What is a stress fracture?
A stress fracture is a very small fracture that can appear in a bone and is often associated with surrounding swelling and pain in the bone and soft tissue (including muscles, tendons etc) around the stress fracture site.
What are the symptoms of stress fractures in the foot?
Stress fractures of the foot are a feeling of soreness that occurs in a bony area of the foot. This feeling often slowly increases with ongoing movement over time.
In its initial stages of onset, the pain will arise with the first few steps when becoming more active again after periods of rest. The pain can develop and become more established with ongoing movement.
How are stress fractures of the foot diagnosed?
It is common place for stress fractures to be identified with imaging such as MRI or bone scans. This can be useful in confirming the problem, however this only provides some of the information needed for a successful long term recovery. A good therapist who has experience working with stress fractures can often identify and begin treatment of a stress fracture during the first session of treatment, without the need for further imaging.
What causes stress fractures of the foot?
The name ‘stress fracture’ implies that the bone is under stress and this is a good indication as to what causes stress fractures of the foot.
Stress fractures can occur in any bone that is under stress, or under ‘load’ and can occur at the front of the foot, the inside or outside of the foot, or in bones towards the back of the foot. Areas within the foot that experience high loading through repetitive movement are more susceptible.
Who gets stress fractures in their feet?
Stress fractures of the foot occur more often in people who perform repetitive behaviours such as playing sport, running, or jobs that require longer periods of standing or walking. It’s also possible for people who have low bone density or other history of bony pathology to be more susceptible to developing stress fractures without performing high amounts of repetitive movements.
What are the treatment options for stress fractures of the foot?
Short term management of stress fractures within a foot are usually targeted at reducing the pain and improving function.
This can include:
- Reducing the amount of provocative activities such as walking, running, playing sport etc.
- Wearing lace up shoes to refrain from excessive movement within the foot and ankle, leading to pain
- Using ice packs to reduce the swelling and pain
- Taking anti-inflammatory medication to reduce the swelling and pain
- In some cases, using crutches or protecting the area with a moon boot can be useful
Successful long term management of stress fractures within a foot must begin with a thorough assessment and understanding of the influencing factors that have caused the problem.
A successful long term management plan will address the underlying cause of the problem and may include:
- Load/ activity management
- Footwear advice/ consideration
- Orthotic therapy to influence biomechanics and gait (the particular way the foot is being loaded)
- Strength and conditioning exercises (to make the body stronger and prevent recurrence of injury)
It is very common that long term management is offered as wearing a protective boot (moon boot) for 6+ weeks without consideration of addressing the underlying cause of the problem, or helping a person return to activity. For this reason, some people can experience recurrence of a stress fracture following healing of the fracture.
What is THE most important thing to consider when you have a stress fracture of the foot?
No two cases of stress fractures of the foot and no two people are the same.
People have different physical requirements, different levels of ability and different goals and should always be offered an individualised program considering their needs and goals.
Podiatrist, Strength & Conditioning Coach