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Stress fracture in knee symptoms: Knee Stress Fracture Symptoms You Shouldn’t Ignore

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Knee Stress Fracture Symptoms You Shouldn’t Ignore

Everyone experiences occasional pain in their knee(s). But there are some symptoms that you just shouldn’t ignore. These can point to larger problems in your knee, like a stress fracture. Even though stress fractures are not as serious or painful as a broken bone, they should not be ignored. If left untreated, they can lead to tiny cracks that transform into more serious issues. If you are experiencing knee pain, you should be aware of certain sensations that might point to something worse that needs attention.

 

The Most Common Knee Stress Fracture Symptoms

A stress fracture is a minuscule crack in the bone that is caused by repetitive use or trauma. Commonly seen in athletes, stress fractures occur over time and are often in the shins, foot, heel, and knee. Because the crack is so small, pain from a stress fracture tends to be less severe than broken bone pain and the problem is sometimes harder to diagnose.

Stress fractures that occur in the knee are normally harder to diagnose than a stress fracture in the tibia or foot. The most common knee stress fracture symptoms include:

  • Pain and swelling in your knee

  • A “pinpoint pain” when touching your knee bone

  • Dull pain that gets worse during activity and goes away with rest

  • Pain that occurs whether you are resting, doing normal activities, or walking

  • An inability to put weight on one leg

  • Bruising around the knee

If you are experiencing any of these symptoms, you may have a knee stress fracture and should contact an orthopedic knee specialist at OrthoConnecticut as soon as possible.

Causes of Knee Fractures

Knee fractures are not common and are usually caused by direct impact to the kneecap. This can happen from a car accident, a hard fall, or a sports injury. If you suffer from osteoporosis or a bone infection you may be at higher risk of a knee fracture from seemingly minor injuries.
Stress fractures in the knee are more common among long-distance athletes like runners. The repetitive movement causes trauma to the bones that make up the knee structure. Other risk factors for knee stress fractures include obesity, poor diet, low vitamin D levels, ill-fitting or worn-out footwear, and poor technique when doing physical activity.

Diagnosing a Stress Fracture of the Knee

Diagnosing a stress fracture in the knee can be more difficult than diagnosing other types of stress fractures. Because all pain may not be localized to the knee and you may not know you have a stress fracture, physicians may first look at other bones for signs of a stress fracture. Diagnosis of a knee stress fracture is done through a physical exam and analysis of medical history. Ultimately, whether or not there is a stress fracture will be revealed through an X-ray, MRI , or bone scan.

Treatment for Knee Stress Fractures

Because of the small size of stress fractures, surgery is not a common method of treatment. Instead, most physicians will recommend rest and a mechanism for bone and joint support. Treatment for knee stress fractures may involve a knee brace or sleeve that supports your knee for limited walking.
While you can address the pain caused by a knee stress fracture by taking some sort of non-steroidal anti-inflammatory drugs (NSAID), the only way to treat a stress fracture is with rest and patience. Methods of treatment involve:

  • Resting for several weeks

  • Icing the knee

  • Eliminating whatever activity causes pain

  • Doing non-impact exercise, if your doctor approves

  • Elevating your leg to reduce swelling

  • Switch out your footwear to something with a more rigid sole that provides more support

  • Using crutches to keep weight off of your injured knee

While these are just some of the methods to treat a knee stress fracture, you should consult your physician at OrthoConnecticut before adopting a treatment plan.

Don’t Ignore Your Symptoms!

The danger of ignoring symptoms of a knee stress fracture can lead to serious complications that might affect you for the rest of your life. If you’ve got a nagging sensation or feeling that your pain might be something more, call your doctor right away. The cost of not calling may be much greater than the trouble of getting an expert opinion by a qualified orthopedic surgeon.

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Knee Fracture

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Knee Stress Fracture Treatment in Columbus, OH

Our knees play an important role in helping us accomplish everyday tasks. That being said, it’s understandable why we can become a little anxious when knee pain creeps in.  

If you are in this situation, do not despair! At OrthoNeuro, we understand how unsettling having knee pain can be. Our goal is to find the source of your pain, provide treatment, and get you on the road to recovery.

A knee stress fracture may be the source of your pain. Contact us in Columbus, OH today to get your knee pain properly diagnosed!

What Is a Knee Stress Fracture?

A knee stress fracture (also known as a hairline fracture) is an injury in which a small crack develops in your kneecap (patella). Your patella acts as a shield, protecting your knee joint.

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While rare, stress fractures of the knee seem to have a higher occurrence in athletes. In other cases, though, your patella may have become weakened after having patella resurfacing surgery.

Causes of Knee Stress Fractures

Generally, stress fractures of the knee are caused by:

  • Overuse
  • Repetitive stress or force (high-impact exercises or sports)
  • Fatigue
  • Muscular weakness
  • Direct blow or fall on your knee (from a sports injury or a car accident)

Additionally, being overweight or having a medical condition such as osteoporosis, which decreases your bone density and strength, may increase your risk of having a stress fracture.

Symptoms of a Stress Fracture

The symptoms of a stress fracture can often be mild. Knowing what to look for could help you prevent further damage and find the proper methods to relieve your pain.

These stress fracture symptoms include:

  • Pain that tends to worsen in the front of your knee (anterior knee)
  • Swelling
  • “Pin-Point” Tenderness (pain when fracture spot on bone touched)
  • Bruising

How Are Knee Stress Fractures Diagnosed?

At times, a stress fracture knee may be difficult to diagnose. To diagnose a stress fracture properly, your specialist will first review your medical history, coupled with a thorough physical examination.

During your examination, your doctor will inspect your knee for abnormalities. You will also be asked to provide a detailed description of your symptoms.

Additionally, x-rays may be taken to provide detailed images and a diagnostic view of the affected leg. An MRI may also be ordered to confirm the diagnosis.

If further tests are needed, your doctor may recommend a bone scan. A bone scan is an imaging technique used to detect the presence and location of a fracture.

How Are Stress Fractures Treated?

There are several different treatment options for stress fractures. Stress fractures can be treated non-surgically and surgically. However, surgical treatment is usually not required.

Depending on the degree of your stress fracture, your specialist will discuss which option best fits your needs and goals and then plan accordingly to help relieve pain.

Can a Stress Fracture Heal on Its Own?

It is important to note that your stress fracture could become severe without proper treatment. If the stress fracture worsens, it may become a true fracture or even a displaced fracture. Not only will your pain intensify, but surgery may then be required.

One surgical procedure used to fix displaced fractures is called internal fixation. During an internal fixation, the fracture site will be adequately exposed, and a reduction of the fracture will be completed.

How Long Does It Take to Recover From Stress Fractures?

Recovery from stress fractures takes time and may vary from person to person. With proper rest and compliance with your doctor’s orders, it may take about 6 to 8 weeks for your stress fracture to heal. Most people do not require surgery.

However, if you require surgery, please keep a few things in mind. Initially, after your surgery, there may be some weight-bearing restrictions put in place by your doctor. Also, physical therapy may be recommended to help you regain your range of motion.

Are Stress Fractures Preventable?

Yes, stress fractures can be prevented. You can reduce your risk by solely participating in low-impact activities and avoiding repetitive movements. One way you can prevent stress fractures is by slowly and progressively incorporating a new exercise into your regimen. Maintaining proper nutrition can also help keep your bones strong and healthy.

Additionally, many have found cross-training to be very beneficial in preventing stress fractures. These low-impact activities can help you avoid repetitive movements that can stress a particular part of your body. Wearing proper footwear can also reduce your chances of having a stress fracture.

It can be an unpleasant experience if you develop stress fractures in your knee. However, having someone who knows how to treat them properly can make all the difference.

At OrthoNeuro, our expert team of trained specialists is ready to help treat your stress fracture. Schedule an appointment at one of our 7 locations in the Greater Columbus area today!

Make an Appointment with an OrthoNeuro Knee Specialist Today!

If you are suffering from symptoms of a knee stress fracture, schedule an appointment with one of our Board Certified Orthopedic Knee Specialists at one of our 7 convenient locations throughout Greater Columbus. 

We will evaluate your unique lifestyle and goals to determine which type of treatment is best for you.

Running Injury Guide: Stress Fracture

The Injury Guide is not a self-healing guide. Its task is only to help you figure out what could cause the injury, what are its main signs, and what is useful to do for prevention. Only a doctor can accurately determine the problem and prescribe treatment, and not an article on the Internet.

Contents:

  • Anatomy
  • Symptoms of injury
  • Causes
  • Treatment
  • How to get back to running
  • Prophylaxis

A stress fracture is one of the most annoying injuries a runner can get. In addition to runners, stress fractures of the lower extremities often occur in football and basketball players, as well as in military personnel.

Anatomy

Each bone is a solid organ that consists of several tissues and performs important functions: supporting and protective, being an integral part of the internal skeleton of vertebrates; hematopoietic, producing red and white blood cells; storage, retaining minerals.

The unique structure of the bones allows them to be quite light and at the same time rigid and strong.

Bones are not only inorganic substances, but also living cells: osteoblasts, osteocytes, osteoclasts, which are involved in the creation and mineralization of bones, maintaining their structure and its remodeling.

The mineralized matrix of bone tissue has an organic component mainly of collagen and an inorganic component of various salts. It is permeated with small tubules through which thin blood vessels pass, and bone cells receive nutrients and oxygen.

What is a stress fracture? When the degree of external impact and damage exceeds the possibility of recovery, microcracks form in the bone tissue. This can happen during a training regimen when the muscles are so tired that they cannot cope with the shock load.

Over time, with repeated overload in a certain area, a fatigue fracture of the bone occurs, in which microscopic cracks “combine” into a larger damage.

Thus, a stress (fatigue) fracture is damage to bone structures that occurs as a result of constant repeated overload during physical activity.

This is not yet a true fracture, since the integrity of the bone is not yet broken, but ignoring the injury can lead to a complete fracture.

Stress fractures mainly affect the lower extremities (80-90% of all stress fractures), accounting for 0.7% to 20% of all sports medicine injuries.

In runners, the frequency of fatigue fractures approaches 16% of all injuries. The most common stress fractures are: tibia (24%) and navicular, tarsus (18%) and metatarsals (16%), femur (7%) and pelvis (2%).

According to the American Academy of Orthopedic Surgeons, the most common stress fractures are the second and third metatarsals, which are thinner (and often longer) than the adjacent first metatarsal. It is this area that receives the greatest load during movement when walking or running.

Stress fractures above the knee (femur, pelvis, spine), where some of the strongest bones are located, can indicate serious diseases, such as osteoporosis.

Stress fractures are often divided into “low” and “high” risk categories. The first group includes stress fractures that heal “by themselves” in the absence of stress and respond well to conservative treatment. Category 2 stress fractures, on the other hand, usually require surgical treatment to speed up recovery and also avoid a complete fracture.

The duration of treatment depends on the area and degree of damage to bone structures and can range from several weeks to a year.

Trauma symptoms

A stress fracture is usually accompanied by increasing pain localized to a specific area of ​​the bone. If you continue to run, ignoring the pain, it will grow and disturb not only during exercise, but also during rest.

The stress fracture site or the area above is sometimes swollen, and intense heat may be felt at the injury site.

The most characteristic symptoms are:

  • pain while walking or running, which sometimes persists even without exertion;
  • acute soreness when exposed to the area of ​​the bone where discomfort is felt;
  • appearance of edema at or above the fracture site;
  • sensation of heat in the area of ​​injury;
  • changes in running biomechanics caused by discomfort when landing on an injured leg.

Often used to diagnose stress fractures jump test : carefully jump 2-3 times on the injured leg. The appearance of sharp pain during landing on a support may be a sign of a stress fracture. Especially if there is pain during palpation and swelling is noticeable.

The “gold standard” for diagnosing stress fractures is magnetic resonance imaging (MRI). But radiographs do not allow diagnosing acute stress fractures, since the resolution of the method is not enough to identify microcracks. Therefore, it makes sense to take an x-ray only 2-3 weeks after a fatigue fracture, when a callus is already formed at the fracture site, visible during x-ray exposure.

When a stress fracture is detected early, it is classified as a stress response. Such damage is less dangerous and will require only 2-3 weeks of rest from shock loads. That is why it is important to contact a specialist for diagnosis when the first symptoms appear.

Causes of occurrence

The most common cause of stress fractures is considered to be a sharp increase in physical activity. Moreover, this may be due to an increase in the frequency, duration, and intensity of training.

Risk factors that can lead to stress fracture:

Chronic underrecovery. A fatigue fracture requires prolonged, repeated impact loading on the bone structure. If there is not enough time to restore such structures, microcracks gradually accumulate and a stress fracture may occur.

Sudden increases in the number of runs, running volume, or running intensity that the body does not have time to adapt to often lead to stress fractures.

Low bone density. In some diseases, such as osteoporosis, bone tissue becomes less dense, and this leads to the fact that the bones can withstand much less stress than normal. This means that the likelihood of microcracks and stress fractures increases even with not very high physical exertion.

Running technique. Suboptimal foot placement while running can lead to a variety of injuries, including ankle or hip stress fractures.

For example, toe-based running increases stress on the foot and lower leg, increasing the risk of ankle stress fractures. At the same time, heel-based running can lead to stress fractures in the tibia. Switching to more minimalist shoes increases the chances of earning a metatarsal stress fracture.

Overweight runners have a higher risk of injury, as they have an increased load on the musculoskeletal system while running.

Nutrition. An unbalanced diet is an additional factor that provokes the appearance of fatigue fractures. Active runners need to constantly monitor their calcium and vitamin D levels. According to studies, stress fractures are more common in winter, when there is a lack of vitamin D in the body.

Abuse of caffeine-containing drinks in certain cases can lead to additional loss of calcium and, as a result, to weakening of bone structures.

Running surface. Not everyone lives near a park with dirt tracks or near a stadium with a special surface. Most runners simply have to run on asphalt, concrete, and other sub-optimal surfaces. Yes, our body can adapt to such a surface, but this takes time and the right shoes. But in the absence of proper technique and muscle imbalance, it is very easy to earn a stress fracture when changing from a less rigid coating to a more rigid one. Especially if the training experience is not yet great.

Incorrect selection of shoes. The use of unsuitable (non-running) running shoes that have lost or lack cushioning capacity can contribute significantly to stress fractures.

The average lifespan of running shoes is 500-800 kilometers. This figure may vary depending on the running surface and other factors. Therefore, pay attention not only to the service life of sneakers declared by the manufacturer, but also to your feelings after a run.

Female. Fatigue fractures are more common in women. The risk of a stress fracture increases markedly if the so-called triad of factors is present: amenorrhea (absence of menstruation), nutritional disorders, and osteoporosis. If you have even one of these factors, you should consult your doctor as soon as possible.

Stress Fracture Treatment

If you experience uncharacteristic sharp pain during runs that does not go away, and other symptoms of a stress fracture, it is advisable to see a doctor as soon as possible to find out the exact diagnosis.

If this is not possible, it is best to follow the RICE protocol (rest, ice, compression, elevation) – rest, cold, compression and fixation of the injured limb in an elevated position.

Rest. Avoid activities that put stress on the leg. If for any reason you have to load it while walking, try to minimize the load and use comfortable shoes. Cork sandals with thick soles are better than thin slippers.

Ice. Apply ice to reduce inflammation and swelling. Use cold compresses for 15-20 minutes 3-4 times a day. Do not apply ice directly to the skin (you can wrap an ice pack in a towel).

Compression. To prevent further swelling, light compression may be used, such as wrapping the injured area in a soft bandage.

Elevated leg position. Rest with the leg above heart level as often as possible.

In general, a two-stage protocol can be safely used to treat most low-risk stress fractures.

The first phase of this protocol begins with pain relief with an ice pack, physiotherapy, and oral analgesics. The use of non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided due to their potential adverse effects on bone healing.

Permissible load on the injured area is allowed for daily activities, but sports should be stopped. At the same time, if the nature of the injury allows, after consulting a doctor, you can use aerobic exercises with minimal impact (elliptical trainer, cycling, running in the pool, etc.). They can help both support the cardiovascular system and speed up healing by stimulating circulation.

The second phase begins after the victim has been pain free for 10-14 days. Its task is to gradually return the athlete to the previous training regimen.

Initially, athletes with a healing fracture should run no more than every other day for the first two weeks after pain has subsided, gradually increasing distance and intensity.

The duration of treatment depends on the location of the stress fracture and its severity. Typically, most stress fractures take 6 to 8 weeks to heal.

“Low-risk” stress fractures (tibia and fibula, for example) tend to heal well on their own with appropriate rest.

“High risk” stress fractures (navicular and femur, for example) take significantly longer to heal and require a smoother return to running.

In addition to the RICE protocol and pain relievers, physicians often recommend that patients temporarily use crutches to reduce stress on the foot until the pain subsides.

Some stress fractures take longer to heal, so the doctor may put a cast on the foot to keep the bones in a fixed position.

Surgery

High-risk stress fractures often require surgery to heal properly. In most cases, this involves supporting the bones with internal fixation. Pins, screws and/or plates are most commonly used to hold the small bones of the foot and ankle together during the healing process.

How to return to running

The main rule of resuming training with a stress fracture after the disappearance of pain symptoms is gradualness. You should start with very short runs, or rather, with alternating walking and short jogging. For example, 6 sets of 5 minutes, of which 1 minute of running and 4 minutes of walking. Gradually, the duration of running segments increases, and walking decreases, and so on until a complete transition to running.

During the first workouts, discomfort and soreness may be felt in the area of ​​injury caused by the formation of scar tissue and remodeling of the injured area of ​​the bone. But they should be different from the pain that was when a stress fracture appeared.

Prevention

Since rest and time are the most critical factors that can speed up recovery from a stress fracture, it is wiser to prevent this unpleasant injury from occurring.

  • Gradually increase the load: the number of workouts, the total mileage, and also the intensity. Stick to the rule of 10% increase in training volumes from week to week.
  • Pay attention to the cadence (steps per minute). Increasing cadence to 170-190 steps per minute greatly reduces the risk of injury.
  • Make light workouts really easy and don’t do too many hard runs.
  • Use strength training. Pay special attention to exercises to strengthen the ankle.
  • If possible, consult a specialist regarding your running technique.
  • Use different running surfaces. If possible, run on well-trodden paths in the park or in nature as much as possible.
  • Eat a balanced diet. Try to get enough calcium and vitamin D in the diet. If their deficiency is detected, adjust the diet and take the appropriate mineral complexes and vitamin supplements.

Train regularly, listen to your body and enjoy running!

This article, like many others, was made possible thanks to the support of our readers. The more you support us, the more we can do for the running community.

Other injuries:

  • Inflammation of the periosteum (shin splint)
  • Chondromalacia and runner’s knee
  • Achilles tendinitis
  • Iliotibial tract syndrome
  • Plantar fasciitis
  • Muscle injuries of the hamstrings

More To Read About Injuries:

  • The 7 Most Common Running Injuries (Infographic)
  • Where do running injuries come from?
  • Popular questions and answers about running injuries
  • How to deal with stress when you have a running injury

fracture.. – Healthy and Happy