Overtraining, significant changes in training location or schedule, inadequate footwear or insufficient vitamin D may contribute to stress fractures of the foot, according to physicians writing in "Sports Medicine" and the "Journal of Bone and Mineral Research." Six to eight weeks of relative rest will allow most stress fractures to heal. But Dr. Francis O'Connor and Dr. Robert Wilder, authors of the "Textbook of Running Medicine," note that navicular stress fractures, proximal fifth metatarsal fractures and sesamoid fractures require careful medical supervision, casting and, in some cases, surgery.
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Things you need
- Fracture boot (also known as cam walker, aircast walker, or short walker)
Adjust the fracture boot until it fits snugly but not uncomfortably. Your foot should be immobile, but the boot should not impede circulation.
Wear fracture boot during the day for six to eight weeks. If the fracture site hurts when you walk, keep weight off your foot and use crutches for the first seven to 10 days or until you can walk in the boot without pain. If the fracture site hurts even when you aren't weighting your injured foot, consult a physician.
While wearing the boot, resume walking and low-impact daily activities. If you experience pain, discontinue or reduce any painful activities for one to two days.
After six to eight weeks, try standing and walking in large, comfortable street shoes. If the fracture site hurts, wear the boot for another week. If ten weeks have passed and you can't walk painlessly in casual shoes, see your physician.
Slowly resume favourite activities such as hiking or running by increasing distance or time spent a little each day. For example, authors of "The Textbook of Running Medicine" recommend that a runner should begin with five minutes of brisk walking "increased by 5 to 10 minutes a day up to 45 minutes" without pain, then jogging for five minutes and walking 40 minutes, then jogging 10 minutes and walking 35 minutes, and so on until she can jog 45 minutes without pain.
Tips and warnings
- To help prevent another stress fracture, keep an exercise log and include where, how much, and in which shoes you exercise.
- Avoid sharp increases in weekly mileage and sudden changes in running or walking surfaces (for example, from dirt roads to asphalt).
- Don't run more than 400 miles in the same pair of shoes.
- If your injury does not improve steadily, if you've fractured your foot in the same location before, or if you have a navicular, sesamoid, or proximal fifth metatarsal injury, see a physician immediately. Poor treatment of such stress fractures can result in nonunion injuries--injuries in which the two broken ends of the bone fail to heal together. Such injuries can require surgery and may become permanent.
- If you have recently fractured multiple bones, you may have osteoporosis or a vitamin D deficiency.
- A painful, easy-to-localise (or point-tender) bony spot may also signal infection or a bone tumour.
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- "Journal of Bone and Mineral Research;" Calcium and Vitamin D Supplementation Decreases Incidence of Stress Fractures in Female Navy Recruits; J. Lappe, D. Cullen, G. Haynatzki, R. Recker, R. Ahlf, and K. Thompson; May 2008
- "Sports Medicine;" Stress Fractures. Current Concepts of Diagnosis and Treatment; M.T. Reeder, B.H. Dick, J.K. Atkins, A.B. Pribis, and J.M. Martinez; September 1996
- "Textbook of Running Medicine;" Francis G. O'Connor, M.D., and Robert P. Wilder, M.D.; 2001