Stress fractures are fractures of bones which usually occur without one serious injury to the bone. They are usually caused by excessive pressure being applied to the bone, either suddenly or over a period of time.
Usual causes are: carrying a heavy load over a long distance, running or walking much further than normal, repeated minor injuries to the same bone, constant pressure on a bone for a period of time, and jumping down on the foot repeatedly. Stress fractures are thin cracks in bone, without separation of the fractured pieces. These fractures may not show up on an x-ray until healing begins, which can be up to 3 weeks after the injury. The most common site of stress fractures are in the metatarsals.
The most common symptoms of a stress fracture are:
- Pain in a very localized area of the foot, which occurs whenever you bear weight on the foot or when you press on the area. The pain is deep within the foot, and over a bone.
- Swelling above the fracture. It is sometimes described as "silver dollar swelling," as the swollen area is the size of a silver dollar. The entire foot is usually not excessively swollen, only the area above the fracture.
- There may not be any signs of "black and blue" discolorations over the fracture, as would appear with other types of fractures.
- When your weight is off the foot, such as when you are sitting, you will usually be able to move the foot without pain.
- These symptoms persist until the foot is treated, or the fracture heals. It usually takes fractures 4 to 8 weeks to heal, with proper treatment.
Stress fractures can be very frustrating because they may not show up on x-rays for weeks after the injury. Doctors frequently make the diagnosis of a stress fracture after a careful history, looking for excessive weight-bearing activities. Other methods of early detection of stress fractures include C.A.T. Scans and M.R.I. Studies.
Treatment and Prevention of Stress Fractures
- Treatment involves protecting and immobilizing the fracture. These goals can be accomplished with: soft casts, injury shoes, and the reduction of weight on the foot (using crutches). If you think you may have a stress fracture, see a podiatrist immediately. The sooner treatment is started, the sooner you will feel better, and healing can begin.
- Prevention of stress fractures is easily accomplished by using good judgment when it comes to physical activities, and by the use of custom-made orthotics. If you have sustained a stress fracture, and continue to repeat the activity that caused the fracture, the stress fracture will recur. To prevent the fracture from returning, podiatrists use custom-made orthotics to remove the excessive stress from the previously fractured site, and redistribute it evenly across the entire foot. This protects not only the stress fracture site, but all the bones of the feet, by making sure each bone will absorb its share of the stress, rather than one bone absorbing it all, and this bone breaking. If you have sustained a stress fracture of your foot and cannot stop the activity that caused it, you surely need custom-made orthotics designed especially to help prevent stress fractures of the feet. Or, if you are an athlete and want to prevent stress fractures from occurring, please read more about custom-made sports orthotics.