With summer sporting events beginning, as podiatrists we begin to see increased foot and ankle injuries in athletes and runners. Some common injuries that will be seen are stress fractures. Stress fractures are caused by a bone not being able to withstand increased repetitive force, improper shoe gear (severe wear), and increasing activity too rapidly. Stress fractures can account for approximately 10% of running injuries and often occur in activities that involve muscle fatigue.
Signs and Symptoms of Stress Fractures
Female athletes are more prone to stress fractures than their male counterparts due to what is commonly called the “female athlete’s triad”. This triad involves eating disorders (anorexia nervosa or bulimia), amenorrhea, and osteoporosis. Each provides increased risk to developing stress fractures due to loss of bone density and mass. As bone density and mass are affected by hormones and nutrition.
If you suspect you have a stress fracture, you will possibly experience:
1. Tenderness over the area
2. Pain upon weight bearing
3. Slight swelling and reproducible pain with activity that is relieved with rest
Diagnosis
To definitively diagnose a stress fracture, an x-ray may be taken or other advanced imaging techniques (bone scan, CT, MRI, etc) may be necessary.
Treatment of Stress Fractures
It is advised to decrease your activity, change the intensity of your activity, change your footwear, and/or you may be prescribed orthoses. It is important to rest as the fracture will need 6-8 weeks to completely heal.
Prevention
To prevent your potential for stress fractures, inspect your shoes for creases and/or wear in the midsole, replace if worn or old, and be aware of changes in your running surfaces, as one the most common areas for stress fractures are the foot, tibia, and fibula. Try to add cross training to your exercise regimen, as alternating with different stretching; strengthening and flexibility exercises can decrease your chance for stress fractures. It is important to follow the medical advice during your recovery period, so that you can get “back on the road” in a shorter period of time. As returning to “normal” activity too quickly may cause a recurrence and possibly a larger, more difficult to heal stress fracture. Be an advocate for your foot health.
