Stress Fractures
If you play competitive sports, do intensive exercise on a regular basis, or have a physically demanding job, you might be prone to a stress fracture.
While they often start as a dull ache, they can become quite painful over time if they are left untreated, which can start to impact your movement and ability to perform day-to-day activities.
Here is how to recognise that you might have a stress fracture and what you should do.
What is a Stress Fracture?
Stress fractures are very small cracks in your bone that gradually develop as a result of repetitive activity or overuse – which congruently impacts its ability to heal.
Often referred to as microfractures, they are most common in professional athletes or people who participate in ball sports like football, rugby, and cricket or track events like long and short-distance running.
Stress fractures are distinct from regular fractures, which occur unexpectedly and instantaneously from a single incident, often a bad fall, sporting injury, or car accident.
Typically, they happen when the bone experiences a force it is unable to withstand and causes it to crack or break.
By contrast, stress fractures cannot be linked to a specific incident but happen as a result of certain body parts, such as your feet and lower limbs, repeatedly being exposed to a stressful impact or force.
The most common locations for stress fractures are your metatarsal shaft and head and sesamoid bones. However, they can also occur in your navicular, 5th metatarsal shaft and base, and calcaneus (aka heel bone).
Causes of Stress Fracture
Stress fractures can occur for several reasons. However, the most common tend to be as follows:
Abnormal and excessive stress from activities like jumping, running, and dancing that result in your feet bearing a lot of weight.
Sudden increase in the intensity or length of time of sporting or exercise activities.
Repeated landing or training on hard surfaces, particularly from high up.
Poor footwear that lacks shock absorption.
People who have calcium and vitamin D deficiencies, which reduce the strength of their bones.
Suffering from conditions that lessen bone density, such as osteoporosis.
Having weak muscles in your feet and lower legs.
Increased loading on your bones due to poor mobility and motion in joints.
Taking prescription medications that lower bone density.
Symptoms of Stress Fracture
If you are experiencing pain in your ankle or heel when you exercise, but it wears off when you rest, there is a good chance you might have a stress fracture.
Initially, this might register as a dull ache. However, it might gradually worsen over time if you do not rest your feet and refrain from physical activity.
Other symptoms that might indicate you have a stress fracture include:
Localised tenderness or swelling around the painful bone.
Pain worsens if you put weight on the affected area or engage in high-impact activities such as jumping, hopping, or running.
You feel pain at night, even if you are trying to rest or sleep.
In many cases of stress fracture, the sufferer ignores early warning signs of pain until such time as it increases to a point where they experience intense discomfort.
Diagnosing a Stress Fracture
At Gold Coast Foot Centres, we diagnose stress fractures by performing a thorough history and physical examination of the affected area.
When doing this, we also factor in your symptoms and the length of time that has elapsed since you first noticed the issue.
To confirm you have a stress fracture, we may require you to have an X-ray imaging Ultrasound or an MRI.
Treatment Options for Stress Fractures
Should you have a stress fracture, we would recommend a rehabilitative treatment plan to heal your injury as quickly as possible. Time is of the essence because the quicker this process can start, the less recovery time you will need.
Often, stress fractures occur as a result of several different factors. So, there is no one-size-fits-all solution.
Subsequently, your recommended treatment plan will be personalised to your individual situation to ensure that you can return to playing sports, exercising, or doing your job as quickly as possible.
As most stress fractures are treated non-surgically, yours could involve one or more of the following:
Ceasing aggravating activity
Getting plenty of rest, elevating your foot and applying ice to it as necessary.
Taking anti-inflammatory medications.
Wearing supportive footwear, such as a moon boot in the initial recovery stage and adequate footwear such as a jogger to reduce stress to the area thereafter.
Modifying your training regime and recovery methods to ensure you don’t suffer further fractures.
Engaging in low-impact activities like bike riding or swimming during the healing stage that won’t add any additional pressure to the injury.
Custom-designed foot orthotics to eliminate biomechanical issues that might be causing or accentuating the likelihood of a fracture.
Stretching and strengthening exercises.
If the stress fracture is severe or occurs in the same place frequently, surgical intervention might need to be performed to support the affected site. This might involve inserting a plate, screw, or pin, which will better enable the bone to heal.
What Happens if I Ignore a Potential Stress Fracture?
If you ignore the warning signs of a stress fracture, then you run the risk of the fracture site not healing properly. This could result in the microfractures developing into a complete fracture, which will take much longer to heal than a ‘regular’ stress fracture.
Additionally, in severe cases, your bone fragments could disintegrate, and you may need to have invasive surgery to rectify your injury.
How to Prevent a Stress Fracture
There are some things you can do to reduce your risk of suffering from a stress fracture.
Firstly, you should give your body plenty of rest, particularly sleep, as this will allow it to heal naturally. Try to get between 7 and 9 hours a day if you can.
You should always ensure you are wearing supportive shoes that provide good cushioning and protection for your feet and replace old ones that have lost their shock absorption.
It is also a good idea to increase your bone strength by maintaining a diet rich in vitamin D and calcium and, where possible, vary your activities to ensure you are not overstressing or overloading one area of your body.
When to Seek Medical Attention
Ideally, you should seek medical attention when you first start to notice a dull pain.
However, you should definitely do this when you find that you cannot bear weight on the affected area.
