What is the scope of physiotherapy in the treatment of stress fractures?

[SA Physio]

What is our role in the treatment of stress fractures? I have searched the Science Direct database, but could find no info or articles regarding this topic. Any advice or references to articles would be fantastic.
Thanks
Ray

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[physiobob]

Well stress fractures have a number of causes. As physio's we should be able to take a sound history that should in turn highlight factors that might have lead to the development of a stress fracture. This includes issues such as: training regimen, diet, footwear etc. From that we would perform our physical examination: local, biomechanical, functional. Then we would be perhaps assisted with some investigations: isotopic bone scan, MRI etc.

Put it all together and the history and symptoms should lead to the cause which we as the practitioner should be able to resolve. The resolution of a stress fracture is always multi-factorial and even aspects such as pyschology (sports and otherwsie) may well play a part. A dietician should be called in as well if access to one isn't a problem.

Strange question to be honest. Are you still a student?

[SA Physio]

Thanks Physiobob.
I just finished my studies end of 2008 and started working this week, so my experience is limited with orthopedic conditions. This will be my first experience with stress fractures.

I have done some reading up today and found, like you mentioned, that you address any intrinsic factors such as muscle imbalances, muscle length etc as well as extrinsic factors, such as sudden increase in exercise load or changes in training regime etc. There is a wealth of information on stress fractures especially in army recruits. The following article proved useful as well if anyone is interested:

Preventing and managing stress fractures in athletes.Kim Bennell*and Peter Brukner. Physical Therapy in Sport 6 (2005) 171–180.

Thanks again
Ray