A stress fracture is a common overuse injury that can be caused by repetitive exertion or unusual mechanical stress on the weight-bearing bones of the lower leg or foot. Often regarded as incomplete fractures, stress fractures are different from other types of fractures in that they are not caused by sudden and severe impact. This fracture is very common in athletes, military recruits, and people with low bone density. Commonly dubbed as a hairline fracture, the injury may be barely noticeable at first. Stress fracture foot symptoms can present themselves gradually rather than suddenly. If ignored, the injury can worsen and possibly lead to more serious complications.
Stress Fractures are commonly caused by excessive exertion on the bones of the feet and lower legs. Bones repair and rebuild constantly to counter the rigors of normal physical activity. However, when a bone is subjected to an extraordinary level of stress, it can exhaust its capability to heal and subsequently develop bone fatigue. Repeated trauma can overwhelm the bone and cause tiny cracks that may eventually progress into a stress fracture. Stress fractures are often caused by repetitive high-impact exercise and sports, and may occur in both amateur and professional athletes. An unusual burst of activity after a prolonged period of inactivity, particularly in sedentary people, is another major cause. Women are more likely to experience stress fracture injuries due to predisposed risk factors such as osteoporosis, low bone density, irregular menstruation and poor nutrition. Teenagers may also be at a higher risk for stress fracture due to the incomplete hardening of their bones. Stress fractures are often attributed to a variety of causes:
• Constant pounding of the feet and legs on hard, uneven surfaces
• High-impact sports, such as gymnastics, track and field, tennis
• Sudden changes in the duration, frequency or intensity of a physical activity
• Inadequate resting periods between exercise sessions • Wearing ill-fitting or worn-out running shoes without proper foot support
• Excessive muscle fatigue from exercise
• Anatomical abnormalities, such as flat feet or high rigid arches
• Previous history of stress fractures
A stress fracture may be barely noticeable on initial presentation. X-rays may not indicate the presence of a stress fracture in its early stages. A common symptom associated with a stress fracture is a dull, generalized pain that might be accompanied with swelling and tenderness in a specific spot. The pain and swelling may worsen with running, walking, standing or exercising. In some cases, bruising or darkening can occur. If neglected, the damage can increase and contribute to an earlier onset of pain with subsequent workouts. Eventually, the pain can persist even during resting, without any weight bearing or exertion, in the affected area.
The most effective treatment for a stress fracture is complete rest. When a weight bearing bone is affected, continuing to put weight on the injured area may increase the healing time. The recovery period generally depends on the severity of the stress fracture, location of the injury, nutritional habits and the body’s individual healing response. The period of recovery can vary anywhere from two weeks to 16 weeks depending on the extent of the injury. A doctor might suggest one or more of the following:
• Complete rest of the area ranging from weeks to months, depending on the severity
• Ice and compression to the affected area to alleviate swelling and pain
• Elevation of the extremities
• Splint, cast or walking boots to immobilize the area
•Crutches to keep weight off of the fracture site
• Rehabilitation with muscle strength training
• Post-remedial orthotics to address specific arch problems or overpronation
• Maintaining physical fitness with low-impact activities
With proper care and treatment, stress fractures can heal completely. After healing is completed, exercise and sports-related activities should be resumed gradually. Complete bone remodeling can take several months. Re-injury within that period can lead to re-fracturing and the possible development of chronic foot problems. Very severe stress fractures, which do not heal on their own, occasionally require surgery.