by Last updated on February 2nd, 2023 at 12:27 pm
Stress fracture foot problems are common and can significantly reduce production time. There are 26 bones in the foot, and anyone is susceptible to a stress fracture. Stress fracture foot problems occur when a bone is subjected to repeated force or pressure commonly associated with walking, running, playing sports, being overweight and carrying heavy items as part of one’s daily chores.
Some are surprised at this, but it must be kept in mind that the force going through the feet during walking and running leading to a stress fracture is 1.2 – 1.5 and about three times the body’s weight, respectively. Stress fractures in the foot are often referred to as hairline fractures because they are so small. They sometimes take about 3 to 4 weeks to show on X-ray.
With appropriate treatment, most but not all stress fracture foot problems tend to resolve quickly without complications. This article will delve into the type of bones that get fractured, how they are diagnosed, and what treatments may help. Read on for mere!
What Are The Different Types of Foot Stress Fractures?
Stress fractures that cause top of the foot pain are primarily associated with the navicular or metatarsals. Other fractures, such as a lisfranc or jones fracture, can cause pain on top of the foot but would not necessarily be considered a stress fracture.
Navicular Stress Fracture
Although the mechanism of injury is still unclear, it’s thought that the shearing force and the impingement that occurs between the first three metatarsal heads and the talus while playing sports or participating in other activities is a contributing factor. Also, it mainly affects the avascular part of the navicular. The foot pain is generally insidious and can be felt on top of the navicular and midfoot when palpated. This location is called the “N” spot.
Investigation
When investigating stress fracture foot problems, plain X-rays are of little benefit in the early stage. Again this is because stress fracture takes about 3-4 weeks to show using this modality. Better options to confirm the diagnosis include MRI, CT or isotope scanning.
Risk Factors
Stress fractures relating to the navicular most commonly occur in sprinters, footballers and jumping athletes, but they can also occur in the normal population. Sprinters, high and long jumpers, basketball, volleyball and football players spend most of their time on the ball of their feet when training and competing. The force going through the feet is about three times the body’s weight. This stresses the navicular, leading to stress fracture foot problems.
The jumping and bouncing activities compound the problem during training, coupled with short recovery time and limited days off from training. Stress fracture foot problems in the general population are associated with repetitive stress to the navicular when walking and running. Those overweight and those who carry heavy weights such as a bag or objects as part of their daily routine are more prone to stress fractures.
Treatment options
A navicular stress fracture is prone to non-union. As such, a medical professional should offer early and aggressive treatment. The immediate treatment involves a non-weight-bearing cast for 6-8 weeks. The cast should be removed, and the navicular palpated to see if there is still soreness. At this stage, a stress fracture foot brace can be used for a few weeks to further reduce any risks.
Stress fractures of this nature can still be sore after the initial intervention. If this is so, another two weeks of non-weight-bearing and movement restriction should be implemented. Keep in mind that the fracture can take a long time to resolve due to delayed or non-union, and therefore surgery may be the next option if conservative treatment fails. Appropriate footwear should also be recommended, and the use of orthoses if excessive pronation is detected.
Metatarsal Stress Fracture
Metatarsal stress fraction foot problems are common. The metatarsals are the long bones in the mid portion of the foot. The second and third metatarsals are the ones which are prone to a stress fracture of the shaft of the bone.
Investigation
Similar to a navicular stress fracture, a metatarsal stress fracture will not show on a plain x-ray for 3-4 weeks; therefore, MRI, CT or isotope scanning are better suited. Your clinician may also ask you to do a hop test. If there is pain on landing from the test, a stress fracture is indicated.
Risk Factors
A metatarsal stress fracture is associated with overuse and altered biomechanics and can affect the general population. However, footballers and ballet dancers are especially prone to stress fractures of the metatarsal bones.
Over-pronation, repetitive movement and reduced ankle joint range of motion are all contributing factors. The repetitive nature of ballet dancing and the reduced protection of some football shoes increases the chance of metatarsal stress fracture foot problems in these athletes.
Treatment options
As with all stress fracture foot problems, the RICE protocol should be immediately implemented. Conservative treatment may include a cast, a stress fracture foot brace or strapping to mobilise the area with the aim of returning to activities in 6-8 weeks. One can keep fit without compounding the problem by swimming or water jogging.
Foot Stress Fracture Symptoms
The first sign of a foot stress fracture is pain. When any area of the human body is damaged, the body responds by producing inflammation. The brain perceives this as pain due to the chemical and mechanical signals it receives. For this reason, the RICE protocol is effective because it reduces inflammation and pain associated with a stress fracture.
Another sign of foot stress fracture is swelling. Again this is associated with inflammation in and around the damaged area but can also result from fluid build-up. The place where stress fracture occurs generally tends to be warm, which is also a sign of injury, inflammation and chemical reaction at the cellular level. A colour change may occur in some cases, mainly if the stress fracture results from trauma and bruising is present.
How Do You Detect A Stress Fracture?
In the early stages, about 3-4 weeks, a stress fracture is very difficult to detect by X-ray. For this reason, an MRI, CT or Isotope scanning is recommended if one suspects a stress fracture.
With a navicular stress fracture, one can palpate the “N” spot to see if its tender. This is because navicular stress fractures tend to have tenderness in this area. However, it must be stressed that this is not a diagnosis, but just one of the clinical presentations, and further investigation will be needed.
Can A Foot Stress Fracture Heal On Its Own?
If you suspect a stress fracture of the foot or elsewhere, you need to see a qualified clinical as soon as possible. With that said, some low-grade or low-risk stress fractures may heal independently. However, others, such as the navicular stress fracture of the foot, are prone to non-union due to part of it being relatively avascular, as mentioned earlier. For this reason, healing can take a very long time. As such, treatment regimes must be strictly followed for a successful resolution.
How Does A Foot Stress Fracture Feel?
A foot stress fracture generally causes an achy feeling since it is associated with a bone, and bones typically emit an achy pain when injured. However, due to swelling, inflammation and tissue damage, there can be burning, shooting, tingling, and numbing sensations as well. This is because nerves in the feet may also get damaged, especially if the stress fracture was caused by trauma.
Can stress fracture in the foot cause pain in the leg?
A stress fracture in the foot is unlikely to cause pain that radiates to the leg. However, a damaged nerve could cause referred pain if there was trauma. Again, and from experience, patients generally describe nerve pain as stabbing, shooting, tingling, numbing or burning. Moreover, pain in the leg could be a sign of some other pathology. Irrespective of the source of the pain, it would be prudent to seek the help of a medical professional.
Final thoughts
With quick and appropriate treatment, most stress fractures are resolved without drama. Individuals who are very active need to ensure that they are getting enough rest, their diet is healthy and that they are getting enough calcium for good bone health. Remember, your health is your wealth!
