Because stress fractures build up over time, the pain can come on gradually without being linked to a certain incident or event. Sometimes, the initial sign may be a slight niggle that is easy to pass off or ignore. Symptoms around the stress fracture site may include:

 

• Pain and localised tenderness, ranging from mild to severe

• Pain that is exacerbated by weight bearing or physical activity

• Pain that tends to settle with rest

• Swelling and/or bruising

• Aching even at rest or in bed

When high-impact forces are repetitively put on a bone, tiny cracks may form. Over time and with more stress to the bone, these cracks can continue to grow and begin to cause painful symptoms. This is a stress fracture. Any activity or condition that results in pressure and heavy loads on a bone, or the weakening of the bone, can contribute to the development of a stress fracture. This includes:

 

• High-impact physical activities such as running

• Sudden increase in training intensity

• Certain foot biomechanics

• Unsupportive footwear

• Increased body weight

• Malnutrition or a mismatch of food intake to energy expenditure

• Decreased bone density, like in osteoporosis

If you suspect that you have developed a stress fracture, the first step is to stop the activities that are causing you pain as it may cause the stress fracture to worsen. It would also be useful to reduce loading on the injured bone as much as possible while you are waiting for your appointment. You can do this by:

 

• Wearing comfortable, supportive and cushioned shoes as much as possible

• Avoiding sporting activities until you have been assessed

• Resting the injured bone as much as possible

• Use ice to reduce swelling if present (for no longer than 20 minutes at a time every 2 hours)

• Elevate your foot above the level of your heart to help reduce swelling and pain

Your Podiatrist will help by conducting an assessment and formulating a treatment plan to allow the bone to heal and address the cause to reduce the risk of it happening again. This may include:

 

• Holistic consideration and advice relating to your presentation, including any precipitating factors such as biomechanics, activity levels or medical concerns (referral will be made where appropriate) 

• Orthotics to address any biomechanical issues of the feet and legs that may be resulting in increased stress through the bones

• Footwear assessment to ensure the shoes are helping and not hindering recovery, and are not causing increased loading through certain bones

• Activity modification to avoid activities that will overload the same bone and cause more damage

• Stretching and strengthening of muscles that may have contributed to the biomechanics of the feet that caused the stress fracture

• Referring for any further investigation or medial input as required

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