The five long bones in the foot that connect the toes to the ankle are known as the metatarsal bones. If a break occurs in one of these bones from repeated stress or injury, this break is referred to as a "stress" fracture. This type of fracture is the result of using the foot in the same manner, over and over again. A stress fracture differs from an acute type of fracture, which results from a traumatic injury that happens very suddenly.
Risk Factors for Stress Fractures:
Individuals at an increased risk for sustaining a stress fracture include those who:
- Suddenly increase their level of activities including walking, sports participation, etc.
- Participate in various work or leisure activities that exert excessive pressure onto the feet such as dancing, long distance running and/or walking, jumping, or military style marching.
- Have chronic bone related conditions like osteoporosis or arthritis.
- Suffer from nervous system disorders that cause numbness in the feet.
- Are women (due to hormonal factors, too little body mass, and/or a diet that may be too low in calcium and fat).
Signs and/or Symptoms of Stress Fractures:
Early signs/symptoms of a stress fracture of the metatarsal bones include:
- Pain occurring during activity, which subsequently disappears with rest.
- Pain felt over a wide area of the foot.
Eventually, these signs/symptoms will involve:
- Constant foot pain.
- Pain that is noticeably stronger in one specific area of the foot.
- Affected area of the foot is swollen and/or tender to the touch.
Diagnosis of Stress Fractures:
X-rays may not indicate a metatarsal stress fracture has occurred until as much as six weeks after it happened. A bone scan and/or MRI may be required to aid in diagnosis.
Treatment Options for Stress Fractures:
Metatarsal stress fractures can take a long time to heal completely. Healing times vary from patient to patient, ranging from four to twelve weeks. A treatment plan may include the following measures:
- Wearing a special shoe and/or boot to provide total foot support. (Superfeet and Lynco provide quality insoles that can address a myriad of health issues, including stress fractures.)
- Applying a cast below the knee in cases of especially severe pain.
- Resting of the affected foot.
- Elevating the foot to reduce pain or swelling.
- Refraining from doing the exercise or activity that initially caused the fracture.
- Using crutches to support the patient's body weight when walking is particularly painful, when recommended by a health care provider.
- Taking over the counter anti-inflammatory (NSAIDs) drugs like naproxen (i.e. Naprosyn or Aleve) or ibuprofen (i.e. Motrin or Advil) to relieve pain and/or swelling.
As the recovery period goes on, a patient must be monitored by a doctor to determine how well his/her stress fracture is healing. The doctor will indicate when the cast can be removed, when to give up using crutches, and when normal work and/or leisure activities can be resumed.
When restarting any activities following a stress fracture, it is extremely important to build up to full levels very slowly. Stop and rest if any foot pain begins.