Feet > Stress Fracture > Treatments

   Support and Relative Rest

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A stress fracture in your second metatarsal is a good example of the type of stress fracture that may be treated symptomatically. In this case, your physician prescribes enough support and rest so that you can walk around without feeling pain. Everyone’s specific treatment is slightly different, based on pain tolerance and the body’s natural ability to heal. But in general, a stress fracture in a bone such as the second metatarsal heals in about eight weeks. Many patients get initial pain relief by wearing a brace called a cam walker. A cam walker is a removable boot, made of nylon straps that fasten around your calf and foot. Most cam walkers have an adjustable hinge at the ankle that can be set to allow the range of motion your physician prescribes. The sturdy bottom of the cam walker is rocker shaped, which enables you to walk. You should be able to walk around pain-free in a cam walker, but you should avoid any strenuous activities or long duration walks. You typically will wear the cam walker for three to four weeks, at which point you should be able return to normal shoe wear without pain. If pain persists, the cam walker may need to be worn for an extended time period. When you can walk in normal shoes without pain, you begin a period of relative rest, which lasts until your foot can withstand the stress of the activity that caused the stress fracture. Relative rest means that you need to keep your activity level below your level prior to injury. For example, if your were running two miles a day when the injury occurred, you should run less than two miles a day when you return to activities. How much less you run is relative to the pain and symptoms you feel in your foot. Some people may be able to run as far as a mile without pain, but others may only be able to walk a mile.

Rehabilitation [top]

Formal physical therapy may not be necessary after a stress fracture. Many patients can adequately restore motion and strength in their foot with a regular cardiovascular exercise program. Most patients can return to sports and activities one to two months after the injury. Begin exercising with short walks and increase the duration and intensity as pain allows. You may be able to use stationary cycles without causing much pain in your foot one to two weeks after the injury. When your pain is gone, start with light jogging before sprinting, jumping, and cutting. Gradually return to activities with pain as your guide. Understand that your level of activity prior to the injury was somewhere above your foot’s threshold to withstand the forces and stress of that activity. Though it is difficult to determine your precise threshold for a stress fracture, it will likely be somewhat below your previous activity level. Increase your workouts slowly, and if pain returns, decrease the intensity and duration of your walks, runs, or other physical activities.

Prevention [top]

As you continue increasing your activity levels after suffering a stress fracture, your foot’s muscles and tendons can become stronger. With proper training, by the time you return to your previous activity level, your foot can be stronger than it was prior to injury, and most patients can return to activities at full strength without risking future injuries. Your physician may prescribe orthotic shoe inserts if your stride is putting abnormal stress on your feet. Orthotics can help distribute weight evenly through your feet when you have problems such as leg-length discrepancies, flat feet, or rigid arches. To avoid reinjury, it is important to wear the proper shoes for the type of activity you perform. Shoe manufacturers design shoes to withstand the forces put on your feet during the motions you encounter in a specific sport. Basketball shoes are designed to withstand cutting and jumping on hard courts; running shoes are made to withstand a sustained, rhythmic pounding, and cleats to prevent imbalances on soft ground. You also should remember the activity level that caused your stress fracture. You have the advantage of knowing the amount of repetitive strain your foot can withstand. If you decide to increase your workouts above the level of intensity or duration that caused the injury, be sure you have stretched and strengthened the muscles in your legs and feet to a higher degree of fitness.

Support and Relative Rest
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