Don’t Stress Out Over Stress Fractures: A Common Sense Approach for Treatment and Prevention

You may pride yourself on your active lifestyle, and you should, as staying active is one proven way to help maintain a higher level of overall health. But suddenly after your workout, you may notice a twinge of discomfort in your foot or ankle with certain activities, even though you don’t recall hitting yourself there. Over time, if you find the pain worsens, it’s in the same area, and the pain improves a little with rest, you may have a stress fracture. You may even have some bruising or swelling in that spot, too.

Unlike a traumatic break to a bone from a fall or accident, a stress fracture occurs from increasing an activity either too fast or with too much intensity. A stress fracture, which is a small crack in the bone, is essentially an overuse injury.

At Central Massachusetts Podiatry, we’re skilled at diagnosing and treating stress fractures. So, if you’re concerned you have this type of injury, give us a call and make an appointment to see one of our doctors for an expert medical evaluation and an individualized treatment plan.

Which sports raise my risk for getting a stress fracture?

Stress fractures occur more commonly with specific sports and activities that involve high-impact movements of the body against gravity such as:

• Running
• Dancing
• Gymnastics
• Basketball
• Jumping
• Tennis

Also, if you normally engage in one sport or activity, then suddenly switch to a different one too quickly and with too much vigor, it can place a strain on the bones and the muscles of your lower legs and feet. Even practicing the same sport but switching environments can place you at risk for a stress fracture. For example, if you always run or jog on a track or a dirt trail, and suddenly run the same distance on hard pavement, it could make a difference.

How can overuse or high-impact activities cause a stress fracture?

Our bones need time to recover after exercise. Why? Bones are living body tissue with cells that break down, then rebuild. Higher-impact activities cause microscopic tears in the bones. The bones then heal themselves and build up their strength with a process known as remodeling. If we don’t give our bones enough time to recover and strengthen between exercise sessions, they become weaker and less able to handle physical stress.

Additional contributing factors that can raise your risk for developing stress fractures are:

• Osteoporosis (weak bones)
• Low vitamin D level in your body and a low dietary intake of vitamin D
• Low calcium level in your body and a low dietary intake of calcium-rich foods
• Flat or high arches
• Being female, as women experience higher rates of stress fractures than men
• Wearing the wrong shoes for the activity (not supportive enough or the wrong fit)

How is a stress fracture treated?

Treatment for stress fractures includes nonsurgical and surgical care. Our Podiatrists examine you and take X-rays of your injured area. Then the doctors recommend treatment tailored specifically to your situation. The next steps depend on how severe your stress fracture is, and where on your leg or foot the fracture is located.

Initial care involves RICE: Rest, Ice, Compression, and Elevation of the injured area. You’ll also be advised regarding which pain and anti-inflammatory medication to take and how often to take it.

Nonsurgical treatment: You may be prescribed special, protective footwear such as a harder-soled shoe or a shoe with a supportive brace. A cast may be placed on your foot or leg, if the doctor feels it will lessen the stress on the injured area and allow for better healing.

Surgical treatment: Some stress fractures require surgery to repair them. Surgery may involve the placement of pins, plates, or screws to hold specific bones together during the recovery process for optimum healing.

How can I prevent a stress fracture?

There are lots of things to you can to take care of your legs, ankles, and feet to make stress fractures less likely. Strategies to help prevent stress fractures include:

• Making sure you get enough calcium and vitamin D in your diet
• Asking your doctor if you need calcium and vitamin D supplements
• Wearing properly fitting and designated shoes for each sport and activity (example: make sure you wear running shoes for running and not cross trainers)
• Asking your doctor for guidance when changing a sport or adding an activity, as well as when and how to increase the intensity or frequency of your workouts
• Consulting with your doctor to see if you need orthotics to correct any arch problems with your feet