stress Fracture: Everything you need to know

What is a stress fracture?

Unlike a fracture caused by an obvious injury, a stress fracture involves a small crack in the bone as a result of the amount of stress put on a particular bone of the foot exceeding the body’s ability to adapt to it.  All weight-bearing bones of the foot can be prone to a stress fracture, however this injury is most commonly seen at the metatarsals.

What causes a stress fracture?

• Sudden increase in activity (frequency, duration, or intensity)
• Repetitive stress (i.e. sports / running)
• Decreased bone strength/density of the foot secondary to other conditions (i.e. osteoporosis)
• Uneven distribution of foot pressures
• Improper footwear

Most commonly affected gender:

Studies show that females are more prone to stress fractures in comparison to their male counterparts. This may, in part, be due to the “female athlete triad” which states that when a women participates in sports, she may be more prone to 3 illnesses: eating disorders, decreased bone mineral density, and dysfunction of the menstrual cycle. As a female’s bone mass decreases, the chances of getting a stress fracture increases.

Symptoms:

• Significant pain with activity
• Swelling with possible bruising
• Tender to touch site of fracture
• Difficulty wearing shoes
• Although some stress fractures present with many of these symptoms, certain cases may have no signs other than slight swelling of the fractured area.

When to visit a foot specialist:

If any of the following symptoms above are present, seek treatment, as a fracture that fails to heal (non-union) or heal properly (malunion) may require surgical intervention.

What Can I Expect During The Visit

• Thorough discussion of your medical history, general health, work, activities, diet, and medications to identify risk factors that you have for a stress fracture.
• Physical examination of the lower limbs
• Padding / Taping techniques
• Footwear modification / immobilization techniques
• Medication to ease pain and inflammation
• Treatment using therapeutic modalities
• Custom made orthotics
• Advice on surgical correction (if needed).

 
Recovery

Recovery ultimately depends on the severity of the fracture, however most stress fractures heal within 6-8 weeks. One of the most common mistakes people make is returning to activity too soon. Being sidelined with an injury can definitely be frustrating, but returning to activity too soon puts you at risk for larger, harder to heal stress fractures that can taken even longer to heal. It is important to confirm with your foot specialist that full healing has occurred before returning to activity. Slowly increase the intensity, duration and frequency of the activity with lots of rest in between to give your bone time to adapt to the new demands placed on it.
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Prevention

• Eating a healthy balanced diet that is rich vitamin D and calcium to increase bone strength
• Avoiding shoes that are worn out and/or do not match your foot type. Stiffer outer soles with softer insoles are two key features to look for in shoes if you have a history of stress fractures.
• Avoid sudden increase in activity.
• Alternate between high and low impact activities to avoid overstressing one area of the body. For example, running one day followed by cross-training the next day (i.e. swimming).

 
Have you ever experienced a stress fracture? Let us know of your rehab process in comments section! Think you have a stress fracture? Call our office today!

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