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Pelvic Stress Fracture

PelvisA pelvic stress fracture is a hairline type fracture in the large pelvis bone. This is due to repetitive impacts or forces, rather than one sudden impact or accident.

Symptoms of a Pelvic Stress Fracture

Pelvic stress fracture symptoms include tenderness over the inferior pubic ramus at the bottom of the pelvis. Pain is felt in the groin or hip which increases with exercise but eases or gets better with rest. The athlete will experience reduced strength and movement in the pelvic area.

Causes

Pelvic stress fractures occur most often in female runners and military recruits. They are more common in females due to reducing bone density after the age of 30.

Stress fractures of the pelvis occur most frequently in the pubic rami. This is the lowest part of the pelvic girdle, where the hamstring and groin muscles attach. Fractures may also occur at the pubic symphysis - the front joint between the two pelvic bones. These fractures may be due to repetitive muscular forces, or through impact and stress transferred up from the foot.

Treatment

What can the patient do?

  • Rest from activities which cause pain.
  • Try to stay off the feet as much as possible for the first 2 weeks.
  • Apply cold therapy or ice to the painful area to ease pain, swelling and inflammation.
  • Seek medical attention.

What can a sports injury specialist do?

  • Refer for investigations such as X-rays, bone scans or MRI's to confirm the disgnosis.
  • Prescribe anti-inflammatory medication to help ease pain and inflammation.
  • Assess the patient for potential causes of the stress fracture. These may be biomechanical, such as oversupination, or may be factors such as low bone density or amenorrhea.
  • Advise on a gradual return to sport programme after 4-6 weeks, when the bone has fully healed.
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