A stress fracture is a small crack in a bone, caused by repetitive force or an underlying condition.
What is a Stress Fracture?
A stress fracture is a small crack in a bone, or severe bruising within a bone. In a stress fracture, the bone breaks but does not shift position. Over time, with repetitive stresses, your bones can become ‘weakened’, which is a stress reaction. This weakness increases the risk of a stress fracture.
Where can stress fractures occur?
Most often found in weight bearing bones of the foot:
- Metatarsal Bones
The second and third metatarsals of the foot are most prone to stress fractures. Less commonly, people may have fractures of the fourth and fifth metatarsals.
The navicular is one of the bones in the middle of the foot. The navicular bone is not commonly associated with stress fractures, and the diagnosis can sometimes be hard to make.
The talus is one of the bones in the heel of the foot. It is an uncommon bone to be affected by stress fracture.
- Sesamoid Bones
The sesamoids are two small bones located in the ball of the foot, beneath the joint of the big toe. These small bones can sometimes be affected by stress fractures.
The calcaneus is the bone that makes up the heel of your foot. It is the second most common area of the foot to develop stress fractures.
What are the causes of Stress Fractures of the Foot?
Stress fractures are predominantly caused by a sudden increase in physical activity. The increase can mean frequency or the intensity of the activity. Bones adapt slowly to load through remodeling, increasing your load too quickly does not give the bone time to adapt.
Other factors that can cause stress fractures are:
- Insufficient bone strength
- Poor conditioning
- Improper technique
- Change in surface (e.g. going from grass court to a hard court)
- Improper equipment
- Foot issues such as flat feet or high rigid arches
- Common in certain supports such as track and field, tennis, gymnasts and dancers
- Having a previous stress fracture
- Lack of nutrients such as calcium and vitamin D
- Underlying conditions such as osteoporosis
What are the symptoms of Stress Fractures of the Foot?
The pain usually develops gradually and worsens during weight-bearing activity.
- Pain that reduces during rest
- Pain that is associated with physical activity
- Swelling on the top of the foot or on the outside of the ankle
- Tender to touch
Treatment for Stress Fractures
X-rays don’t often show stress fractures, If your physiotherapist suspects a stress fracture they may refer you back to your GP for an MRI to correctly diagnose.
- Self management techniques
- Patient education
- Tailored exercise programs
- Moon boot to limit loading during healing
- Biomechanical assessment after healing to correct issues and prevent reoccurance
Your physiotherapist may also recommend crutches to keep weight off your foot until the pain subsides.
What can I do at home?
- Resting and limiting physical activity
- Icing the inflamed area every 1-2 hours for 15-minutes – sometime ice can make a fracture uncomfortable
How can I prevent a Stress Fracture?
There are many simple steps that can be taken to help prevent stress fractures:
- Make changes slowly.
Bone needs time to adapt to load. When starting a new exercise program, be sure to start it slowly and make progression gradually. You shouldn’t be increasing the amount you exercise by more than 10-30% per week.
- Use proper footwear.
You can reduce your risk of a stress fracture by ensuring that your shoes fit well and are appropriate for the exercise you are doing. If you have flat feet, ask your physiotherapist about custom orthotics.
Ensure there is a variety of low- and high-impact activities to your exercise plan to prevent repetitive strain.
- Enjoy proper nutrition.
To keep your bones strong, ensure you are consuming enough calcium, vitamin D and other nutrients.
- Book a running assessment.
It identifies areas of your exercise regime which may need improvement to help prevent injury. It also identifies areas where you may be placing excessive load on your body. Your physiotherapist can show you how to modify this during your training.
How to book an appointment?
If you think that you may be suffering from stress fractures, or you’re looking for a ‘physiotherapist near me’, our team at Vitalis Physiotherapy can assess and diagnose the condition. They will then tailor your treatment plan to aid in your pain relief and recovery.
All you need to do is just give us a call on 0410 559 856 and request an initial appointment. Please let our friendly reception staff know the background and severity of your condition.
You can visit our FAQs for more information about appointments at Vitalis Physiotherapy.