A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture. Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface (a tennis player who has switched surfaces from a soft clay court to a hard court); improper equipment (a runner using worn or less flexible shoes); and increased physical stress (a basketball player who has had a substantial increase in playing time). Most stress fractures occur in the weight bearing bones of the lower leg and the foot. More than 50 percent of all stress fractures occur in the lower leg. Pain with activity is the most common complaint with a stress fracture. This pain subsides with rest. It is very important that during the medical examination the doctor evaluates the patient's risk factors for stress fracture.
During year 6 (2005–2006) of the Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin surveillance study, 6,747 isolates were collected at 119 centers. The susceptibility of these isolates to macrolides was compared with data from previous years. Macrolide resistance increased significantly in year 6 (35.3%) from the stable rate of ≈30% for the previous 3 years (p<0.0001). Macrolide resistance increased in all regions of the United States and for all patient age groups.
Sometimes, the stress fracture cannot be seen on regular x-rays or will not show up for several weeks after the pain starts. Occasionally, a computed topography (CT) scan or magnetic resonance imaging (MRI) will be necessary. The most important treatment is rest. Individuals need to rest from the activity that caused the stress fracture, and engage in a pain-free activity during the six to eight weeks it takes most stress fractures to heal .If the activity that caused the stress fracture is resumed too quickly, larger, harder-to-heal stress fractures can develop. Re-injury also could lead to chronic problems where the stress fracture might never heal properly. In addition to rest, shoe inserts or braces may be used to help these injuries heal. Major Research is been done in United States by American Society for Microbiology, National institute of Allergy and Infectious diseases.