Stress Reaction and Fractures

Overview

4.9 out of 5 (16 Reviews)

Credits

1.00

Post-Assessment Questions

12

Start Date

1 Sep 2023

Last Review Date

17 Feb 2025

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


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Activity Description

Stress reactions and fractures represent a continuum of bone injuries caused by repetitive submaximal loading. The range of injuries includes periostitis, periosteum inflammation, and full cortical fractures. Common among athletes, particularly runners and those in jumping sports, these injuries often result from sudden increases in training intensity, volume, or changes in training surfaces. The lower extremities are most frequently affected, though upper extremity injuries, eg, in the ulna, occur less often. Stress fractures develop when bone remodeling is disrupted (ie, osteoclasts outpace osteoblasts) either secondary to the repetitive and excessive strain placed on structurally normal bone, specifically loading, exceeding the process of remodeling, or when normal stress is applied to a bone with impaired bone formation, leading to weakened bone integrity. Symptoms typically emerge 3 weeks after activity changes, progressing from postactivity discomfort to persistent pain.

Risk factors include energy deficiency, vitamin D deficiency, the female athlete triad (ie, disordered eating, amenorrhea, and low bone density), and biomechanical issues. Accurate diagnosis involves history, physical exams, and various imaging studies. Treatment varies by injury severity and location. Low-risk fractures often heal with rest, activity modification, and gradual rehabilitation, while high-risk fractures may require surgical intervention to prevent complications like nonunion or displacement. Preventive measures include progressive training adjustments, proper footwear, and addressing underlying nutritional or hormonal deficiencies. Advanced imaging, physical therapy, and gradual return-to-play protocols are integral to recovery, underscoring the importance of early diagnosis and intervention.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, and nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Identify the etiologies of stress reaction and fractures.

  • Differentiate the clinical features of stress reaction injury and fractures.

  • Implement the management approaches for stress reaction and fractures.

  • Apply interprofessional team strategies to improve care coordination and outcomes in patients affected by stress reaction injuries and fractures.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

 

Nurses: StatPearls designates this activity for 1.00 ANCC contact hour(s). Nurses should only claim credit commensurate with the extent of their participation in the activity.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the US Food and Drug Administration. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

Reviews

Don I. on 5/6/2021

Bhupendra G. on 3/24/2022

Peter M. on 12/14/2022

Trang N. on 5/9/2023

edwin g. on 5/25/2023

Sarah S. on 7/31/2023

Randall S. on 8/18/2023

Keaton A. on 9/14/2023

Danial K. on 10/27/2023

Denise W. on 10/28/2023

good vignets

DANIEL F. on 1/1/2024

Chelsea V. on 2/11/2024

Helean Z. on 3/10/2024

I thought this was a great summary but spondylolysis should have been covered to be complete

Erich W. on 6/10/2024

Stephanie K. on 9/6/2024

Dr S. on 3/3/2025

Unlimited Nurse CE

Stay up to date on the latest medical knowledge with 6743 CE activities. In these online self-assessment activities, read our reference articles and test your knowledge with more than 8017 hours of CE.

1 Year Unlimited Nurse CE

Access to all the Unlimited Nurse CE activities in all specialties.

$39.99 per 1 year per user