What is Hairline Fractures?

Hairline fractures, also called as stress fractures, are now slowly becoming an infamous dilemma in the area of sports medicine. Caused by application of repetitive strain and excessive training, hairline fractures are minute cracks on the bones, which can become severe if not immediately treated. Basically, this injury is caused by the depressed response of the bone with the ground-reaction forces that are applied to the bones during activities like jumping, running, or walking. Despite that bones have the ability to bend a little if stress and strain is applied to them, they can also develop small cracks once they are being overused.

4 Symptoms of a Hairline Fracture

Hairline fractures or stress fractures are not easily detected or felt as compared to other types of fractures. Patients may sometimes feel tenderness at the affected area coupled with some swelling. These symptoms are further amplified during activities and will reduce with rest. Hairline fractures are actually tiny cracks in a bone resulting from overuse and are frequently observed in places where repetitive loads are encountered such as the ankle. Hairline fractures often occur during high impact sports and a few factors can influence it such as the duration of exercise, frequency of exercise as well as the intensity of it. However, patients who do not participate in sports can also experience hairline fractures due to weak bones in their body. Bone diseases or osteoporosis causes a loss in bone density and places one to be more susceptible to stress fractures. In this article, we will further explore some symptoms of a hairline fracture.

Gradual pain

Pain develops gradually in patients suffering from stress fractures. As mentioned above, the pain is only present during instances of weight bearing and will go away at rest. It is different from an ankle sprain whereby pain is present throughout. In some patients with higher pain tolerances, they may not be able to feel this pain as the endorphins produced during activities can mask it, misleading the patients and result in more serious consequences.

Localised swelling

During injuries, our body’s immune system will kick in. Chemical signals are released by the brain to widen capillaries which will result in increased blood flow to the injured area. The white blood cells will then fight against any infection present. This increase in fluid causes swelling which is visible on the outside and can be relieved through the use of ice packs or anti-inflammatory medication.

Reduced pain when at rest

Another common symptom is the immediate reduction of pain experienced when at rest. This would mean that the injury sustained is not involving any muscle groups nor is it a major fracture. Patients suffering from hairline fractures will get immediate relief when they stop whatever activities they are doing.

Constant pain after continuous trauma

When patients ignore the advices of doctors to rest and choose to continue playing, their condition can worsen and there is a high risk that the stress fracture has already evolved into a complete fracture. Pain can be felt throughout even when the patient is at rest.

It only takes about 6 to 8 weeks for a hairline fracture to heal whereas a complete fracture takes around 6 months to heal. It is up to you whether you wish to sacrifice at most 2 months of your time to heal it completely or risk being out of the sport forever.

Hairline Fractures and Their Causes

Hairline fractures (Stress Fractures) are caused by repetitive forces acting on the bones usually in places such as the foot and lower limb. Due to an imbalance between the resorption and growth of new bone tissues and cells, bones are unable to regenerate and timely replacement cannot happen. Due to this fatigue, micro cracks in the form of hairline fractures are ultimately formed. What are some causes of Hairline Fractures?

High impact sports

High impact sports such as soccer, basketball and rugby are at a higher risk of developing stress fractures. This is due to the stressful nature of the game and the forces involved. The 3 sports require constant jumping and running throughout the duration of the game. Over time, fatigue will kick in due to insufficient rest and micro cracks will happen as a result.

Increase in intensity of activities

Fractures can happen to people who have a sudden change in the intensity of their activities. For someone who is used to sitting in the office for prolonged periods of time, a change in lifestyle can lead to a rapid increase in intensity of activities and cause hairline fractures. This is especially so in people who are trying to lose weight or increase muscle mass. A sudden increase in physical activities will place tremendous pressure on the body and lead to a higher risk of injury.


Menopause in women will result in the thinning of bones and studies have concluded that an average woman loses 10% of her bone mass within the first 5 years. Menopause will cause a drop in oestrogen levels which is responsible for maintaining bone strength in women. Due to this decrease in bone mass, it is at a higher risk of fractures, especially stress fractures.

Ballet dancers

Ballet dancers are often required to be using the ball of their foot and this adds a lot of stress to the bones there as the entire body weight is acting on this. Coupled with requirements to turn and jump around, the intensity is amplified, placing the foot to be at an extremely high risk of hairline fractures.

Causes of hairline fractures are plenty and they are quite painful. However, due to their tiny nature, they often heal themselves within a few months if proper care is administered. They can be caused by daily routines as well as sports. Be mindful of restraining yourself from strenuous activities when you are a patient of hairline fractures and you will soon be on your way to pre-injury status.

What are the Treatment for Hairline Fractures?

The main treatment for hairline fractures is refraining from doing activities that can aggravate the injury for approximately one month and half. Once the bone has been healed of its minute cracks, the person can start resuming his normal activities gradually. In cases when extreme pain is experienced, the affected area must be put at rest and must be immobilized by casting or bracing. Shoe inserts like supportive orthotics and walking crutches can also be recommended but only when the patient’s normal movements are already affected.

Use of analgesics is also prescribed when the pain is unbearable. People who have hairline fractures can better visit physical therapists so that they could be advised with strengthening exercises that are non-weight bearing like swimming. Fortunately, hairline fractures rarely need surgery because they can be easily mended with just two weeks of rest. However, the injury can still worsen if the fractures are not given appropriate medical attention.

Dos and Don’ts when recovering from Hairline Fracture

Only those who have experienced fracture will know the immense pain when the fracture first occurred. The immediate onset of pain followed by several limitations that will cause us to alter our activities to accommodate to the inconvenience caused. After everything is over, it’s time to start the recovery process. Recovery from a hairline fracture is a spontaneous process that does not require any external energy to kick start it. However, there are some Dos and Don’ts which should be observed to expedite the healing process and prevent reoccurrence.

Partake high energy food

Although healing is a spontaneous process, prompt and fast healing will require extra energy input. The daily caloric intake needs to be increased to promote healing. Metabolic demands of the body increases drastically. An adult will require around 2500 calories daily while a patient suffering from fracture will need about 6000 calories! So start eating more food that is packed with energy.

Increase protein intake

Our bone is like a rigid sponge that is filled with a protein matrix embedded with calcium reinforcements. Half of the bone is made up of protein and protein is the building block of our body. During a fracture, the structure is compromised and the body will start to synthesis a new protein matrix. As a result, it will require tremendous amount of protein. An increase in protein intake will also result in an increase of growth factors such as insulin that will increase muscle strength and promote bone renewal. If protein levels are insufficient, the healing process will be compromised and delayed.

Increase antioxidants intake

Antioxidants are great against free radicals such as oxygen. During a bone fracture, the damaged tissues generate a huge amount of free radicals that will attack the collagen in the body. These free radicals will cause inflammation and lead to an even further damage on the collagen structure. Antioxidants will neutralise these free radicals and promote healing.

Do not exert force on the fractured area

The fracture region is already very weak and further exertion of weight can cause the fracture to get worse. Imagine a piece of glass that is shattered. If you place something heavy on the crack lines, you will notice it spreading out. This applies the same to a fracture. If you really need to move around, use crutches or a walker to help you along.

Although a hairline fracture is not as serious as a full fledge fracture, it still poses a huge risk to the patient. Any further aggravation will cause the injury to worsen and lead to undesirable consequences. Always remember to get plenty of rest and consume foods that are high in calcium, essential minerals and protein.

At the Singapore Sports and Orthopaedic Clinic, our orthopaedic specialists are ready to help you get back to the activities you know and love. Call us today for an appointment @ +65 9734 3087 to get a professional assessment of your condition & start your journey toward a better life!