What are they?
A stress fracture is a type of bone break caused by repeated or cumulative strain on a specific area. These fractures most commonly affect the long bones or metatarsals of the foot, particularly the three middle metatarsals, with the second metatarsal being the most frequently involved. The primary symptom is pain, which may vary in intensity and could be accompanied by swelling and discoloration. Often, a lump or soft tissue enlargement is noticeable at the site of the fracture. Stress fractures can be problematic because they are often overlooked or misdiagnosed. Typically, the fracture may not be visible on a standard x-ray for about ten days to two weeks after the injury occurs. Early identification and proper management by a specialist are crucial for a successful recovery and to prevent unnecessary complications.
What causes them?
Stress fractures are caused by repetitive or cumulative strain on a specific bone site. Activities such as spending long hours on hard surfaces, undertaking a strenuous hike or exercise walk, or participating in military marches or band performances can all stress the metatarsal bones, potentially leading to fractures. This strain involves repeated smaller loads over time, or occasionally, heavier strain over a shorter period. Stress fractures may not be immediately visible on x-rays, but they usually become apparent about ten days after the injury. In some cases, more advanced imaging techniques like bone scans may be used for earlier diagnosis.
How do you treat them?
Treating a stress fracture generally involves the same principles as treating other bone fractures. The affected area must be protected, supported, and immobilized to facilitate proper healing. Movement at the fracture site should be minimized to ensure effective recovery. Typically, a protective fracture shoe is used to achieve these goals. The patient should limit walking and regularly consult a foot specialist to monitor the healing process and adjust treatment as needed.
