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Healthy Living Video Series #2 of 4: Stress Fractures

Stress Fractures


Here is Dr. Pelto's second video in a series of 4. 



Transcript Below

hi and welcome back to healthy living
I'm dr. Donald Pelt oh and I want to
answer a common question I get in the
why does my foot hurt when I start to
exercise many people in the summertime
they start to increase the activity they
start to walk outside because the
weather is nice they go on vacation
where they walk maybe four or five not
miles when they're not used to it and
then their foot starts to hurt they may
or may not have swelling and they're
wondering why does my foot hurt there's
probably hundreds of types of problems
that can happen but one of the most
common problems is called a stress
fracture now why a stress fracture
what's so stressful about a stress
fracture let me show you a picture here
of a stress fracture if you look at this
picture on the left hand side you can
see that there's a little white line
that's going through the bone and
there's a red circle around it this is
showing an area of stress fracture let
me show you what happens with this foot
model when you have a stress fracture
you increase the amount of walking that
you're doing and there's a lot of
increased pressure going through your
foot your foot and your muscles and your
tendons are all used to transfer your
foot pressure and all this compression
up the leg and to help you go forward if
you do a lot of walking
you can put increased pressure
underneath one of the bones what happens
to the bone is that the bone swells yes
you can get swelling inside of your bone
and that eventually that swelling can
cause a little bit of a crack in the
bone and if we go back to this picture
you can see that actually on the pit on
the right hand side the second bone is
longer than the first and the third bone
and that is one of the mechanical causes
so this bone here on this image is
actually longer you're going to have
increased pressure on that area due to
the mechanics that's just one reason
that you could have a stress fracture
there are other reasons a lot of people
as they become older they start to have
weakening of the bones or osteoporosis
if you have this and you do a lot of
you could get a stress fracture easier
other people they try to increase their
activity they say you know I'm going to
join I'm going to do my 5,000 steps a
day with their Fitbit and they do all
this walking and then their foot starts
to hurt because they're not used to it
but why to explain it simply your body
is used to doing a certain amount of
activity you've been doing that activity
for years and your muscles tendons and
your bones are all used to that amount
of activity if you increase it by 50
percent or a hundred percent your bones
aren't used to it and there's a greater
chance of injury because the bone has to
adapt and for the bone to adapt and for
the bone to get stronger it takes time
and if this doesn't happen you're going
to have an injury and that can be a
tendon injury but more commonly it's a
bone injury there's a there's a certain
type of this fracture it's called a
marching fracture that happens and you
see this a lot of times in young
athletes when they go into the military
because when they go into the military
they start doing a lot of activity they
start to a lot of marching and their
foot bone is not strong enough and it
causes a stress fracture what happens
with the stress fracture you get a
little bone break and your body tries to
heal it so what are the treatments you
can wear a more stable shoe you can wear
one of the walking boots and actually
for a lot of people that do a lot of
running we just say keep running because
a stress fracture doesn't go throughout
the bone it's usually only a portion of
the bone if you keep running it'll
either get better over time which is six
to eight weeks or it'll break totally
through in which case you know it'll
take six to eight weeks to get better
but during that time you might find
yourself limping you may find you have
swelling in the foot and sometimes if
you go to the doctor right away it
doesn't show up on the x-ray but you
thought what I thought fractures are we
show up in the x-ray well they don't
because sometimes a fracture if it's a
stress fracture it's only one portion of
the bone and you don't see the fracture
until you see the healing because if we
go back to this picture you can see that
there are this this area around the bone
it's called bone callus and that bone
callus is kind of like a straw
to help stabilize the bone so that it
can heal once the bones healed that bone
callus goes away so how do you avoid
getting a stress fracture go slow when
you start to work out only increase your
activity about 20 percent a week you can
double or triple the amount of walking
and the amount of activity but go slow
and also you'll avoid other types of
foot problems as well be aware as well
the type of shoes that you're wearing
many people wear their worst shoes for
the hardest activities so for example
let's say your shoe is six months or a
year old and then you decide well I'm
going to wear the shoe now when I go on
a long walk or when I mow the lawn and
that doesn't give you enough cushion in
the shoe and it can cause a stress
fracture if you want to learn more about
stress fractures please go to and you can find more information
out about this condition thank you
Dr. Donald Pelto Dr. Donald Pelto Dr. Donald Pelto is a Podiatrist at Central Massachusetts Podiatry, in Worcester and Westborough. Author of several books on foot health, he also speaks Portuguese and Spanish. He likes to go on family hikes and loves learning and talking about health related topics and healthy life hacks. Watch some of his interviews about health and video lectures on

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