A stress fracture of the foot can slow down even the toughest athlete -- and it's good that is does. The key to healing this type of small bone crack is allowing the injured bone adequate time to rest and heal. Treatments may be nonsurgical or surgical and require your doctor’s involvement to monitor the healing process. Analyzing the factors that contributed to the stress reaction in your injured foot bone is essential for successful treatment. These factors often relate to your exercise habits and behaviors.
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Stress fractures occur when demands placed on the feet exceed what your bones can tolerate. This is often caused by repetitive-impact sports, such as running and basketball. After a stress fracture, rest, ice, compression and elevation -- or R.I.C.E. -- is recommended. Resting your foot will give your body a chance to repair the damage, while ice, wrapping your foot with an elastic bandage and elevating your foot above your heart will help minimize inflammation and swelling. Images of your foot -- via x-ray, bone scan or magnetic resonance imaging -- show the fracture size and allow your doctor to determine an appropriate treatment plan.
It may be necessary to temporarily reduce pressure on your foot by using crutches and wearing a supportive shoe to allow your bone-repair machinery time to catch up. Early on, high-impact exercise such as running and jumping should be avoided. Bone is constantly replacing itself, however, and becomes stronger by bearing some weight. Therefore, once you get approval from your doctor, you can gradually begin low-impact exercise such as biking or swimming, weight-bearing activities, strengthening and cross-training.
Bone injuries generally start as a mild stress, similar to a bruise, and can progress to a stress fracture with repetitive impact. The frequency and magnitude of impact will affect the size of the fracture, and surgery may be needed to stabilize the bone. This often requires the placement of plates and screws to align the bone for proper healing. The recovery and rehabilitation after surgery are more extensive than for nonsurgical treatment and may require many months instead of the typical 6 to 8 weeks if surgery is not needed.
Both nonsurgical and surgical treatment for a stress fracture in the foot are often paired with a rehabilitation program that consists of strengthening, stretching and balance exercises, combined with changing problematic behaviors. Strengthening exercises focus on the foot, ankle, knee, hip and core, since weakness in these areas can affect foot-impact forces. Stretching leg and hip muscles restores flexibility, and performing balance exercises will improve overall stability. Periods of rest between exercise are essential for allowing continued bone repair. Other important factors for proper healing include wearing supportive, cushioned footwear and proper nutrition, including adequate amounts of vitamin D and calcium.
Certain medical conditions that decrease bone mass can increase the potential for stress fractures, including osteoporosis, nutritional deficiencies and eating disorders. Treatment for these conditions is more complex and should be closely monitored by a medical professional.
- Sports Health: Imaging of Sports-Related Midfoot and Forefoot Injuries
- Therapeutic Exercise: Foundations and Techniques; Carolyn Kisner, Lynn Allen Colby
- American Academy of Orthopaedic Surgeons: Stress Fractures of the Foot and Ankle
- British Journal of Sports Medicine: Exercises for Improving Bone Strength