Stress Fractures

Excerpt

Stress fractures were first reported in military personnel as "march foot" in the mid-19th century. It was seen in military recruits and was diagnosed with foot pain and swelling. Stress or fatigue fractures occur in normal bone when it is subjected to abnormal forces like military training. Julius Wolff (1836-1902) was a German surgeon who proposed bones will remodel and adapt to the loads being placed on them. A stress fracture occurs when the adaptive ability of the bone is unbalanced. Normal bone is constantly being remodeled by osteoclasts absorbing and osteoblasts laying down new bone. During military training, for instance, the body cannot adapt fast enough, so the bone develops microfractures. If the activity persists, the bone eventually develops a fracture. When an abrupt change in physical activity occurs, there is about a 3-week lag before symptoms begin to manifest. It generally starts with pain after activity, and then the pain will last for progressively longer periods of time.