Important Things to Know About Stress Fractures
/With Spring here more folks are outside, including runners. Oftentimes runners complain experiencing pain in the mid foot. The first concern would be to rule out stress fractures. Stress fractures occur with either normal force on abnormal bone (example: elderly) or abnormal force on normal bone, (example: new activity or increased load on the foot).
Symptoms include pain with walking, running or any increase in activity. Swelling may also be a problem.
A visit to the podiatrist is critical to help rule stress fractures out before they become more of a serious problem. X-rays can be taken in office to look for evidence of stress fractures. It should be noted, however, that early stress fractures may not show up on the x-ray until 2 weeks after the start of symptoms.
The most common bone in the foot to experience a stress fracture is the 2nd metatarsal bone due to it being the longest bone in the row. The 2nd metatarsal will generate greater loads and greater stress, repetitive loads for a period of time can cause a stress fracture.
Sometimes a person may experience the same pain and symptoms of stress fractures due to a phenomenon known as over use or stress syndrome. Medical tibial stress syndrome is an irritation of the tibia (shin bone) at points where the soleus and tibialis posterior muscles attach to it. It is caused by over-use in runners, however, there are a number of factors, such as altered foot, knee and hip posture, that can predispose a person to the syndrome. This is considered as a precursor to stress fracture. An MRI can help detect this and will show increased signal in the affected bone.
The best treatment is rest and protected weight bearing. Sometimes taking up to 6-8 weeks, something athletes never want to hear. Pain may be treated with ice and anti-inflammatory. Once improved, the goal would be to reduce chances or recurrence with slow modifications and likely functional inserts with specific design to the individual.
By: Dr. Adam M. Thomas, DPM