Managing a Foot Stress Fracture the Right Way

Managing a Foot Stress Fracture the Right Way

A stress fracture in the foot is usually associated with an overuse injury to weight-bearing bones. Most athletes affected are involved in high-impact sports that involve running and jumping such as distance running, basketball, tennis, and football.

Bones generally respond to stress by hardening along their outer margins. When suddenly exposed to strong forces or ongoing stress, there is little time for bones to adapt.  Meanwhile, muscles associated with the feet lose their shock-absorbing capacities when fatigued. These uncontrolled forces inadvertently transfer to nearby bones, possibly resulting in small cracks that are better known as stress fractures.

Foot pain caused by stress fractures generally occurs on the top portion of the foot but can also radiate along the heel, side of the foot, and within the ankle joint itself.  Stress fractures commonly occur along the outer ridge of the forefoot over the fifth metatarsal bone. This is often referred to as either a Jones fracture or a Dancer’s fracture, depending on location.

Individuals with a stress fracture usually experience increased pain with movement and, as the condition worsens, even while resting.

Sources of Sore Feet

High-impact activities that result in overuse and put frequent pressure on the lower extremities can lead to stress fractures, such as running, soccer, football, basketball, gymnastics, etc. 

Wearing footwear with little to no shock-absorbing capacities is another contributing factor. Women are more likely to be affected than men, possibly due to poor eating habits/eating disorders and disruptions in their menstrual cycle. Among both genders, excessive aerobic exercise with insufficient rest periods can also increase the chance of getting a stress fracture.

Notably, the presence of underlying bone diseases or disorders can drastically increase the risk for these painful foot conditions.

Signs & Symptoms of Stress Fractures in the Foot

  • Localized foot pain that is dull, aching or sharp and occurs during activity (especially running) and/or periods of rest
  • Mild-to-severe foot swelling and tenderness
  • Pain that worsens with prolonged exposure to ice and during sleep
  • An initial sensation of sharp pain followed by intensifying aching  
  • Localized discoloration and possible stiffness in surrounding joints

Professional Treatment for Stress Fractures

  • Get plenty of rest and apply ice.
  • Consult a physician early on to obtain an exam, X-rays and special testing, if necessary.
  • Avoid placing excessive weight on the affected foot.
  • Wear shock-absorbing footwear, and if symptoms worsen, use a walking boot to help mitigate stress on the injury site.
  • Use a non-weight bearing cast and crutches, if necessary.
  • Eat healthy and ingest the Recommended Daily Allowance (RDA) amounts of calcium and Vitamin D to help restore bone integrity.
  • When symptoms improve, engage in strength training for the arch, toe flexors and weak muscles in the lower extremity.
  • Maintain an ideal range of motion for the surrounding muscles and joints, specifically the Achilles, calf, plantar fascia, great toe and ankle joint.

Ask the Right Questions like a Pro

Here’s what smart pro athletes would ask a sports medicine specialist to ensure a fast and safe return to their beloved game or sport:

1. What do you believe is the main reason(s) why this injury occurred?

2. Are diagnostic tests necessary to further assess the injury?

3. How can I best manage this pain and get back to my sport?

4. What non-surgical treatment options are available, if any?

5. Do I have any leg length disparities or other biomechanical abnormalities that require orthotics or other treatment to avoid long-term foot pain issues?

Elite Sports Medicine Tips from Mike Ryan

  • Time is of the Essence –  Visit a sports medicine specialist as soon as symptoms appear to best manage foot pain from the onset.
  • Rest Rocks –  It’s boring, but REST is the #1 tool to tame a stress fracture.  For how long, you ask?  Prepare yourself for 2 to 6 weeks of inactivity if symptoms persist. 
  • Proceed with Caution – Resume your pre-injury activities at a slow pace, adding strengthening and stretching exercises to your routine.
  • Mix it Up –  Cross Training is king. Add varied activities such as biking, swimming, yoga, and elliptical training to stay in shape and save your “marriage” during this break from activity.
  • Accessorize Appropriately – Ensure all footwear and exercise equipment meet the required standards to prevent re-injury.
  • No Big Break – Stress fractures can easily develop into typical bone fractures if left untreated.  Setting limitations from the get go can help you avoid the “big break.”

How To Eliminate Heel Pain

How To Eliminate Heel Pain

In order to eliminate heel pain, it is important to understand its underlying cause(s). Although the term “heel pain” is somewhat generic, you can testify to its significance if you suffer from this condition.  Sources of the pain, which is located in the arch area on the underside of the foot, can vary.

Heel pain may be caused by trauma such as a forceful strike of the heel against a hard surface, but an overuse injury such as plantar fasciitis is also a potential culprit.

The underside of the heel, or calcaneus, bone has a thick layer of fat and protective fascia that provides padding as the heel makes contact with the ground.  Excessive forces or repetitive pounding can cause this fat pad to move or become inflamed.  When the protective layer under the heel bone loses efficiency in this manner, heel pain and burning feet are painful side effects.

Common Sources of Heel Pain

  • Plantar Fasciitis – A common source of arch pain, this inflammatory condition involves the plantar fascia in the back of the arch.
  • Heel Bone Spur – This problem occurs when excessive bone forms underneath the calcaneus (heel).
  • Heel Contusion – Simply put, this is a bruised heel bone.
  • Calcaneal Stress Fracture – This represents either a preliminary or significant fracture of the calcaneus bone.
  • Tarsal Tunnel Syndrome – This painful condition occurs when nerves encroach upon the back of the foot and arch.
  • Calcaneal Bursitis – This manifests itself as inflammation that occurs within the sack of fluid that sits under the heel.

Heel Pain Signs & Symptoms

  • Tenderness associated with the surface of the heel bone
  • Increased warmth and potential swelling of the underside of the heel bone
  • Arch pain that originates on the heel and can extend into the underside of the foot, towards the toes
  • Posterior heel pain trigged by bearing weight on the foot, which may worsen with active toe flexion

Professional Treatment for Heel Pain

  • Ice the entire heel bone with an ice bag, ice massage or, ideally, with an ice bucket.
  • Rest the area to minimize pressure on the calcaneus.
  • Gently massage the arch and toes.
  • Wear appropriate shoes that bolster padding for the heel bone and help absorb shocks.
  • Stretch the calf to foster pain-free movement of the ankle joint.
  • Consider utilizing orthotics or arch supports, depending on the anatomical alignment and biomechanics of your lower extremities.

The treatments noted above may improve heel bone spur symptoms and help avoid surgery.

Ask The Best Questions to Receive the Best Care

To ensure you receive the best possible care for your injured foot, ask questions like smart professional athletes would as they seek a quick, safe return to the sport they love. Specifically, here’s what a pro athlete would ask his or her sports medicine specialist:

1. Are you 100% certain of the diagnosis provided?

2. Do I need an X-ray to determine the extent of this injury?

3. What are my injury treatment options?

4. What can I expect when dealing with this injury over the next 2-6 weeks?

5. Can you recommend any expert heel pain rehab specialists in this area?

6. Will you provide me and my therapist with a detailed protocol to direct my rehab regimen?

Tips for a Speedy Recovery

  • Act Fast – Arch pain and heel pain are not injuries to ignore.  By prioritizing treatment, it is possible to resolve this injury quickly with minimal downtime.
  • Do Some Sole Searching – Shoes are typically the source of the problem.  Old, improper shoes and worn shoe soles are common factors that lead to arch pain and burning feet.
  • Remember That Ice is Your Friend – Yes, it’s a reality check:  Ice hurts, but it’s exactly what you need for this injury.  Professional athletes will tell you that ice is their best teammate.  Stop complaining and do what is needed….ICE, and lots of it.
  • Know What to Expect – Heel pain typically dictates minimal recovery time.  Provided there is no stress fracture, large bone spur or significant plantar fasciitis, the downtime required for this injury can range from a couple of days to a few weeks.  Quickly determine the source(s) of the problem and seek the appropriate treatment, and you’ll be back in the game before anyone even knew you were cooling your heels!