September 23rd, 2011 / posted by paularath

We drew a line to show where the stress fracture is, as it's hard to see here.

It seems as though stress fractures of the feet are on the rise, at least among my own friends, family and acquaintances. I can hardly leave the house without seeing someone limping or wearing an orthopaedic boot.

I have had stress fractures twice, both times while traveling in Europe, which is a big bother. I think the reason I got stress fractures in my feet is simply from overuse – walking too much and on uneven surfaces such as cobbled streets.

You see, when I’m home, I balance my workouts: Pilates, swimming, NIA, Zumba, weight training, elliptical, treadmill. But when I’m traveling all I can usually do is walk…and walk…and walk. That puts added stresses on my feet, hence stress fractures.

Sad to say, stress fractures often recur. About 60% of people diagnosed with a stress fracture have also had one previously.

Stress fractures are far more likely to develop in people who have just started a new exercise or abruptly stepped up the intensity of their workouts. When the muscles aren’t conditioned, they tire easily and can’t support and cushion the bones as well. Increased pressure is exerted directly on the bones, which can lead to a stress fracture.

Stress fractures are more common in women, especially women who do not have regular or any menstrual cycles. Wiomen with osteoporosis (weakening of the bones) are at greater risk, as are teens, since their bones aren’t fully hardened. Any anatomical abnormalities, such as fallen arches, can distribute stress unequally through the feet and legs, which raises the risk, as does poor quality equipment such as worn-out athletic shoes.

What is a stress fracture?

It’s one of the most common sports-related injuries, a tiny break in the bone caused by repetitive stress from activities such as running, jumping, marching, walking or dancing. It is most commonly seen in those who overdo a new exercise and fail to build up their tolerance to it.

Early medical reports described stress fractures in soldiers and called them march fractures, as they were caused by soldiers who were not used to walking miles and miles in heavy boots.

Although a stress fracture can be quite painful, they usually heal themselves if rested for a few months.

 What are the symptoms?

A stress fracture starts with dull pain around the site of the fracture. The pain worsens while exercising, walking or standing. There is often swelling as well.

How is it diagnosed?

With a thorough physical exam, preferably by an orthopaedic surgeon or sports medicine specialist.

Xrays do not reveal any abnormality of the bone during the first few weeks of the stress fracture. Your doctor may use a bone scan or other imaging technique to make the diagnosis. After four to six weeks, an xray will show a small fracture line and new bone formation.

The healed stress fracture.

How to heal?

Healing occurs as new bone is grown at the area of stress over a period of approximately six weeks.

The initial treatment is to rest the affected area. However, it’s important to continue some stimulus to the area, such as partial weight-bearing walking during the course of healing. If you put the foot or leg in a cast or use crutches to completely immobilize it, a stress fracture will take longer to heal. 

– Paula Rath

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