Fatigue fracture and osteopathy
What is a stress fracture?
A fatigue fracture also called stress fracture corresponds to a pathology of the bone tissue which adapts to an overload of stress. It corresponds to micro cracks in the bone tissue.
The bones most affected are the metatarsals and the tibia, but fatigue fractures can also occur in all bones of the body.
Causes of stress fracture:
Fatigue fracture is related to an overload of stress on a bone in a repetitive manner. It can occur in a marathon runner in preparation who has intensified his training as well as in a person walking around a city for several days and walking much more than usual.
Factors favoring stress fracture:
It is aggravated by:
- Overtraining
- Ill-fitting shoes
- Practicing physical activity on a floor that is too hard
- A postural disorder such as one that would cause a greater pressure on a metatarsal
- Poor physical condition or lack of physical preparation
- Poor diet, nutritional deficiency
- Anorexia
- Osteoporosis
- Hormonal disorders
- Context of stress, anxiety
Clinical examination of stress fracture:
- Palpation of the area reproduces the pain
- Percussion of the area reproduces the pain
- Palpation of a swelling
- The positive tuning fork test: this test consists of vibrating the bone. When the bone tissue is damaged, it causes pain, as in the case of a fatigue fracture.
Complementary examinations of the fatigue fracture:
Radiography:
X-rays are often taken, however, in the first 3 weeks after the fracture, it is very common that they do not appear on the X-ray. It can be seen on x-rays taken after this date because the signs of healing of the fracture are visible.
Ultrasound
The ultrasound is a very good diagnostic tool. The examiner will be able to find a bulge in the cortical bone.
Scintigraphy or MRI
Fatigue fractures can be detected early with bone scans or MRI, but these tests are very rarely used as a first line of defence. They are also useful for making a differential diagnosis.
Fatigue Fracture Complications:
- Chronic pain
- Hypertrophic wedge
Fatigue Fracture Treatment:
Short-term treatment consists of rest and unloading, and a walking boot can be used to modify the support of the foot to limit the stress on the affected bone.
It is also possible to use kinesiotaping or strapping.
Healing usually takes 4 to 8 weeks, while the bone structure is rebuilt.
The second part of the treatment is the elimination of the cause: A podiatric examination is therefore recommended for fatigue fractures of the lower limbs as well as an osteopathic assessment.
Osteopathy and fatigue fracture:
It is advisable to wait for the bone to consolidate before going to see the osteopath.
Indeed, when the patient limps, he becomes unbalanced. I think it is useless to manipulate a patient who will become unbalanced again in a few days.
If the patient were to consult for pain other than in the foot, the osteopath could, however, take care of him/her with certain precautions, for example, he/she would not manipulate the bone of the fractured foot to avoid breaking the consolidation that has taken place.
Once the bone is consolidated, it is strongly advised to consult an osteopath to rebalance the body but also to treat all the causes of the stress fracture.
Marie Messager
Osteopath for sports
in Versailles Chantiers
78 - Yvelines
