Stress fractures are tiny cracks in bones often caused by overuse or osteoporosis. These injuries can occur in various parts of the skeleton, including the sacral region (the lowest part of the spine), the pubic bone (often resulting in groin pain), and the femoral neck (the upper part of the thighbone, at the hip). A common and significant type of stress fracture in adolescents, especially athletes like gymnasts, is spondylolysis, which involves a stress fracture in the bones of the lower spine.
This condition is the most prevalent cause of structural back pain in children and teenagers. The primary symptom is back pain, but it can also include leg pain, commonly due to hamstring tightness, and muscle spasms. It’s important to note that these symptoms can be mistaken for sciatica, which has similar manifestations. Spondylolysis can also affect the patient’s posture and gait.
With chronic repetitive stress, virtually any bone in the body can break, but it’s more likely in certain bones such as the tibial shaft, the metatarsal shafts, the femur, and the bones of the pelvis. New fractures might not be evident in plain film radiography.
Bone stress injuries (BSI) encompass a spectrum of stress injuries, from mild stress responses like shin splints to full bone stress fractures. Physical stress is crucial for the growth and development of musculoskeletal tissues, and both children and adults become fit by adapting to graduated stresses.
To learn more about spondylolysis and pars fractures, visit HSS. For further information on spondylolysis and spondylolisthesis in pediatric patients, check out HSS. To understand fractures without significant trauma, visit University of Washington Radiology. For more about stress fractures, their prevention, and treatment, see Northwell Health and Mayo Clinic. Information about pediatric spine patient education and spondylolysis/pars defect can be found at Washington University Orthopedics. For details on stress fractures in children and teens, visit Children’s Hospital of Philadelphia. And for patient stories about stress fractures, see HSS Back in the Game.
