Stress Fractures

*requested by Emily Guo, who is unfortunately stuck in a boot because of her stress fracture*

What are Stress Fractures?

Stress fractures are tiny cracks in the bone caused by a repetitive force, typically overuse. They are common injuries for people who continually put large amounts of pressure on their bodies, such as track and field athletes, basketball and tennis players, dancers, and gymnasts. Oftentimes, increasing the intensity or amount of an activity too quickly can lead to a stress fracture, as bones do not have enough time to heal. Bones typically heal through remodeling, or the the process of destroying and rebuilding bone tissue. However, increasing the intensity of an activity in a short period of time can lead to the rate of resorption (destruction of bone tissue) being faster than that of healing. Although all kinds of people can develop a stress fracture, those whom are most susceptible have high and rigid arches, weakened bones (osteoporosis), eating disorders, or a lack of nutrients, especially Vitamin D and calcium. Symptoms of stress fractures include pain originating from a single area and diminishing during rest, swelling, and/or bruising.

Most Common Areas in a Foot for a Stress Fracture:

https://orthoinfo.aaos.org/en/diseases--conditions/stress-fractures-of-the-foot-and-ankle/

How to Prevent and Treat a Stress Fracture

1. Make Changes Slowly

When starting a new activity or sport, it is important to gradually allow your body to become accustomed to the training rather than doing too much too quickly.

2. Proper Footwear

Whether for running or simply for running, proper footwear and foot support is essential to preventing stress fractures. For flat-footed people, arch supports can be beneficial for improving shock absorption and injury prevention.

3. Cross-training

Cross-training helps to avoid continually stressing a single area of your body. For high-impact sports like running, low-impact activities such as swimming and cycling can be used for a more balanced training style.

4. Calf Flexibility

Calf tightness has been found to cause the heel to lift earlier, which can lead to a larger amount of force being placed on the front of the foot. In fact, a study in the Journal of Orthopedic and Sports Physical Therapy found that subjects with tight calves were 4.6 times more likely to sustain a metatarsal stress fracture.

5. Proper Nutrition

Increasing the intake of certain nutrients like Vitamin D, calcium, and potassium can help build bone strength and bone density. Vitamin D is found in fish (salmon, tuna, mackerel, to name a few), egg yolks, cheese, and Vitamin D fortified foods. Foods high in calcium include dairy, kale, sardines, broccoli, bok choy, okra, and almonds. Potassium can be obtained from potatoes, watermelon, spinach, beets, beans, edamame, squash, and yogurt.

6. Avoid Non-steroidal Medicine

Non-steroidal medicines, or NSAIDS, are often used to decrease inflammation and pain, but have recently been found to interfere with remodeling and hinder tendon repair.

7. Avoid Running on Hard Surfaces

The impact of running hard surfaces can put pressure on the bones on the foot, so avoiding them until the bones are fully healed will speed up recovery and repair.