Stress Fractures of the Foot
Author: Dr. Christina Weber

Stress fractures are subtle breaks in weight-bearing bones of the foot and lower leg that occur from overuse, abnormal repeated stress from faulty shoe gear or abnormal biomechanics, weakened bone from an underlying disease. Stress fractures are most common in very active individuals and athletes, but can also occur in the non-athlete due to the weakening of bone (osteoporosis). Osteoporosis is secondary to vitamin deficiencies, hormonal imbalances and lack of weight bearing exercise over time. Some conditions that can weaken the bone include, not limited to, chronic liver disease, Rheumatoid arthritis, digestive conditions, endocrine gland diseases.

A fractured bone is a partial or complete break in a bone and occurs after an acute traumatic event such as a sprain or fall. A stress fracture is painful when weight-bearing and presents with varying degrees of swelling to the foot but not all. An acute fracture is painful when weightbearing with swelling and bruising.

An acute fracture is often diagnosed with a physical examination and x-rays. A stress fracture can be diagnosed with a thorough examination and not always seen on x-rays especially early on when the symptoms start. MRI study is ordered when necessary to help confirm the presence of stress fracture.

Treatment depends on the type of break and location. Casts are often used to treat fractures to protect and hold the injured bone in a neutral fixed position. Surgery in some cases is necessary to realign the fractured bone if significantly out of place, not healing with conservative treatment or at high risk for non-union.

Prevention of stress fractures is imperative with nutritional counseling, proper shoe gear and slow return to training for athletes following the 10% rule