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What causes stress fractures?

By Foot health with Leana

A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture.

Symptoms

Symptoms of a stress fracture include:

• Swelling

• Pain

• Tenderness in a specific spot

• Increased swelling and pain with activity

• Earlier onset of pain with each successive workout

• Continual pain at rest as the damage progresses

At first, stress fractures may be barely noticeable, but attention should be paid to the pain.

Causes

Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface (a tennis player who has switched surfaces from a soft clay court to a hard court); improper equipment (a runner using worn or less flexible shoes); and increased physical stress (a basketball player who has had a substantial increase in playing time).

If your bones are subjected to unaccustomed force without enough time for recovery, you'll utilise bone cells faster than you can replace them. As a result, you develop "bone fatigue". Continued, repetitive force causes tiny cracks in fatigued bones. These cracks progress to become stress fractures

Risk factors

Factors that may increase your risk of stress fractures include:

• Certain sports – Stress fractures are more common in people who participate in sports such as track and field, basketball, tennis or gymnastics.

• Increased activity – They often occur in people who suddenly shift from a sedentary lifestyle to an active training regimen — such as a military recruit subjected to intense marching exercises; or an athlete who rapidly increases the intensity; duration or frequency of training sessions.

• Gender – Women who have abnormal or absent menstrual periods are at higher risk of developing them.

• Foot problems – People who have flat feet or high, rigid arches are more likely to be susceptible.

• Weakened bones – Conditions such as osteoporosis can weaken your bones and make it easier for stress fractures to occur.

Tests and diagnosis

While doctors can sometimes diagnose a stress fracture from the medical history and physical exam alone, imaging tests are often needed to confirm the diagnosis. Therefore tests like x-rays, bone scans and MRIs are required to help with detection.

Treatment

The most important treatment is rest. Individuals need to rest from the activity that caused the stress fracture, and engage in a pain-free activity during the six to eight weeks it takes for most of them to heal.

If the activity that caused the injury is resumed too quickly, larger, harder-to-heal stress fractures can develop. Re-injury also could lead to chronic problems where proper healing might never take place.

Therapy

In addition to rest and therapy, orthopaedic appliances may be used to aid the healing process.

To reduce the bone's weight-bearing load until healing occurs, you may need to wear a walking boot or brace, or use crutches. In severe cases, the doctor may need to immobilise the affected bone with a splint or cast.

Home care

Proper self-care and treatment can prevent the injury from worsening. So it's important to give the bone time to heal. In the meantime:

• Rest – Stay off the affected limb as directed by your doctor until you are cleared to bear normal weight.

• Ice – To reduce swelling and relieve pain, your doctor may recommend applying ice packs to the injured area as needed — up to three or four times a day for a period of 10-15 minutes.

• Resume activity slowly – When your doctor gives the okay, slowly progress from non-weight-bearing activities such as swimming to your usual activities. High-impact activities, such as running, should be resumed on a gradual basis, with careful progression of time and distance.

Prevention

Simple steps can help you prevent stress fractures:

• Make changes slowly – Start any new exercise programme slowly and progress gradually.

• Use proper footwear – Make sure your shoes fit well and are appropriate for your activity. If you have flat feet, you need to check out arch supports or orthotics for your shoes.

• Cross-train – Add low impact activities to your exercise regimen to avoid repetitively stressing a particular part of your body.

• Get proper nutrition – To keep your bones strong, make sure your diet includes plenty of calcium and other nutrients.

Your feet mirror your general health . . . cherish them!

Leana Huntley is an English trained foot health practitioner

attached to ALMAWI Limited – The Holistic Clinic. Call 662-1732 for an appointment or e-mail

lhuntley@almawiclinic.com Tuesday - Saturday.

Check for the Clinic at

www.almawiclinic.com.

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