Stress Fractures

Broken bones aren’t always obvious. They don’t always lead to misalignment or a malformed appearance (these are called displaced fractures), and they may not even be related to a single specific injury.

Stress fractures are a prime example. One of the most common foot and ankle sports injuries, these are tiny, hairline cracks in bone (they may even be too small to show up in an X-ray at first) that form as a response to overuse. You may not be able to “see” them, but you’ll definitely feel them.

When Bones Can’t Handle the Stress

This type of small crack almost always develops slowly over time rather than due to a single dramatic impact. They’re often a response to a rapid increase in activity, or simply too much high-impact exercise in too short a time without adequate rest in between. Distance running, throwing yourself suddenly into a new sport (like tennis or basketball), or even sudden shifts in surface or terrain (such as moving from trail running to concrete) can put you at risk.

Here’s how the process generally works: performing repetitive, high-impact sports causes muscles and other soft tissues in the feet and lower legs to become fatigued. Tired muscles aren’t able to absorb shocks and impacts as efficiently, and as a result those forces get transferred directly to the bones. Over time, cracks form.

How Can You Tell If You Have Stress Fractures in Your Feet?

It may be difficult to tell the difference between this injury and other conditions that may cause soreness and pain in your feet. If any of the above scenarios describe your situation, or you notice that pain has gradually gotten worse and increases with activity, a hairline fracture would be a top possibility.

Ultimately, though, a positive diagnosis will require X-rays, or occasionally at CT scan or MRI to confirm the presence of cracks in the bone.

 Stress fracture of the foot

Treating Stress Fractures

Fortunately, these breaks rarely need any direct medical intervention, aside from occasionally prescribing medications or performing cortisone injections to deal with the pain. The most important treatment method, by far, is rest.

Now, “rest” doesn’t mean “only run 10 miles this week instead of 20.” You need to avoid high-impact exercises or sports entirely, for as long as your foot & ankle specialist believes you need to, for your feet to fully heal—often about 6 to 8 weeks. It’s important to follow through to the end even if symptoms seem to have cleared up: resuming activity too quickly—before your bones have had a chance to completely heal—at best will cause a setback, and at worst may lead to even more severe fractures or even chronic pain.

In more severe cases, we may provide cushioned shoe inserts, braces, crutches, or other tools to keep weight and pressure off of your feet while you heal. Surgery is almost never required, although may be considered in the most extreme instances.

We may also recommend other longer-term aids (such as custom orthotics) if we determine that a secondary condition (such as flat feet or other structural issues) puts you more at risk for this injury.

Preventing Future Problems

Stress fractures can often be prevented before they even begin by making smart decisions about training and taking care of your feet. Such strategies include:

  • Wear good, well-fitting, sport-appropriate shoes in good repair, with sufficient cushioning.
  • Ease into new activities slowly to give your body time to adapt. Increasing speed, distance, and/or intensity by about 10% per week is generally appropriate.
  • Vary your routine and cross train in some non- or low-impact activities (like swimming or cycling). This prevents feet from getting overstressed.
  • Do strength-training exercises targeting muscles in the feet and lower legs, which allows them to absorb more shocks without fatigue.

If you’re feeling pain and soreness in your feet—whether you suspect stress fractures or not—please call the experts at North Austin Foot & Ankle Center by dialing 512-593-2949. You can also request an appointment online.