The Center for Podiatric Care and Sports Medicine

Overuse Injuries in Youth: Is Your Child Athlete at Risk for Stress Fractures?

Posted by on Tuesday, October 7th, 2014


Dr. Josef Geldwert is Board Certified in Foot and Ankle Surgery and was the academic coordinator for the residency program at Beth Israel Hospital. He’s currently serving as the team podiatrist for the NY Lizards and has served as a consultant for the NY Liberty (WNBA), NY Magic (W-League), and Central Park Track Club. He sees patients of all ages, primarily for sports injuries. One of his biggest concerns, he says, are the younger patients with overuse injuries. Unfortunately, the number of “trophy kid athletes” is on the rise in New York City. In today’s post, find out if your child is at risk. 

stress fractures in children
Dr. Geldwert explains risk factors, symptoms, and treatment of stress fractures in children.

Which kids are at risk for stress fractures?

Stress fractures are hairline breaks in the bone due to overuse and repetitive motion. Doctors may categorize the fracture as “low-risk” if it is in the upper body — like the ribs or arm bone — or “high-risk” if it is in the thigh bone, foot, knee cap, or spine. It is particularly concerning if the fracture occurs where two bones meet at a growth plate although long-term disturbances to growth and development are relatively rare.

Children may be at risk if they:

– Participate in running, basketball, swimming, gymnastics, soccer, dance, or tennis

– They play the same sport all year round

They drink a lot of sugary sodas instead of milk

– They are overweight

– They are female

– They do not participate in bone-strengthening exercises

– They train for more hours per week than the number of years old they are

How can you tell a stress fracture apart from more benign injuries?

The #1 symptom of a stress fracture is pain. Usually, it’s a gradual pain, which is in stark contrast to acute injuries that happen suddenly on the field or court. The pain is deep and localized — usually worsening with activity and diminishing with rest. It is a misconception that one will be “unable to walk” with a stress fracture. Our patients are typically able to walk, as the nerves and muscles affecting motion remain unaffected by the hairline crack in the bone. More often than not, what begins as a nagging ache or simple discomfort (like a pulled muscle) progresses to intolerable pain and the inability to bear weight. The affected bone is often painful to the touch. Mild swelling, bruising and redness may or may not accompany the pain.

The only way to know for sure is to see a doctor for a professional diagnosis. In addition to a general exam, your child may need an x-ray to look for a break in the bone, an MRI scan to assess swelling and inflammation, or a bone scan to look for fine fractures that may not show up in a standard x-ray. Stress fractures typically do not show up on x-ray until at least two weeks after symptoms begin.

Looking for stress fracture prevention or treatment programs in NYC?

Treatment may last a month or two — quicker if your child is diagnosed and seen right away. Dr. Geldwert practices at The Center for Podiatric and Sports Medicine in NYC. Once diagnosed by our trained clinicians, stress fractures may be treated with walking boots, casts, braces, and physical therapy. We understand how difficult it can be for young people to “take it easy,” so we cover the emotional aspects of recovery and offer insightful suggestions to help your child recover as effectively as possible. We like to have kids swim, row, or participate in some other types of low-stress activity during recovery, whenever possible. Emphasis is added to employing training techniques to prevent future sports injuries and eating an adequate amount of calories, proteins, carbs, fats, calcium, and vitamin D. We help parents manage overtraining concerns and learn how to strike a better balance of activities. Book your child’s appointment in Manhattan or Westchester here.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.