Femoral Neck Stress Fracture

author : AMSSM
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Member Question

I have a femoral neck stress fracture and have been sitting for six weeks.  I am also aching/stinging in my hip but I have no idea if it is related to the stress fracture. My doctor had said that If I am not better in two more weeks that he may look into a rehab facility - I have never heard of that.

He also said he did not want to give me another MRI because it will not show much improvement, how am i suppose to know if I am healed? I do not know if this pain is related or just muscular.

Any help would be greatly appreciated.

Answer by Stephen T. Yip, DO
Member AMSSM

Femoral neck stress fractures most commonly happen to runners and soccer players who overuse their hip or suddenly increase their training intensity.  The injury occurs due to repetitive stress from activities like running.  When repetitive stress is placed on the femoral neck, microscopic fractures can develop.  If time for healing is not given and further repetitive loading occurs, then the microscopic fractures become a stress fracture.

The femoral neck is the insertion point for some of the major muscles that provide essential motion to the hip including the iliopsoas, piriformis, quadratus femoris, and gluteus medius.

Depending on the fracture location, muscles that insert to the bone may become irritated and inflamed which may cause aching and stinging.  In some cases, the stress fracture may occur at a location that doesn’t get great blood supply.  This may lead to prolonged and sometimes inadequate healing and necrosis of the femoral neck which causes more aching and stinging and may require surgical repair.  

Non-weight bearing is the typical treatment for femoral neck stress fractures. Typically, this takes six weeks.  With these types of stress fractures, it is imperative that non-weight bearing occurs throughout the healing process.  If the fracture is severe or in a location with poor blood supply, then surgery may be required to ensure proper healing.  When the bone is fully healed, athletes are able to weight bear without pain.  They then have to go through rehab to regain strength, stamina, flexibility, and proprioception in the hip and leg.

If you have religiously adhered to non-weight bearing for the past six weeks and are continuing to experience pain with weight bearing, it is likely time to get a follow-up MRI to determine if it is ok to continue conservative management, i.e. non-weight bearing, or if surgery is indicated.  Also, I often think of other reasons why bone hasn’t healed in the expected six week timeframe.  Things like osteoporosis or inadequate caloric intake can make fractures occur more easily and prolong bone healing. Seek advice from your medical provider to see if you suffer from osteoporosis or poor nutrition.

To prevent femoral neck fractures and other overuse injuries, it’s imperative to start easy and slowly increase intensity of training. Avoid overtraining by listening to your body. If something hurts, please get it examined to determine if further training will make the injury worse. And always, make sure to maintain a healthy weight with adequate caloric intake to cover your caloric output and to hasten recovery.

Hope this helps! 

Sincerely,

Stephen T. Yip, DO
OHSU Family Medicine

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date: October 30, 2013

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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avatarAMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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