Stress fractures of the foot and shin bone

Stress fractures happen when:

• something puts too much stress on your bone
• your bones get overworked faster than they can repair themselves.

Factors that make you more likely to get a stress fracture include:

• overuse or repetitive activity, such as running and jumping without enough rest
• sudden increase in activity, such as starting a new sport, training harder or running longer distances than usual — for example, training for a marathon
• worn-out shoes or hard surfaces, which can add extra stress to bones
• flat feet and high arches that put extra strain on certain areas
• weak bones or low bone density — conditions like osteoporosis, or nutritional deficiencies, such as low calcium or vitamin D
• having a low body weight.

Pain and swelling usually develop gradually and get worse over time. The pain is often very localised — you can point your fingertip to the sore spot on your bone.

The pain tends to get worse with activity and will initially improve when you rest. But it can then become a constant dull throbbing ache, even at night. This becomes a worse sharp pain when you put weight on it. It is important that you do not keep pushing through the pain.

If you think you might have a stress fracture and are experiencing symptoms, your healthcare provider, physiotherapist or a podiatrist can do tests.

They will talk to you about your symptoms and do a physical exam. They may refer you for an x-ray or other scan.

If the fracture is treated early, you can avoid more serious problems, such as a stress fracture that:

• will not heal
• turns into a bigger break in the bone.

You will need to stop the activities that caused the stress fracture and rest to allow your bone to heal. Depending on the severity of the fracture, you may need to reduce or avoid putting weight on your foot. You may need a cast, moon boot or brace and be given crutches.

Using a pair of crutches

Your rehabilitation will be supervised by your:

• healthcare provider
• physiotherapist
• podiatrist.

They will help you gradually introduce activity when it is safe to do so. While your bone is healing, you may be able to do non-weight-bearing activities such as:

• swimming
• aqua jogging.

As long as you can feel pain, the bone is still fragile in that area, and could break again in the same place. It usually takes 6 to 8 weeks for a stress fracture to heal.

A stress fracture may return if you:

• start your activities again too early
• increase the amount of activity too quickly.

Be guided by your symptoms. Stop exercising or training as soon as you feel pain. Never 'play through pain'.

Keeping your muscles strong can help support healthy bones.

A podiatrist may prescribe custom orthotics to help keep your foot in a neutral position.

Foot orthotics

Other lifestyle factors can also help support strong bones, including:

• eating well
• keeping a healthy weight
• limiting alcohol
• not smoking
• getting adequate vitamin D from sunlight or a supplement