Stress Fracture Questions

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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1. Whether or not a cane or crutches should be used in the face of foot pain of uncertain cause is a judgment call, but as you express concern, why not tell your doctor that you want to use either and then do it unless he/she can cite a substantive reason why not to. I do not generally prescribe either for a metatarsal stress fracture in my patients. I use elastic compression, analgesics/anti-inflammatories and a surgical or sometimes a very hard soled shoe.

2. Stress fractures are real fractures, but are generally not occasioned by the sort of overt trauma normally associated with a fracture. Healing time would be generally consistent with the healing time for any other fracture of that particular bone. You don't indicate which bone it is, but if it's a metatarsal, six weeks should be an average time. Radiological evidence of healing would be the same whether or not it is a stress fracture or any other type of uncomplicated fracture. The reason that a stress fracture often cannot be immediately seen on an x-ray is because the fracture line is so thin. Within 2 weeks (but sometimes longer) it can be diagnosed by the visualization of healing bone callus on x-ray.

3. Once well-healed, a stress or any other fracture should be as strong as it was prior to the fracture, as unlike most tissues in the bone, bone heals with bone cells rather than fibrous scar. Radiological evidence of healing is generally considered to appear to be about 2 weeks behind actual physical healing, but that is something that your doctor has to decide and deal with, not you.

 

Thanks for the response.... Yes it was a metatarsal bone that was stress fractured.

Even if my foot feels fully healed at my next doctor visit, (3 weeks from onset of pain).. I will more than likely not do any gym excersises that stress the foot area for at least 3 more weeks (longer if the doc tells me so)... (to be safe)

It's good to hear that when completely healed, the bone should be as strong as before... That was one of my main concerns...

I'll tell you this, I have a new appreciation for my feet. I never gave much though to how much they play a factor in my daily life until this injury.....

 

I was reading your posts and I have a few questions for anyone that may help. I am not an athlete....just clumsy. I was out one night, wearing heels in a dark club, and I missed a stair. I held onto the railing but felt my foot turn inside my sandal. I thought by morning it would be okay. I woke up with the most excruciating pain and went to the emergency room. They said it was a sprain, there was no podiatrist in the building being that it was the 4th of July. The nurse wrapped up my foot and said that if it feels like it's healing there is no need to see a podiatrist. I am worried it is a stress fracture since the fractures can't be seen in x-rays. It's been about a week and sometimes it feels like it's getting better and other times it feels like I'm back to the very first day with that incredibly awful pain. It only swelled up right after the emergency room visit and isn't tender to the touch anymore. I know I should probably go see a podiatrist but I am leaving for Europe next week. I was just wondering if anyone knows how to tell when healing has begun. And, if it is a sprain, how long would that take to heal? Thank you for your help!

Clumsy me

 

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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First of all, the classic definition of a stress fracture is, in part, one which occurs without any overt traumatic cause, and although that does not technical fit your story, one could still have sustained the sort of fracture which is normally termed a stress fracture though mild overt trauma such as you report. It is not uncommon for a stress fracture not to be notable on standard x-rays for 2 to even as much as 6 weeks, as initially it often can only be radiologically diagnosed by evidence of a healing process rather than seeing an actual fracture line. It would be unusually for the swelling and tenderness to only have been evident for one day, but that might be a peculiarity of the patient rather than the injury. As 8 days have past and you apparently have no symptoms, you either have incredible pain tolerance or probably there is nothing seriously wrong. I suppose that as you are leaving the country, to allay any concerns, a podiatrist might be consulted for a look-see, though in the absence symptoms and negative x-ray finding, I don't know how one would determine what if any healing had taken place or is still necessary.

 

Foot Doc, Thank you.

I'm not sure what the deal is with my foot. When I said it isn't tender to the touch I just meant that I can touch it without it hurting. Initially, I couldn't even lightly touch the top middle section of my foot without suffering terrible pain (and yes, I do have an oddly high tolerance for pain). Right now it feels achy...and when I do probe it (a little) it feels as a bruise would feel when poked. I do know that at the ER the doctor said it was the third metatarsal and I've noticed then when I have put weight on my foot during the day it aches more at night, and when it's been rested it's not so bad. Also, it feels much better when wrapped up, almost as if the pressure soothes it. What can I say, perhaps I am an exceptional case. None the less, thank you for your reply.

 

Hello, I was reading this thread and wanted to ask about my own situation.

I am a 20 year old ballet dancer who dances several hours every day. Yesterday I had a day off and was choreographing a bit of ballet in my living room. I didn't exert myself much, nor did I do anything to agitate my foot. But suddenly I realized my left foot was hurting. I went to bed, and when I went to dance class this morning, the pain was still present and prevented me from doing everything. I performed on it today, but now I'm starting to think something is actually wrong.

There isn't much pain when I'm resting (sometimes there's a dull pain on the top of my foot). It feels worse when I have weight on it and I begin to releve (lifting up the heel to balance on the ball of the foot) or if I have no weight on it and begin to point my foot. I feel such an intense pain (it's hard to localize, but it's in the metatarsal area) that I have to immediately get the weight off of it. It then continues to hurt for a few minutes before fading to an ache. In class, I was unable to push off the foot into a turn, to jump, and it's beginning to hurt when I stand on it with it turned out.

I know I should see a doctor, and will in a few days if the pain isn't gone, but could I have a stress fracture?

 

Maybe, but how would a yes or no help you. You have a painful condition of your foot which, as a ballet dancer, you stress beyond reasonable levels as a daily routine. You need to see a podiatrist or orthopedist, lest you potentially really do yourself some damage.

 

I just started college and I have to walk about a half mile from my apartment to campus which is fine, it's downhill. Walking back up isnt bad either. The past 4 or 5 days when i have to walk it though i get a REALLY sharp pain on the top of my left foot and going slightly up my left ankle, on the shin side. It hurts when I am walking on flat, leveled ground as well, but not nearly as bad as if I am going up or down hill. When walking on flat ground i can bear the pain it's just somewhat uncomfortable probably a 3 on a scale of 1-10, but when going up or down hill on a scale of 1-10 my pain level would be a 7. HELP PLEASE!

 

Hi Footdoc,

I had a car accident that fractured my 3rd, 4th and 5th metatarsal on 13 Apr. i have been refrained myself from walking since. However my foot is still slightly swollen and i tried walking recently to keep myself in shape (hoping to get back to work soon). I know it normally takes 6-8 weeks for fracture bone to heal, but how about 3 fracture bones? And i am wondering what are the shoes that i should wear supposedly i am allowed to go back to work (special sole boots or normal sneakers,etc)?

Btw, my age is 25