A stress fracture is a crack in a bone, or in certain cases, bruising within the bone. The bones of the human body are constantly undergoing change, based on the workload that is placed on them. As with any other type of cell in the body, bone undergoes a process of remodeling – replacing old bone with new. Stress fractures most often develop as the result of overuse, where the bone’s capacity for rebuilding is exceeded by an increase in damage from a new activity or overall change in activity level.
Stress fractures are most common in the bones of the lower, weight bearing parts of the body: the feet, ankles, legs and pelvis. These are the parts of the body subjected to the greatest stress from running, walking, jumping and even accidental falls. They usually start as small fissures with low-to-moderate pain, which escalates as the damage increases.
A great percentage of stress fractures are seen in athletes, who tend to undergo repetitive stress as part of their training and are more prone to overuse injuries. This is true of all types of disciplines, including individual and team sports. Even healthy athletes can become more susceptible to experiencing stress fractures with abrupt changes to their training regimen.
These can include:
- Changes in intensity, volume or variation in movement
- Change in footwear
- Change in the type of training surface (asphalt, trails, clay, etc.)
- Stress fractures are also common among military recruits because of the sudden increase in activity levels associated with rigorous training and boot camp conditions.
What Causes Stress Fractures?
As described above, most stress fractures are the direct result of overuse, where stress on a bone causes damage that outpaces the body’s natural healing response.
A stress fracture can also occur as a result of osteoporosis, a bone disease in which an individual loses bone density, making the skeletal structure weaker over time.
Stress fractures can also develop as a result of a change to the structural integrity of the foot and ankle. This can occur when there is an issue of deformity (such as bunions) or neuropathy, as in Charcot foot.
Using a new pair of shoes that reduce your ability to absorb repetitive forces can cause a stress fracture to develop. Such shoes cannot absorb shock, instead transferring the stress to the anatomy of the foot.
What Does a Stress Fracture Feel Like?
The symptoms cost commonly associated with stress fractures of the foot include:
- Pain that occurs when carrying out your normal daily activities but decreases when you rest
- Pain in certain foot positions (rotation, flexion, extension)
- Tenderness when pressure is applied to the area
- Swelling in the foot or ankle
- Localized bruising
- Pain that starts within 1-2 weeks of taking on a new sport or activity, or a change in training intensity
Treatment for Stress Fractures
If you suspect that you have suffered a stress fracture, you should promptly see a podiatrist. These foot specialists are uniquely trained to diagnose problems of the foot and ankle, protecting your mobility and aiding you in returning to normal function.
As you await you podiatry appointment, you can try the following conservative treatments to reduce pain and inflammation symptoms:
- Apply R.I.C.E. – Rest, Ice, Compression and Elevation
- Use non-steroidal anti-inflammatory drugs (NSAIDs), such as Naproxen or ibuprofen to reduce the pain and swelling in the affected area.
- Reduce or avoid weight-bearing activities that caused the stress fracture until healing has occurred
- Use a walking boot, firm and supportive shoes, or a brace designed to relieve stress on the affected area
A podiatrist will be able to guide you toward the appropriate treatment for optimal recovery. Surgery is not usually necessary, unless your fracture is deemed to require internal fixation, or there are other complications such as bone cell death or enchondromatosis.
At Houston Foot and Ankle Care, we remind all patients that it is not normal to live in pain. Many patients will tolerate pain in the ankle or foot for long periods of time, allowing underlying conditions to progress to the point where treatment becomes more difficult and complex. Don’t allow an underlying condition or deformity to cause stress fractures or other serious problems that will impair your mobility. If you feel that localized pain and tenderness in the foot is severely limiting your ability to perform normal daily activities, call (713) 541-3199 to schedule an appointment with Houston podiatrist Gabriel Maislos, DPM, FACFAS. We accept most major forms of medical insurance.
Call (713) 541-3199 if you experience:
- sudden pain related to increase in activity or training levels
- swelling of the affected area
- bruising at the site of injury