Stress Fracture in the Foot
Have you ever seen one of those machines that test the strength of
different materials? You stick a concrete block or an iron beam or a china
cup on the bottom half, and then turn it on. The top half of the machine
descends, touches the object, and puts more and more pressure on it until
the cup shatters, the iron beam twists, or the concrete block cracks and
splinters, littering the room with bits of shrapnel.
Hate to break it to you, but you’re kind of like that machine. And your
bones? They’re the material being tested, particularly the bones in your
foot. Every time you put weight on your feet, you’re putting pressure on
your bones. And, while bones are pretty darn good at holding you up (that’s
what they’re there for, after all), they can crack under pressure if it’s
great or consistent enough. These breaks in the bone aren’t always big and
traumatic; sometimes, they’re tiny cracks in the bone called stress
Stress fractures are usually caused by overuse of the bone, (like when you
stand around all day on concrete floors, or do a lot of running or
jumping), although conditions such as osteoporosis (gradual bone loss) can
make even everyday activities (like slow dancing in the kitchen with your
broomstick) hazardous for your bones. Certain types of shoes can also
increase your risk for developing stress fractures in your feet. High heels
put a great deal of strain on the bones that make up the ball of your foot,
and it shouldn’t be a surprise that wearing concrete blocks on your feet
isn’t a fantastic idea (especially if you plan to go swimming in a dank and
dirty river while wearing them). Those who are overweight also put more
strain on their foot bones than those who are not.
Normally, old bone material is resorbed at about the same rate that new
bone material is added, which means your bones are usually pretty stable.
But, add pressure and stress, and the bone growth can’t keep up with the
damaged material. Your bones become fatigued, then develop tiny cracks that
can lead to stress fractures. And, if stress fractures aren’t taken care
of, they can lead to more dramatic breaks of the bone.
Because we tend to think of fractures as traumatic events, you may not even
be aware that you’ve developed a stress fracture. When your bones start
cracking under the pressure, you’re likely to experience pain in the area
of the fracture (especially if you press down on the affected bone). This
pain may improve with rest at first, and then come back with activity,
although it’ll likely show up earlier and earlier with each successive
workout, and feel worse and worse over time. Eventually, the pain may
continue during periods of rest as well. In addition to pain, you may
experience swelling, redness, and sometimes even bruising near the stress
If you experience the symptoms above, it’s a good idea to see your
podiatrist, who has most definitely seen bones crack under pressure. He or
she is, fortunately, also well-versed on treating these damaged bones. In
order to ascertain if you’ve experienced a stress fracture, your podiatrist
will take a history of your symptoms and any factors that may be
contributing to them. He or she may ask about your shoes, your work
environment, the types of sports you’re involved with, whether you’ve
recently changed your exercise regimen, the medications you take, any
medical conditions you may have, and whether you’ve stuck your foot in one
of those pressure machines lately.
If your podiatrist suspects your bone may be cracking, you might expect him
or her to take an X-ray right off. And your podiatrist may do that,
although stress fractures don’t often show up on X-rays until a few weeks
after symptoms appear (although this does NOT mean you should wait a few
weeks before seeing your podiatrist). Instead, your doctor may need to
order other imaging studies such as an MRI or bone scan. And, of course,
there will probably be a physical exam of your foot.
Stress fractures are often treated with rest and sometimes immobilization.
You’ll need to take a break from many high-impact activities while you
heal, although (with doctor approval) you might be able to participate in
activities such as swimming, biking or aerobics while your foot heals.
However, your podiatrist could recommend staying off the foot entirely, in
which case you’ll be the lucky recipient of a pair of crutches (and
possibly a cast to keep your foot immobile). Your foot may also be
protected from stress by stiff-soled shoes or a brace, or you might have a
cast boot or fiberglass cast applied to keep your bones in place while they
Applying ice (20 minutes on over a thin towel, 40 minutes off) and keeping
your foot elevated above the level of your heart will help keep the
swelling and pain at bay. Anti-inflammatory medications such as ibuprofen
may also help with the pain, although they can inhibit bone repair. So,
your doctor may suggest using acetaminophen instead.
In some cases, especially if the stress fracture is in an area with poor
blood supply, surgery may be necessary to help your bone make a full
recovery. Surgery may involve pins, screws or plates to keep the bones in
place while they heal.
Healing from stress fractures usually takes around six to eight weeks,
although it can take twelve weeks or longer. But, no matter how much you’re
raring to get back to jumping jacks or marathons, it’s essential that you
give your bones time to heal, or you risk complications like breaking your
bone completely. You’ll also want to resume your previous activities
slowly, so your newly healed bone doesn’t collapse again under the
Call 719-543-2476 today to schedule your appointment!