By Dr. Cory A. Messerschmidt
Beaufort Memorial Orthopaedic Specialists
You know you have a good workout because you feel it. But what if that muscle soreness isn’t actually muscle soreness, but something more serious?
A stress fracture is a small crack in a bone that can feel a lot like muscle soreness but requires very different treatment.
Treating a fracture like a sore muscle can make things much worse. Getting it checked out early helps you start on the road to recovery as soon as possible.
If you’re hurting after exercise or daily life, here’s how to tell whether it’s just soreness or if you broke a bone.
Overuse injuries
Anytime you exercise, you cause your bones and muscles to experience microtrauma. Rest helps your body recover from these tiny injuries. If you don’t get rest, these tiny bits of trauma build up until you have an overuse injury. Muscle soreness and stress fractures can both be overuse injuries.
When you begin working out more often, for longer periods of time or with greater intensity, you increase the risk of stress fractures and other overuse injuries.
Other reasons your muscles may ache include:
- Chronic health conditions, such as lupus or fibromyalgia;
- Infections, such as Lyme disease or the flu;
- Injury or trauma.
Put simply, sore muscles hurt. The pain often appears during exercise or immediately afterward. In some cases, it can kick in 24 hours later. When it takes this long to feel the pain, it’s known as delayed onset muscle soreness (DOMS).
Whether you have DOMS or other muscle soreness, you may feel pain in more than one place. That’s because when you exercise, you work multiple muscles and joints at the same time. So, your legs, back and shoulders may all hurt, especially if it’s been a while since you exercised.
Wherever your soreness settles, it may cause the following:
- Difficulty moving the affected limb.
- Pain.
- Stiffness.
Managing sore muscles
Usually, muscle soreness lessens with each passing day and goes away after a few days. DOMS, however, can last up to a week, according to the National Academy of Sports Medicine.
To manage the pain, you can take a few simple steps.
- Get a massage — A gentle massage can help ease muscle aches brought on by overuse.
- Rest — Avoid using the hurting limb to give it time to recover.
- Take medicine — Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help relieve pain.
- Use ice and heat — When soreness starts, apply ice to the injured body part. This helps reduce swelling, pain and inflammation. After a couple of days, apply heat to your aching limb. It can feel good and speed up the healing process.
If these steps don’t help, you have severe pain or your pain doesn’t improve after a few days, contact your healthcare provider. It may be a stress fracture or other issue.
Stress fracture risk factors
Anyone can break a bone, but certain factors increase the likelihood that you’ll develop a stress fracture.
These include:
- Previous injury — A stress fracture in the past increases the likelihood of one in the future.
- Race — White people have weaker bones and lower bone density, which leads to more fractures.
- Sex — Females are more vulnerable to stress fractures. The risk is highest among female athletes who participate in gymnastics, cross country and track, according to the American Academy of Orthopaedic Surgeons. You’re also at higher risk if you don’t eat enough calories and have menstrual dysfunction and impaired bone health, a combination called the female athlete triad.
Stress Fracture Symptoms
Symptoms of a stress fracture include:
- Bruising in the area surrounding the fracture;
- Pain concentrated in the affected area that comes on during activity and goes away with rest;
- Swelling in and around the injured area;
- Tenderness around the damaged bone.
Anytime you suspect a bone fracture, contact your care provider and take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and swelling. You can also ease your symptoms with the RICE method: resting, icing, compressing and elevating the injured bone.
At your medical appointment, your care provider will ask about your symptoms and health history. Then, your care provider will examine the injured area, applying light pressure.
If this pressure causes focused pain, it’s often a fracture, and additional tests can then confirm the diagnosis.
Imaging services that help diagnose a stress fracture include bone scans, MRIs and X-rays.
Within six to eight weeks, your stress fracture should heal fully. Before returning to physical activity, get cleared by your orthopedic surgeon. Returning before your stress fracture heals or ignoring the problem will make your recovery take longer. It can also make your injury worse and cause long-term complications. Your minor stress fracture may turn into a full break, which requires additional surgery.
Fellowship-trained in sports medicine, Cory A. Messerschmidt, M.D., FAAOS, is a board-certified orthopedic surgeon with Beaufort Memorial Orthopaedic Specialists who sees patients at the practice in Port Royal and Okatie.
