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As an avid runner who has been known to log over 120 miles in two weeks and who has been running for over three decades, since the age of 12, I am amazed at how well my feet have withstood the test of time in terms of not sustaining any sort of stress fracture.
Perhaps I am just fortunate enough to have good genetics and solid bone structure, but it did lead me to do a bit of research on the subject. In my mid 40s now, I want to make sure I can continue with my daily runs without incident well into my 90s.
According to the online source “Your Orthopaedic Connection,” a stress fracture is a small crack in the bone. These fractures can develop through overuse due to high-impact activities, such as running or basketball. Most of these fractures occur in the bones that bear the most weight in the lower legs and in the feet. When one is engaged in a high-impact sport, which also includes tennis, track and field, gymnastics, and dance, the repeated stress caused by the foot striking the ground can create problems.
Overuse is the culprit. When muscles become tired, they lose their ability to reduce the shock of repeated impacts. As such, the muscles transfer the stress to the bones, resulting in small cracks or fractures. Stress fractures of the foot are most commonly noted in the second and third metatarsals. They are also common in the heel and in the outer bone of the lower leg, as well as on the bone that rest on top of the midfoot.
When you increase your activity through frequency, duration, or intensity, you are setting things up for the possibility of a stress fracture. Even those who do not engage in physical fitness activities can be at risk. Osteoporosis or other diseases can contribute to weakened bones and resulting fractures. This is referred to as bone insufficiency.
Aside from over-conditioning, athletes who use improper equipment, such as worn or stiff shoes, are at risk for stress fractures. Even going from a treadmill to the uneven pavement of the outdoors for running purposes can contribute to a fracture.
It is advisable to engage in proper training or techniques when involved in high-impact activities. Anything done to alter the mechanics of how the foot absorbs any impact when it hits the ground may increase the risk of a stress fracture. For example, if someone has a bunion or a blister that causes him or her to alter the weight distribution on the foot could be requiring a boney area to handle more weight than usual.
Female athletes who exhibit irregular or perhaps no menstrual cycle at all may have decreased bone density. Studies indicate that female athletes tend to sustain more stress fractures than male athletes. Doctors often call this the “female athletic triad.” This is a three-sided condition that includes irregular menstrual cycles, osteoporosis, and eating disorders When a woman’s bone mass decreases, the odds for getting a stress fracture increase.
Symptoms of a stress fracture include pain that develops over time and increases with any weight-bearing endeavor, diminishing with rest. Sometimes the pain will intensify during normal daily activities. Swelling may present around the ankle or on top of the foot. The foot may be tender to the touch and bruising may be evident.
Upon seeing a doctor, the evaluation may include some imaging tests. Surprisingly, stress fractures are difficult to assess on an x-ray image until they have begun to heal. A bone scan or an MRI are more sensitive than an x-ray and can reveal a stress fracture in the early stages.
If you believe you may have a stress fracture, the first step is to stop the activity in which you are engaged. Then, apply an ice pack and elevate your foot above the level of your heart. Ibuprofen may help to alleviate any pain and swelling, but it can also inhibit the bone’s ability to heal. Avoid putting any weight on your foot until you see your doctor.
Among the treatment options, your doctor may recommend that you rest and take a break from your physical activities. Stress fractures generally take six to eight weeks to heal. It may be suggested to you to wear some protective footwear, such as a stiff-soled shoe, a wooden soled-sandal, or some sort of brace shoe. Stress fractures occurring in the outer side of the foot take much longer to heal, and your doctor may need to apply a cast to keep your bones in a fixed position.
A final option may require surgical intervention in order to allow the bones to properly heal. This involves using pins, screws, or plates that are surgically inserted into the foot to hold the small bones in place to allow for healing.
If you are an athlete and engage in a host of high-impact sports, it is important to note that participating in cross-training endeavors can alleviate the repeated stress on the foot and ankle. Go for a swim or ride a bike….or even take an occasional day off to put your feet up! Your feet just may thank you for it!
(Information for this article was obtained from http://orthoinfo.aaos.org.)
Add a Comment2 Comments
Hi Ann - Thanks for this comprehensive look at stress fractures, especially the information on what causes them and how we can protect ourselves. We seem to get questions about stress fractures after the fact, but your article provides helpful information that we can use to avoid getting them. Thanks!
November 11, 2009 - 5:33pmTake good care,
Pat
This Comment
Thanks, Pat. I am simply grateful that my feet have put up with all of the pounding I do every day with my intensive runs. I plan on running still when I am 100 years old, so I better treat my feet well. Guess I will have to convince my husband that I need more foot rubs, huh?
November 11, 2009 - 7:15pmThis Comment