Stress fractures can be a difficult thing to diagnose, but they’re generally a very easy thing to treat. Many active patients come in with pain, most often in the front part of their foot, swollen, and completely flummoxed about the source of this new pain, since they don’t recall any injury to the area.
Stress fractures are a type of broken bone that occur because of chronic overuse rather than a single traumatic incident.
So how did I break this bone? Common causes are a switch to unsupportive shoegear, excessively high heels, working long hours on concrete, or a recent increase in repetitive athletic activity.
So what makes it so tough to diagnose these things? This particular break is so tiny that it can’t be seen on x-ray. The first 10 days after the fracture, your x-rays can look completely normal. It’s only later, on follow up x-rays, that we start to see the bone form a healing callus. This confirms the diagnosis.
So how do we know it’s a stress fracture to begin with? Certain foot types are pre-disposed to this injury, and one bone in particular is the usual victim, so when we see you in our clinic, we can determine by exam if a stress fracture is likely.
And how do we fix it? A stiff-soled surgical shoe or CAM boot (a rocker-bottom soled surgical boot) for a few weeks with modified activities will generally do the trick. If there is excessive pain and swelling, we may also apply a soft cast for a few days to relieve your discomfort.
Most important: how do I prevent this? Wear good supportive shoes! If you’re an athlete, make sure you’re wearing the appropriate shoegear for the surface you’re playing or running on. (See my blog on supportive shoes for more info!)