Stress Fractures Rise for Kids and Adults after Vacations. What’s Up with That?

We see more foot stress fractures when kids (and adults) return to school and work. Here’s why this happens.

stress fractures in children

Children are particularly susceptible to stress fractures after periods of inactivity.

Say goodbye to playing video games all day, no more lounging around the pool, no more afternoon siestas and no more building snowmen (or “snow people” as I l called them back in Maryland) during the holidays.

Sadly it will be time to say goodbye to our lazy summer days or snowbound Christmas holidays before we know it and get back into the swing of things. This also means more of our patient will be dealing with an increased risk of common stress fractures… uggh.

This might mean getting back on the football field or tennis courts for our student athletes, running from one end of the campus to the other for our college students, and standing for hours at a time for our teachers and professors.  Going from a sedentary lifestyle to more activity in a short time can definitely take a toll on your feet.  In fact, it can increase your risk of getting stress fractures.

What is a stress fracture

When people hear the word fracture, they generally think of a broken bone.  They associate it with some sort of known traumatic event such as falling or dropping something on their foot.  However, did you know that not all fractures are due to trauma? There’s another type of fracture called a stress fracture.

A stress fracture frequently occurs due to increasing the amount or intensity of an activity too quickly. Normally, the bone’s ability to gradually adapt to increased pressure through a process known as remodeling. Remodeling allows for the destruction and rebuilding of bone so that it is stronger.

However, with increased pressure over a short time, the bone does not have enough time to adapt thus leading to increased stress to bone. This causes increased inflammation inside the bone and tiny hairline fractures to outside of bone.

Who is at greatest risk for stress fractures?

Patients who increase activity or start a new exercise regimen over a short period of time are the most susceptible to stress fractures.  That’s why it’s always important to slowly transition into activities and allow your feet and bones to acclimate to increased loads.

Structural deformities such as a bunion can cause overloading to lesser metatarsals resulting in pain. Increased weight will also cause strain to your feet. Wearing softer soled shoes like Converse, Vans, and Toms will reduce foot stability and increase risks of stress fractures.

Remember that your feet carry all the weight of your body and you need to give them the proper support with stable rigid shoes and even orthotics. Females with osteoporosis, medications such as prednisone, and vitamin d/calcium deficiencies are also more susceptible to fractures in general due to softer bone integrity.

What are the symptoms of foot stress fractures?

Symptoms include insidious pain with weight-bearing and improvement with rest. Pain is generally on the top of a foot. Swelling and skin discoloration can also be seen often, but not all the time. .

Most patients point to a generalized area but with clinical assessment, podiatrists can generally pinpoint the area of the fracture.  A tuning fork can also be useful in identifying a stress fracture, believe it or not.

A tuning fork is generally used to assess nerve sensation. In a normal exam, we put a tuning fork on a specific bone and patient should only feel a vibration. In the area of a stress fracture, patients will feel pain secondary to fracture.

The most common location to get a stress fracture is at the 2nd metatarsal or long bone associated with your 2nd toe. Other common bones affected are the metatarsals and tibia and fibula.

Does Imaging help diagnose fractures?

foot stress fracture x-rayImaging can help, but unfortunately stress fractures are not always seen on x-ray. For this reason, they are often misdiagnosed. In order for them to appear on films, they must have at least 30-50% decrease in bone density.

If a patient have been walking on stress fracture for a long time, a bone callous will form around the fractured bone. The very best way to determine if a stress fracture is present is an MRI. An MRI will take a 3D image allowing us to see both the inside and outside of each individual bone. It will show where there’s increased inflammation associated with pathology.

Fortunately, because they are significantly more expensive than a normal x-ray, MRIs are not always necessary to diagnose a fracture. Diagnosis is also based off patient history and clinical symptoms.

How do we treat stress fractures?

Treatment for stress fracture includes immobilization in walking boot for 4-6 weeks. If specific bones such as the heel bone are affected, we may completely immobilize foot with crutches depending on pain. Anti- inflammatory medications are also recommended to reduce swelling.

Stress fractures generally heal and surgical intervention is rarely required. However, it is always a good idea to find out why a patient may have gotten a stress fracture in the first place to prevent future injuries. It’s our goal to start you off on the right foot this school year and help prevent injuries throughout.

 

WHY IS UNIVERSITY FOOT AND ANKLE INSTITUTE THE BEST CHOICE FOR CARE IN CALIFORNIA?

The doctors at UFAI are thoroughly trained and highly skilled in all the effective ways to treat your plantar warts. We will carefully analyze your condition and prescribe one (or a combination) of our many weapons against plantar warts.

If you’re experiencing problems with your feet, we’re here to help. Our nationally recognized foot and ankle specialists offer the most advanced podiatric care with the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.

For more information or to schedule a consultation, please call (877) 736-6001 or visit us at www.footankleinstitute.com.

Dr. Avanti Redkar, DPM

Dr. Avanti Redkar, DPM

Dr. Avanti Redkar is board certified in podiatric medicine and joined University Foot and Ankle Institute under a fellowship in sports medicine and ankle reconstruction. She attended podiatry school at the New York College of Podiatric Medicine and went on to complete her surgical residency at Good Samaritan Hospital in West Islip, New York, where she was trained in foot and rearfoot surgery, wound care, and hyperbaric medicine.

Dr. Redkar specializes in foot and ankle pathology and is available for consult at our Mid-Wilshire Los Angeles and Beverly Hills locations.
Dr. Avanti Redkar, DPM

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