A stress fracture is a small crack or severe bruising within a bone. Usually stress fractures are caused by overuse and excess stress and over activity. Most commonly found in runners and those who participate in sports that involve a longer period of running. Stress fractures usually occur when high loads are being placed through that particular area. This can be through increasing training loads or a change on training surface or training footwear.
Most often stress fractures occur in the mid foot in the second and third metatarsal. This is because they are much thinner and absorbs the majority of impact when running, jumping or walking. As well as in these areas, a stress fracture can be located in the heel or on the outside of the lower leg.
The most common presentation of a stress fracture in the foot is foot or ankle pain. Pain will gradually worsen during activities and with weight bearing movements.
- Swelling around the top of the foot sometimes associated with bruising
- Pain that eases with rest
- Tenderness to touch of the painful area
- Throbbing type pain
- Pain that is made worse with weight bearing movements
Normally stress fractures occur from a spike in training intensity and volume. Bones need time to adjust and develop in line with the stress we place on them. If the recovery period is not long enough then bones don’t have adequate time to heal which makes them more vulnerable to a stress type fracture.
These risk factors have been said to increase chances of a stress fracture in the foot.
- Poor diet – ensure you maintain healthy balanced diet with all the correct vitamins to promote healthy recovery from exercise
- Sex – women who have abnormal or absent menstrual period may be at higher risk
- Foot problems – people who have flat feet or high arches are more likely to develop a stress fracture over time
- History of stress fractures– previous stress fractures can increase your risk of another
- Increased activity – increase in activity level or a sudden shift in training amount can significantly increase the risk of developing a stress fracture
- Sporting demands – high impact sports such as running, basketball, dance or gymnastics can cause increased risk of stress fracture
- Underlying health conditions – conditions like osteoporosis can weaken your bones and place you at higher risk of a fracture
Prevention and immediate care
Simple steps in the prevention and short-term management:
- Gradually adjust training
- Wear correct footwear
- Cross training, low impact activities as well as high impact
- Ensure you maintain healthy balanced diet
If you suspect you may have a stress fracture you should take the following steps:
You must seek medical attention if you believe you may have stress fracture this is to protect and ensure that the stress fracture doesn’t turn into a complete fracture of the bone.
Until your appointment follow the RICE protocol.
REST – rest the area do not do activities that cause pain
ICE – user cold pack for fifteen minutes at a time maximum every 3-4three to four hours
COMPRESSION – to prevent further swelling apply a soft bandage to the area
ELEVATION – As often as you can sit with the foot raised up higher than your heart