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Stress Factures

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What is a Stress Fracture?

A stress fractures is an overuse injuries in bones. Usually, the complication occurs when the bones in the body experience repeated and high levels of force. For instance, when runners increase their speed and distance. The injuries typically occur in the metatarsals, which are small bones that exist behind the toes.

The fractures can also be classified as minute cracks that occur in the bone, otherwise referred to as “hairline fractures.” The common bones that get affected are the bones that are responsible for bearing most of the weight of the body. Some of these bones include the navicular, metatarsals and the tibia.

Even though stress fractures are mostly described as “overuse injuries”, they can occur due to various other factors. These include factors such as osteoporosis (a bone disease) and or body system issue such as eating complications. More so, women are more susceptible to the condition, probably because they are prone to the conditions mentioned above.

The foot is an intricate part of the body, that comprises of 33 joints, 107 ligaments, 26 bones and 19 muscles. These components in the foot can experience tear and wear, so complications that damage the foot can compromise its health.

Foot Bones and Anatomy

The human foot has 26 bones, which help to support the weight of the body. The bones are classified into three main categories, including the tarsal bones, phalanges, and metatarsal bones. The bones are living tissue, which grow and develop in relation to various factors. Some of these factors include your diet, weight, lifestyle, genetics and more. The major bones that exist in the foot include:

  • Tarsal bones – the tarsal bones are a specific number of bones, that make up the rear aspect of the foot. The tarsal bones might comprise of:
  • The ankle bone or talus. The talus is a bone on the top section of the foot. The bone connects to the tibia and fibula bones on the lower part of the leg.
  • The calcaneus or heel bone – the calcaneus is the biggest of the tarsal bones. It exists below the talus and is vital in hoisting the weight of the body.
  • The tarsals – these are bones that start between the arch of the mid-foot. They include the intermediate, medial, cuboid and more.
  • Metatarsal bones -The metatarsal bones are a collection of tube-like bones in the centre of the foot. The bones connect to the phalanges and tarsal bones. More so, the metatarsals are aligned in a row, with the first one existing close to the foot arch.
  • Phalanges -The phalanges are bones that exist in the toes. The second to fifth toes all consist of three phalanges.

The largest toe or hallux comprises of two phalanges, which are the distal and proximal. The metatarsal-phalangeal joints are the joints that make up the ball of the foot. The first metatarsal joint exists close to the big toe and is a common cause of foot pain and other complications.


The telltale sign of a stress fracture is high levels of pain with increased physical activity. As such, the foot won’t necessarily cause pain in the morning but might increase gradually through the day. Unlike a pull or strain, the ache that relates to a stress fracture doesn’t usually resolve within a few hours or days. Therefore, a medical professional might order for additional tests such as a bone scan or M.R.I test.

In the U.S.A, the annual occurrence of stress fractures among athletes ranges between 6 to 31%. Furthermore, women and physical enthusiasts are also at risk of getting the condition. The occurrence rate increases with age, primarily due to a decrease in Bone Mass Density that occurs with age. Children are also at risk since their bones have not yet achieved full strength or density. Other key risk factors associated with stress fractures include:

  • Activity factors – stress fractures will most often occur in the bones that bear the weight of the body, especially in the legs. The fractures can occur when there is a significant adjustment in the stress or pressure that these bones experience. These adjustments can include an increase in mileage or B.M.I. The bones require time to adapt to the increased pressure or stress on the foot area.
  • Gear factors – wearing the proper, cushioning footwear is vital in controlling any stress fracture or foot complication. For instance, a tight or worn out shoe can affect the structure of the foot, and lead to discomfort. Also, a significant change in the running surface, such as moving from trails to a road, can also increase pressure around the foot area.
  • Physiological factors – various physiological health studies have shown that a tight calf muscle structure, affects the lift of the heel as you run. As such, the forefoot experiences increased pressure, thus leading to a potential fracture. Also, muscle fatigue can contribute to one getting stress fractures. The muscles have the role of acting as shock absorbers in the body. That said, the muscles in the lower leg, can become prone to fatigue, especially after you engage in intense physical activity. The increased stress on the bones also increases the likelihood of fractures.
  • Diet factors – while being light weight is important for optimal health and activities such as triathlon, diets that have compromised nutrient intake can lead to fractures. For instance, diets that lack nutrients such as vitamin D, calcium and dairy products can put athletes at increased risk. In his book “The Endurance Diet”, renowned diet specialist Matt Fitzgerald recommends a few nifty guidelines. “Consume everything, ensure its quality, focus on carbs and consume enough. This technique is not meant for weight loss, but for maintaining the ideal Body Mass Index (B.M.I) level.

What are the Symptoms and the Diagnosis Process?

Pain is perhaps the single most notable symptom of a stress fracture. Usually, the pain increases when you engage in physical activity. Other accompanying factors include tenderness and swelling. More so, such issues might be accompanied by complications such as bruising and bleeding. The pain might increase with any form of weight-bearing the increases in relation to the activity. That said, the pain will subside with sufficient rest, but might increase if the person experiences a bone injury. Additionally, the individual might experience an area of localized tenderness on the bone or increased swelling.

Prior to performing any scans or X-rays, a physician will perform an exam on both feet and legs. The podiatrist will also ask the patient a few questions in relation to the nature of the condition. Furthermore, they may even evaluate the pelvis and the back. They may seek information on risk factors the client has experienced in the past. Following this, a CT or MRI scan might also be beneficial, with each method providing an accurate diagnosis.

Who is at Risk?

Stress fractures can affect individuals from both sexes and all age groups. The complication can occur in all 26 bones in the body, particularly in those who engage in high-intensity sports. These are people who are more prone to the highest levels of injury. In a recent medical study, it was noted that women and athletes are highly likely to experience stress fractures. That said, stress fractures can affect almost any individual that places excessive pressure on the structure of the bones. People who also have poor diets, such as lack of sufficient calcium or Vitamin D in the body are also likely to get the condition.

What are the Options for Treatment?

Athletes and physical enthusiasts never like to hear it, but the first line of treatment for stress fractures is rest. Simply put, take a break for the activity that led to the stress fracture in the first place. More so, consider applying a change in footwear, such as shoes that provide enhanced weight-bearing benefits. Consider something simple such as shoes with comfortable soles, or more advanced such as crutches or walking boots. Rigid insoles are also excellent orthotics because they provide enhanced foot support and comfort.

Furthermore, adjusting your diet can also be beneficial. For instance, improving your calcium and vitamin D intake will help to heal your bones. Fortunately, most stress fractures resolve themselves with proper DIY care. While older medical records would suggest the use of NSAIDs, such medications tend to lead to dependency issues. As such, unless the individual absolutely needs the prescription, reduction or avoidance of such class of drugs is suggested.

Once the individual has been pain-free for 7 to 10 days, the treatment will focus on rehabilitation of the affected area. Consider the following factors to keep your feet healthy and injury-free:

  1. Awareness – your choices of activity can increase of decrease the likelihood of getting stress fractures. Stating informed about your body weight and the lengths to which you can get workouts meaningful. Any radical adjustment from your current physical activity regimen might cause intense pressure on the foot bones.
  2. Rome was not built in a day – when you start a new physical activity plan or active lifestyle, try and develop gradually. Avoid making significant alterations to your workout session, or intensity. If you are prone to stress fractures, consider developing a suitable workout plan in relation to your needs. For instance, consider running on “even” days and cycling during the odd. More so, consider the long term factors in choosing your daily physical regimen.
  3. Diet evaluation – keep track of your consumption of Vitamin D and calcium. Since the sun is a good source of vitamin, many in the northern hemisphere, especially in winter will consume Vitamin supplements. Calcium is readily available in various types of meals such as tuna. That said, consider stopping to consume products such as NSAIDs, because they can compromise bone repair procedures.
  4. New Kicks – while it’s tempting, avoid old and worn-out shoes, primarily if you use them for activities such as running. If the shoes have reached the end of their useful lifespan, invest in new ones. Wearing proper shoes is among the leading ways to take good care of your feet.
  5. Insoles – most shoes don’t often come with proper cushioning or provide adequate support required for high-intensity activities. There are various types of insoles, that can provide lightweight and flexible support for the structure of the foot. A good example would be Scholl`s WORK insoles, which are both comfortable and durable.
  6. Nip it in the bud – remember that if you notice that you have one or more symptoms of stress fractures, then consider stopping the activity. Give yourself a chance to resolve the complication for a few days. That said, if the symptoms come up again, consider contacting a local health service provider. Being able to recognize the signs early is vital in the treatment process.

Prevention Methods

Similar to the treatment and management methods of stress fractures, prevention relates to many factors. For instance, prevention can refer to factors such as lifestyle habits, bone structure, body health, and more. Various preventions methods have been proposed over the years for managing stress fractures. For instance, altering the biomechanics of training activities and schedules play a significant role in controlling the occurrence of stress fractures. Furthermore, the use of orthotic insoles has also been shown to be beneficial for people who engage in intense physical activity. Diet also plays a significant role in the physical structure of the bones and muscles in the body. As such, it is recommended that you consume a high calcium and vitamin diet for the best results.


Being able to keep your bones strong and healthy is essential not only for avoiding foot health complications but your overall quality of life. The human feet are relatively delicate structures that have to support the entire weight of the body. As such, our bodies need excellent conditions such as proper shoes and healthy diets to avoid issues such as stress fractures. While some people are prone to stress fractures, there are various useful prevention and management techniques to consider. Consider developing unique workout routines and keeping the feet free from any form of pressure. More so, consuming the appropriate diet, which consists of calcium and vitamin D intake, is also beneficial.

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About the author


Hi, I’m Brian Bradshaw. I’m a super duper mega hiking enthusiast, with a love for everything that has to do with outdoors, hiking, gear, footwear and more.

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