Stress Fractures

By Dr. Brian Richman

(This is a newspaper article that I wrote on the treatment of stress fractures for the Ogden Standard Examiner on August 25, 1997. )

Your feet are biological masterpiece. They are designed like a truss of a roof or an arch of a bridge, able to support the human body; they easily adapt to uneven terrain and meet the demands of daily use. No two feet are alike. The human foot contains 26 bones, 33 joints, and a network of tendons, muscles and ligaments. In fact, your two feet contain 25 percent of all the bones in the human body. Many people will have some type of foot problem sometime in their life and may require professional foot care.

Stress fractures are common foot problems that can cause severe pain, inflammation and difficulty wearing shoes. Stress fractures are common in women, ballet dancers, athletes, long distance runners, joggers, basketball, soccer players, and military personnel. Stress fractures are caused by repetitive forces aggravating individual bones in the feet and ankles. Stress fractures are a common occurrence in the metatarsal (foot) bones an the tibia and fibula (ankle) bones. Usually the second and third metatarsal and fibula are the most common areas for stress fractures to occur. X-rays, bone scans, and a tuning fork are used to help diagnosis stress fractures. With proper medical treatment, stress fractures will take 6 to 8 weeks to heal. Most stress fractures respond well to conservative care and generally do not require surgery. Treatment of stress fractures includes ice, ace wrap, non-steroidal anti-inflammatory medications, insoles, orthotics, stiff soled tennis shoes, cast therapy, immobilization, bone stimulator and decreased activity. In my opinion, immobilization (cast therapy) for 4 to 6 weeks is necessary to heal stress fractures. Calcium supplements and are prescription medicine called Fosamax and Miacalcin may help in healing stress fractures. Fosamax is an oral medication and Miacalcin is a nasal spray used in the treatment of osteoporosis and has been found helpful in treating some fractures.