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What is an Occult Fracture?

Last updated on February 25, 2020 By Dan Baumstark, MSPT, CHT 4 Comments

two women running through park
The word occult according to Webster’s dictionary means “secret or mysterious.” In orthopedics, the word occult aptly describes rare types of fractures that do not show up on x-rays. Occult fractures pose a particular danger to patients who are prescribed exercise or physical therapy as a remedy for pain.

running in marathonAn excellent example of the occult fracture can be seen in women who are avid distance runners. Distance running efficiency heavily favors a narrow pelvis. Most women have the unfortunate disadvantage of having a significantly broader pelvis than do men. A broader pelvis results in an increase in stress on the bones of the hip, knee, and foot. Women who train for marathons place a large amount of force on these bones, and the result can be “stress fracturing” of boney surfaces. A great visual analogy of a stress fracture is a glass windshield of a car that develops fissures from a rock striking it.

The fissuring of bone with an occult fracture is problematic, because if the fracture remains undiagnosed, the patient runs the risk of doing considerably more damage. In short, exercise and running are generally contraindicated with fractures.

If you are having sharp pain in a joint or bone from repetitive stress (running or exercising), stop the activity and see a doctor. If your pain does not respond to conservative management (light stretching, physical therapy, massage), it is worth asking your doctor if a more thorough diagnostic test is in order. MRIs for example show more detail than a typical x-ray does.

The remedy for an occult fracture is removal of weight bearing forces through the bone until healing occurs. Using crutches to de-weight one’s leg for a month or longer is not glamorous, but it is better than the alternative.

Filed Under: Featured, Injury Prevention, Orthopedic Injury



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About Dan Baumstark, MSPT, CHT

Dan is a licensed Physical Therapist in the District of Columbia, license #PT2916. He has a Masters of Science degree in Physical Therapy from Washington University in St. Louis, MO. Dan specializes in sports medicine & upper extremity rehabilitation. He is a Certified Hand Therapist, certified by the American Society of Hand Therapists (initial certification date 11/6/2004, certification #1041100023). Dan has extensive continuing education in manual therapy from the Michigan State University School of Osteopathic Medicine.
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Discussion

  1. BONNIE HOLSTROM says

    August 14, 2017 at 6:31 am

    What should I do about an Occult fracture to my pinkey. The top knuckle down to my wrist hurts and my finger won’t bend closed but crossed.

    Reply
    • Dan Baumstark, MSPT, CHT says

      August 14, 2017 at 2:07 pm

      It probably needs six weeks to heal. I would either buddy tape it to the ring finger or put a brace on it. Once you have the okay from the doc ( I am hoping that you saw a doc about this), you can start with active ranges of motion. Trying to gently open and close the hand WIHOUT the help of the other hand. This can sometimes start as early as 3-4 weeks after the fracture took place.

      Reply
  2. Mary Beth Huey says

    April 17, 2018 at 8:05 pm

    My Dr thiinks I may have a ocultt fracture of my elbow it’s veey painful and burns awful!! She said she thinks we need a MRI!!

    Reply
    • Dan Baumstark, MSPT, CHT says

      April 18, 2018 at 7:56 am

      Take it easy in the mean time Mary Beth. No heavy lifting!

      Reply

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