Stress fractures in Athletes

So, you’ve finally decided to enter that marathon/triathlon you’ve been talking about for a while and have started training harder than ever. You are past the initial ‘why on earth am I doing this phase!’, you are starting to feel like you are getting into a groove and getting some solid km’s under your belt. All of a sudden, you wake up one morning and notice an intense pain in your foot that you haven’t experienced before. It is quite different to the post run muscle pains you have been experiencing and feels quite focal to one particular area. Even though these symptoms could be attributed to a range of different injuries, there is a chance that you have a stress fracture!

Stress fractures are a common over-use injury that we see across our Cairns Podiatry clinics. Every step that you take during a run results in 3-4x your body weight going through each foot. This, particularly if your body isn’t custom to the impact from running, can lead to repetitive bone stress and breakdown which eventually results in a stress fracture. So who is at risk for a foot stress fracture?

• Sudden increase in running
• Sudden change in activity e.g. from gym to running
• High or low arched foot type
• Inappropriate footwear for your biomechanics
• People with low bone density/osteoporosis
• Individuals with a poor diet (low calcium, protein etc)
• Significant muscle tightness
• Previous history of stress fractures

How is a stress fracture diagnosed?

Stress fractures in the foot are normally diagnosed with a combination of a thorough history, clinical examination and imaging. Plain x-rays often don’t show a stress fracture, particularly in the first two weeks so gold standard imaging usually involves an MRI or bone scan. As you can see from the below imaging, if a stress fracture is found on a plain x-ray, they are generally characterized by a ‘cloudy’ appearance around the fracture site. This is a phenomenon where your body is trying to produce more bone tissue to promote healing.  

How do we treat Stress Fractures of the foot at FNQ Podiatry & Orthotics?

Treatment for a stress fracture of the foot is based around short-term immobilization and rest. The more load we can take off the fracture site, the quicker the bone will heal. Given this, we will place you into a cam-walker (moon boot) for a period of time that will be determined by the site and severity of your stress fracture, generally ranging from 4-12 weeks. For higher risk stress fractures (e.g. mid-foot or heel), we may suggest crutches for a short period of time to take further pressure off the site. 

Other recommendations for nonsurgical treatment may include:

• Modified activities. It typically takes from 6 to 8 weeks for a stress fracture to heal. During that time, we will recommend activities that place less stress on your foot and leg. Swimming and cycling are good alternative activities. However, you should not resume any type of physical activity that involves your injured foot or ankle – even if it is low impact – without our recommendation.
• Non-weight bearing exercises to restore some strength and movement in that foot/ankle

• Protective footwear – We will often use a soft in-shoe orthotic device and supportive pair of runners to help you progress away from your moon boot into normal shoes. This will help to support the foot and help with a gradual return to normal activities.

If you require further information, call our friendly team to arrange an assessment. Book online now or give us a call on 40 455 749