Stress Fracture Foot

Pain on the top of the foot

Insufficiency fractures are cracks in the bones of the feet and ankles which occur in weakened bones under normal forces. As the name implies, these bones can’t sufficiently stand up to the stresses of everyday load-bearing activities. This stress fracture foot injury is relatively common in older adults and others with impaired bone strength.

More common by far are fatigue fractures. These occur when bones are placed under extreme, repetitive stress for long periods of time. They’re understandably common among anyone who’s on their feet for long periods performing vigorous physical activity.

Stress Fracture Foot Bone Density

Besides simple overuse, a wide variety of factors contribute to stress fractures. Bone density and thickness vary among individuals and play a large role. Biomechanics also vary considerably, and the alignment of a person’s bones and joints can greatly increase their risk. Muscle mass, strength, and bodyweight are also important considerations. It’s also been shown that female athletes are much more likely to experience stress fractures than their male counterparts.

A small cross-sectional bone diameter is one of the best predictors of the likelihood of stress fractures. What this basically means is that thinner bones are far more susceptible to developing hairline cracks. To date, several major sports medicine studies have demonstrated that even a small increase in bone diameter greatly increase bone strength. Even though they’re likely to weigh more, distance runners with a thicker bone structure sustain far fewer stress fractures.

Orthotics for Stress Fracture Foot

While athletes can’t change their bone structure there are still highly effective ways to reduce their risk. Orthotic inserts can positively impact a person’s biomechanics, and heel lifts can correct for leg length inequality. Inserts are also available which limit excessive or uneven hip rotation and compensate for fallen arches. This last item is particularly important, since flat feet are a major contributor to stress-induced fractures.

Female athletes who overtrain while on a calorie restricted diet experience a very high rate of stress fractures. Formally diagnosed eating disorders are unfortunately common among this group, which can complicate the problem by further decreasing bone density. In such cases behavioral counseling combined with nutritional education have proven helpful.

How does age impact the likelihood of stress fractures?

Age can significantly impact the likelihood of stress fractures. Here’s how:

1. Youth and Adolescence: During periods of rapid growth, bones might be more vulnerable to stress fractures, especially in sports or activities with repetitive impact.

2. Young Adults: Individuals in their late teens and early twenties may engage in high-impact activities, and if bone density is not yet optimal, this age group can be susceptible to stress fractures.

3. Middle Age: As people age, bone density tends to decrease. This, coupled with potential issues like osteoporosis or reduced bone mass, can increase the risk of stress fractures.

4. Older Adults: Bone density continues to decline in older adulthood, making bones more brittle and prone to fractures, including stress fractures. Activities that put strain on the bones may pose a higher risk.

5. Postmenopausal Women and Older Men: Hormonal changes, especially in postmenopausal women, can lead to a decrease in bone density, elevating the risk of stress fractures.

Are there preventive measures to avoid stress fractures?

Yes, there are several preventive measures to help avoid stress fractures:

1. Gradual Progression: Increase the intensity and duration of physical activities gradually to allow your bones and muscles to adapt.

2. Proper Footwear: Wear shoes with good arch support and cushioning, especially when engaging in high-impact sports or activities.

3. Cross-Training: Incorporate a variety of exercises into your routine to reduce the repetitive stress on specific bones.

4. Nutrition: Ensure a balanced diet rich in calcium, vitamin D, and other nutrients essential for bone health.

5. Stay Hydrated: Proper hydration supports overall bone and muscle health.

6. Warm-Up and Stretching: Warm up before exercise, and include stretching exercises to improve flexibility and reduce the risk of injuries.

7. Rest and Recovery: Allow adequate time for rest and recovery between intense workout sessions to prevent overuse injuries.