What are the signs and symptoms of a lower extremity stress fracture?
Athletes with stress fractures tend to complain of an acute onset of pain most often after a long training session. The athlete will not have a history of a single mechanism of injury, but will complain of a more gradual onset of pain over time. The athlete may complain of point tenderness directly over the stress fracture site. The pain may diminish with rest, but will return with activity. The pain may increase as the activity level increases but especially on weight-bearing activities (jogging, running, jumping, and landing). One symptom that is unique to stress fractures is that the athlete may experience an “aching” or “throbbing” pain late at night when the athlete has quieted down for the day. The athlete may also experience swelling over the fracture site with associated heat radiating from the area due to the amount of biochemical activity in the area. The heat can be detected by running the back of the hand over the length of the tibia or fibula. If there is a hot spot and it
