Foot Stress Fracture

A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb shock and repeated impacts. Over time the fatigued muscle transfers this stress to the bone, resulting in a small crack (a stress fracture).

A complete or incomplete hairline break in a foot (metatarsal) bone. The term march fracture arose during World War I when many young soldiers, not conditioned for stress, were put into ill-fitting shoes and required to take long hikes over rough terrain. The X-ray appearance may be similar to a bone tumor. Stress fractures may not appear clearly for several weeks after pain begins in the foot.

BODY PARTS INVOLVED

• Metatarsal bones of the foot.
• Metatarsal joints.
• Soft tissue around the fracture site, including muscles, nerves, tendons, ligaments, periosteum (covering to bone), blood vessels and connective tissue.

Causes

Stress fractures often are the result of overuse or repeated impacts on a hard surface. Increasing the amount or intensity of an activity too rapidly is a common cause of a stress fracture, as is using improper equipment. Fatigue of the foot bone(s) caused by repeated overload, as with marching, walking, running or jogging.

Signs & Symptoms

• Pain in the foot when walking or running. Pain diminishes or disappears when the load is taken off the feet.
• Tenderness to the touch in the fracture area.
• Pain in the forefoot, aggravated by running?

Treatment

Follow your doctor's instructions. Instructions are supplemental.

• This fracture does not require setting (realignment) because the fractured bone is not displaced.
• Immobilization may be necessary. If so, a rigid walking cast will be placed around the foot,ankle and lower leg for 3 weeks, followed by a supportive shoe. Sometimes a stiff-soled shoe provides enough support and immobilization to allow healing.
• Use frequent ice massage after the cast is removed. Fill a large styrofoam cup with water and freeze.Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a baseball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
• Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
• Take whirlpool treatments, if available.
• Massage gently and often to provide comfort and decrease swelling.

Home Diet

During recovery ,Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

• Heed early warnings of an impending stress fracture, such as foot pain after extended standing or walking. Adjust activities before a fracture occurs.
• Maintain a healthy diet. Make sure you incorporate calcium-rich foods in your meals.
• Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk product calcium supplements.
• Use the proper equipment. Do not wear old or worn running shoes.
• Rest for 6 to 8 weeks if a stress fracture is suspected. Use crutches if necessary.