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.