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 Stress fractures are a common injury and are caused by inappropriate shoe selection, repeated impact on a hard surface, increasing the intensity of an activity too quickly, and overuse. High impact sports such as running, track, gymnastics, and basketball can increase the risk of stress fractures. In all of these sports, the repetitive stress of the foot striking the ground can cause trauma. Women are more likely to develop stress fractures, usually in the lesser metatarsal bones, than men. When symptoms of a stress fracture occur such as swelling and pain, it is important to see a podiatrist.
A stress fracture is a crack in a bone caused by repetitive stress. It may occur in any bone, but is quite common in the metatarsal bones of the foot. Individuals with stress fractures often don't recall a trauma or injury. Symptoms include: sharp pain in the forefoot after some activity - this pain is aggravated by walking, swelling over the forefoot,
and tenderness over the fracture area. Without proper treatment, this
injury may progress to a "through and through" (overt) fracture of the bone. Some stress fractures may not become apparent on
x-ray until a few weeks after the initial injury.
Causes
Causes of stress fractures include:
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Decreased bone density, osteoporosis
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Unusual stress on a bone due to malposition, a forefoot deformity such as a bunion, repeated impact on a hard surface
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Abnormal foot structure or mechanics, such as flat feet
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Increased intensity of activity, especially without proper conditioning
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Obesity
Treatment
If symptoms of a stress fracture occur, it is important to seek professional help from a podiatric physician
as soon as possible. The podiatrist will examine the foot and recommend a treatment plan, which may include physical therapy or use of a plaster cast. The RICE formula should be used immediately upon experiencing symptoms of a stress fracture:
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Rest - keep weight off the injured foot as much as possible. Using crutches will allow movement without placing undue weight on the injury. An air cast or splint may be applied for support.
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Ice - Applying ice to the injury reduces swelling. The usual routine is to apply ice packs for 20 minutes at a time every hour or so for the first day after the injury, and thereafter as long as swelling persists. Place ice in a plastic bag, wrap the plastic bag in a lightweight towel, and apply to the area of swelling; do not place ice directly against skin.
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Compression - Compression means supporting the ankle and foot with a firmly wrapped elastic bandage, compression stocking or gel wrap. If swelling causes the bandage to become tight, it should be loosened immediately. Do not wrap the injured area too tightly.
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Elevation - Elevating the foot above the level of the heart minimizes blood pooling and swelling in the affected area. This should be done as much as possible during the first 48 hours after the injury.
Wear a shoe with a very stiff sole.
Rest from the activity that caused the stress fracture; stress fractures will likely heal within six to eight weeks.
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