Stress Fracture - Leg & Foot
Stress fractures tend to occur in certain bones in the feet. Stress fractures commonly occur in the heel (calcaneus), top of the midfoot (navicular bone), and second and third metatarsals. The metatarsals are long bones in the forefoot.
People that begin a strenuous exercise routine before they are conditioned or train to extreme fatigue are at risk for stress fracture. Using improper form during exercise or sports or inadequate sports equipment and shoes can cause stress fractures. Dancers, military members in initial training, and athletes that participate in high impact sports are at risk for stress fractures because of jumping, running, and marching.
Women have a higher risk because of the effects of hormones on muscles and ligaments. Tall people, those with leg length discrepancies, and cigarette smokers also have a higher risk. Some people have an inherited predisposition for stress fractures.
Stress fractures cause gradual pain that becomes progressively worse with activity. Rest may relieve pain, although night pain is common. The top of your foot or outside of your ankle may become swollen, bruised, or tender.
An X-ray, bone scan or MRI may be used to create an image of your bones to confirm the fracture. Fractures typically do not show up on X-rays until later, so a bone scan or MRI, which are more sensitive, may be used.
At the appropriate time, you may be referred to physical therapy for rehabilitation. Physical therapists can teach you exercises to strengthen and balance your muscles. Aquatic therapy is great for conditioning because the water eliminates the effects of gravity. Physical therapy modalities, such as cold therapy can help as well.
Surgery is used for select fractures that are severe or in areas that typically heal more slowly. Surgical hardware, such as screws and plates are placed internally to position the bones while they heal. Bone grafting may be used in some cases.