Any bone in the foot can crack through overuse stress. It can happen at any age, but is most common in teenagers and young adults. One possible complications of a navicular stress fracture in children under the age of ten is avascular necrosis, or loss of blood supply to the bone, which is known as Koehler’s disease.
What you Feel When you Have Stress Fracture to the Foot?
The first sign is usually an ache over the bone after exercising, or later on in bed at night. If you rest for a few days, the pain goes away, but returns if you resume the same training. If you continue, the pain gradually gets worse, so much so that even walking hurts. The bone is tender if you press it. You may notice slight swelling.
Causes of Stress Fracture of the Foot?
Repetitive stress, mainly due to muscles or tendons pulling on the bone, causes micro-trauma. Biomechanics are a bigger factor than simple jarring. You may have increased your running mileage, resumed training after a lay-off, or done intensive sessions of rope skipping or hopping and bounding. If you are normally sedentary you can be at risk if you go on long hikes over several days without proper preparation.
Which bone is affected depends on your style of walking or running and your activities. For instance in ‘Morton’s Foot’ a stress fracture can happen in the second metatarsal head which leads into the second toe, whereas if you tend to oversupinate, turning the foot outwards, the fourth or fifth metatarsals heads are more vulnerable.
Stress fractures happen in healthy bone. They happen more easily when bones are weakened by dietary deficiency, osteoporosis or disease.
Treatment for Stress Fracture of the Foot
You should not need a cast, although sometimes immobilisation in a walking cast is used for a child, especially if there is a complication such as Kohler’s disease. Avoid repetitive or painful activities for as long as it takes for the bone to heal. Do pain-free alternative training to stimulate healing. You may be able to cycle. Metatarsals usually heal within six weeks, while the thicker bones, such as the calcaneus and the midfoot, can take up to three months. Allow two weeks after healing before gradually resuming your sport.
