad.
Stress Fracture Symptoms
Fractures often occur in weight-bearing bones of the foot and leg. You may get one while participating in high-impact activities, like long-distance running. A fracture can also occur when you’re just walking. No matter what brings it on, the symptoms are often the same.
Symptoms of a stress fracture include:
- Bruising in the area surrounding the fracture
- Pain concentrated in the affected area that comes on during activity and goes away with rest
- Swelling in and around the injured area
- Tenderness around the damaged bone
Detecting and Treating a Stress Fracture
Anytime you suspect a bone fracture, contact your care provider and take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and swelling. You can also ease your symptoms with the RICE method: resting, icing, compressing and elevating the injured bone.
Read More: Common Elbow Injuries: How to Reduce Your Risk
At your medical appointment, your care provider will ask about your symptoms and health history. Then, your care provider will examine the injured area, applying light pressure.
“If this pressure causes focused pain, it’s often a fracture,” Dr. Messerschmidt says. “Additional tests can then confirm the diagnosis.”
Imaging services that help diagnose a stress fracture include:
- Bone scan — A nuclear imaging specialist injects you with a small amount of radioactive material, which collects in bones. This material gets detected by a special scanning device and gives a clear view of the bones.
- Magnetic resonance imaging (MRI) — MRI can show stress fractures that are too small to appear with other imaging technologies.
- X-ray — Radiation helps capture black-and-white images of your bones to identify fractures and other bone abnormalities.
If you’re diagnosed with a stress fracture, treatment options may include:
- Home care — Use the RICE method and NSAIDs and avoid stressing the injured limb.
- Lifestyle changes — If you want to stay active, participate in physical activities that don't put pressure on the broken bone.
- Protective measures — Special shoes or casts help protect foot fractures from getting worse while the fracture heals.
- Surgery — During bone fracture repair, an orthopedic surgeon inserts screws and other materials to hold the fractured bones in place during the healing process.
Within six to eight weeks, your stress fracture should heal fully. Before returning to physical activity, get cleared by your orthopedic surgeon. Returning before your stress fracture heals or ignoring the problem will make your recovery take longer. It can also make your injury worse and cause long-term complications. Your minor stress fracture may turn into a full break, which requires additional surgery.
Think you may be living with a stress fracture? Get the right treatment, so you can get moving again soon. Request an appointment with one of our orthopedic sports medicine specialists to get started.
