If you have pain in a specific spot in your foot or lower leg that you barely noticed at first but is getting worse over time, yet decreases when you rest, you may have a stress fracture. A stress fracture is a tiny crack in the bone, typically so small it cannot be seen by X-ray for 4-6 weeks. Unlike other fractures that are caused by a single event, stress fractures are caused by repetitive activities such as walking and running that exceed the bone’s ability to recover.
Although anyone can experience a stress fracture, people that are involved in high impact sports like basketball, volleyball and running are most at risk. Stress fractures also often occur in people who were not previously active, who start an aggressive exercise routine.

“March fractures” are a type of stress fracture that often occur in people who are participating in basic training. Long marches in boots they are not accustomed to and a new level of exercise can cause March fractures and in some cases the bones may actually break.
If you have flat feet, high arches or weakened bones (i.e. from osteoporosis) you’re at an increased risk of suffering a stress fracture.
Here are the most common treatments for stress fractures:
Rest – Most stress fractures take six to eight weeks to heal.  Stay off the affected limb. And resist the urge to resume your activities until your doctor says you can bear normal weight. Participating in an activity too quickly may cause larger, harder-to-heal stress fractures to develop. Re-injury can also lead to the stress fracture never healing properly.
Reduce stress on your foot and leg – A stiff-soled shoe, a wooden-soled sandal, or a removable short-leg, fracture brace shoe may help to protect your feet until the fracture heals.
Apply a cast – Stress fractures in some bones take longer to heal. Your doctor may apply a cast to your foot to promote healing and remove stress on your leg.
Ice regularly – Icing the injured area 3 or 4 times a day for 10 minutes at a time will help to reduce swelling and relieve pain.
Resume activity slowly – When your doctor approves, slowly progress from non-weight bearing activities to your usual activities. If you like to run, pay careful attention to how quickly you add time and distance.
Consider custom foot orthotics – Custom foot orthotics can ease pain when you are recovering and reduce the risk of the stress fractures recurring. Canadian Certified Pedorthists will advise you if a custom foot orthotic is right for you.
When it comes to stress fractures, prevention is always best. Here are some tips to help you remain fracture free:

  • Don’t wear worn out shoes.
  • Pay attention when walking on uneven terrain.
  • When engaging in any new sports activity, start slowly and gradually increase weekly.
  • Cross-training is important. Instead of running every day, run and bike on alternating days.
  • Maintain a healthy diet. A diet that includes foods rich in calcium and Vitamin D helps the body to recover.

By Jim Pattison, C. Ped (C), Prince Albert, SK