Conditions + Treatments

Stress Fractures in Children

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"We advise kids not to specialize in just one sport. Multi-sport athletes tend not to get as many stress fractures and other kinds of overuse injuries. And for practicing, we advise kids and coaches to alternate exercises and vary drills. In the long term, your muscle memory is better if you change up your practice exercises."

Orthopedic Team, Boston Children's Hospital, Orthopedic Center

If your teen or child has been diagnosed with a stress fracture, we at Children’s Hospital Boston know that she’s experiencing discomfort, as well as some disappointment that her sports training has been disrupted. We’ll approach your child’s treatment with sensitivity and support—to get her back into sports safely.

About stress fractures

With more and more kids playing organized sports and specializing early, there’s been a rise in the number of overuse injuries among children and teens. As a common overuse injury, stress fractures occur largely among runners and other athletes whose sports involve high-impact contact of the foot with the ground or floor—say, basketball and tennis players, track and field athletes, gymnasts, runners and dancers. At Children’s, our patients with stress fractures are usually teenagers or post-adolescents, since this is the age group that’s most likely to run and train competitively.

  • Stress fractures and other overuse injuries are sports-related microtraumas (small injuries) that result from repetitively using the same parts of the body.
  • A stress fracture results when fatigued muscles can’t absorb the shock (stress) of impact and transfer the stress load to a bone.
  • Most stress fractures occur in the weight-bearing bones of the foot or lower leg; over half occur in the lower leg—but can also occur to the hip (femoral neck).
  • Signs and symptoms of stress fractures—pain and inflammation—can resemble those of shin splints—so a proper diagnosis is important.
  • The risk of stress fractures increases if a runner:
    • has flat feet (fallen arches), which unevenly distribute the stress from impact
    • trains too hard before being properly conditioned

Stress fractures can often be prevented with:

  • proper conditioning and training (especially cross-training)
  • sport-appropriate equipment and protective gear
  • adequate rest between exercise sessions
  • a calcium- and vitamin D-rich diet (especially for teenage girls)
    • While boys and girls are equally vulnerable to stress fractures, adolescent female athletes experience these more often than boys (see more on this in In-Depth)

Children’s Hospital Boston’s approach to stress fractures and overuse injuries

You can have peace of mind knowing that the team in Children’s Orthopedic Center has treated thousands of children, adolescents, adults and professional athletes with injuries ranging from the minor to the highly complex. We can provide your child with expert diagnosis, treatment and care—as well as the benefits of some of the most advanced clinical and scientific research in the world.

Sports Medicine at Children’s has provided care to thousands of young athletes and is the health care choice of professional athletes and world-renowned dancers. We are the official orthopedic caregivers for the internationally famous Boston Marathon and the renowned Boston Ballet.

Children’s orthopedic team  provides comprehensive assessment, treatment and follow-up care to children, adolescents and young adults who have sports-related orthopedic injuries. Our skilled orthopedists and sports medicine experts work with physical therapy staff to develop long-term treatment and activity plans. Our team has also developed innovative evaluation programs and effective injury prevention programs and strategies.

Our orthopedic staff includes 24 orthopedic surgeons, 10 primary care sports medicine specialists, two podiatrists, a nutritionist, a sports psychologist, eight physician assistants, 14 nurses and four certified athletic trainers. In addition to our busy practice in Boston, Children's physicians see hundreds of patients every week at our locations in Lexington, Weymouth, Peabody and Waltham. Our surgeons perform an average of 5,000 procedures each year.

Children’s Orthopedic Center: Ranked With The Highest

As one of the first comprehensive, multidisciplinary programs, Children’s Orthopedic Centeris the nation’s largest and most experienced pediatric orthopedic surgery center, performing more than 5,000 surgical procedures each year. Our program—consistently ranked among the top three by U.S.News & World Report—is the preeminent care center for children and young adults with congenital, neuromuscular, developmental and post-traumatic musculoskeletal problems.


Stress fractures: Reviewed by Yi-Meng Yen, MD, PhD
© Children’s Hospital Boston; posted in 2012


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