Stress Fractures

There’s more than one way to break a bone. Not all of them begin with a horrifying crack and an instant rush of severe pain.

If you’ve started to develop chronic pain and tenderness in the middle or front part of your feet that seems to be worsening over time and spikes during activity, you may have something called stress fractures.

While this type of foot injury may seem less severe than an acute fracture or other sudden trauma, don’t be lulled into a false sense of security. Trying to play through the pain will only prevent the stress fractures from healing, and potentially lead to more severe pain down the road.

Woman Holding Foot In Pain
Woman Holding Foot In Pain

What Are Stress Fractures?

Rather than breaking through a bone, a stress fracture is a crack that develops along the surface. Although stress fractures can happen in many parts of the body, they are especially common in load-bearing areas, such as the metatarsal bones of the feet.

In the early stages of the injury, you may not feel anything other than some mild tenderness during activity. However, continuing to put weight and pressure on the fracture causes it to worsen over time.

If your stress fracture is severe, the pain may be intense and will not fully go away even during periods of rest. There is also a risk that the crack will ultimately develop into a full break of the bone.

What Causes Stress Fractures?

Unlike most broken bones, stress fractures develop gradually over time due to repetitive impacts and overuse. They are most likely to occur in situations where you suddenly increase the intensity or duration of your physical activities, or significantly change your workout routine in a short timeframe.

Exercise can be stressful for soft tissues and bone, especially if you aren’t used to higher levels of athletic activity. It’s crucial to not overstress your body at first when you’re beginning a new challenge, and to give your body plenty of rest time after exercise to recover. When you do this correctly, tissues and bones are able to rebuild themselves stronger than they were before.

When you increase intensity too quickly and don’t provide your body with that necessary rest, the repair functions can’t keep up. Fatigued muscles and tendons aren’t able to dampen impact forces on the bones. Over time, a stress fracture may develop.

You may be at increased risk of stress fractures if:

  • You are a runner or play high-impact sports
  • You’ve recently increased your activities (such as a new exercise routine, or taken a more physically demanding occupation)
  • You have weakened bone density due to age, nutritional deficits, or conditions such as osteoporosis
  • You have flat feet, high arches, or other foot structure problems that increase pressure on certain areas of the foot

How Are Stress Fractures Treated?

The central component of any treatment plan for stress fractures is rest. Simply put, your body needs time and space to fully complete its repairs. Depending on the severity of the stress fracture, this rest may take the form of simply avoiding physically intense activities, or we may recommend partially or entirely offloading weight from the foot via a stiff-soled shoe and/or crutches.

On the positive side, most stress fractures do not need any further treatment beyond rest. On the negative side, rest alone as a treatment strategy may require several weeks to several months of downtime from high-impact activities. Restarting activities too soon can undo the healing progress that’s already been made, and if the root causes of stress fractures are not addressed, they can easily return.

But it’s not all bad news! At Rainier Foot & Ankle Associates, we provide comprehensive care for stress fractures, with a focus on helping our patients return to activities as quickly and safely as possible, as well as prevent future episodes. This may include strategies such as:

  • Supporting your feet properly with better shoe gear and, if necessary, arch supports or custom orthotics. 
  • Using advanced nonsurgical procedures such as MLS laser therapy to accelerate pain relief and tissue healing processes.
  • Providing detailed guidelines on how and when you can begin to perform certain exercises and activities during your recovery. (Typically this progresses gradually from low-impact to higher-impact.)
  • Coaching you on how to prevent future training mistakes that can lead to a recurrence of the injury.

In rare cases, surgery might be necessary to repair a stress fracture, particularly if the fracture is severe and located in an area with weakened blood supply. However, this is considered a last resort, and the vast majority of people are able to heal their stress fractures non-surgically by not delaying treatment and carefully following our guidelines.

A Stress Fracture Is A Serious Injury, So Don’t Delay Treatment

While it’s tempting for many athletes and active people to try to ignore chronic pain until they literally cannot bear weight anymore, this a terrible strategy for just about any sports injury—stress fractures very much included.

Ignoring the pain will only prolong it, and increase your risk of developing more severe fractures and arthritis. While no one likes to have to slow down their activities for a time, taking action early is the best way to keep your downtime to a minimum!

Request your appointment with the team at Rainier Foot & Ankle Associates today by reaching out to us online or calling our Enumclaw office directly at (360) 761-1285.