What is a Stress Fracture?

A stress fracture is an incomplete fracture of bone caused by repetitive stress.  It is found within a weight bearing bone, such as the bones within the foot. A stress fracture has also been termed a “hairline fracture”. Symptoms of a stress fracture include tenderness in the area and pain with weight bearing.

Stress fractures commonly occur in athletes that play sports requiring excessive running.  They also occur in sedentary people who begin to exercise.  This happens because their body is not used to exercise; therefore, it is overwhelmed by the repetitive weight bearing forces.  Stress fractures can occur from muscle fatigue.  Our muscles help to provide stability, support, and shock absorption for our bones.  If these muscles become fatigued, our muscles ability to perform the role of shock absorption decreases.  This causes increased risk for a possible fracture. 

After a stress fracture, rehabilitation consists of decreasing weight bearing on the fractured bone to allow it to heal.  After the bone heals, physical therapy is often recommended to strengthen the muscles surrounding the injured bone to return the patient back to all daily activities and to prevent re-injury.

Types of Medications Commonly Taken by Patients

Pain Medication

Some examples of pain medication are oxycodone, motrin, and codeine.  When you experience pain, the nerves in the body send a signal to the brain so you perceive pain.  Pain medications decrease pain by slowing down or blocking the pain signal to your brain.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

The most common NSAID is aspirin.  Prostagladins are synthesized by cyclooxygenase to cause inflammation.  By taking a NSAID, it inhibits cyclooxgenase.  This prevents this cycle from taking place, causing decreased pain/inflammation.  There are COX1 and COX2 enzymes and aspirin inhibits both.  COX1 enzymes help to protect the stomach and kidney lining.  Therefore, a side effect to taking aspirin is gastric damage and decreased renal function.

Muscle Relaxants

Examples of muscle relaxants are baclofen, flexeril, and skelaxin. Muscle relaxants are used to treat muscle spasm and spasticity.  They are used to decrease muscle excitability by acting on the spinal cord or directly within the muscle fiber. Muscle relaxants increase the activity of GABA (gamma aminobutyric acid) receptors, which inhibit excitatory neurons. This causes the skeletal muscle to receive fewer signals and relax.

All the above medications are commonly taken while receiving physical therapy.  They help the patient to progress through physical therapy by alleviating pain, inflammation, and muscle spasm.  These medications should be regulated by a physician to insure proper dosage and duration of usage.

What is Electrical Stimulation?

Electrical stimulation is a treatment modality used by physical therapists to help relieve pain.  Electrical stimulation uses a low voltage electrical current to stimulate nerves and sends signals to the brain that block or interrupt normal pain signals. It can be used for muscle pain, joint pain, tendonitis and bursitis.

Another use for electrical stimulation is to strengthen muscles. This type of stimulation is called NMES (Neuromuscular Electrical Stimulation). When there is muscle weakness (atrophy), electrical stimulation is used to elicit a contraction of the muscle. The electrical impulses work to retrain muscles to function normally. This is most commonly used after ACL surgery and a stroke.

Electrical Stimulation