Nothing strikes fear into the hearts of distance runners quite like the possibility of a stress fracture. Unlike most muscular injuries, which one can usually treat through physical therapy with the hope of a speedy recovery, a stress fracture means nothing other than weeks or even months off from running.
Stress fractures are caused by repeated forces against the bone, leading to the formation of a small crack. While they can occur in many bones of the leg, this article will focus on stress fractures in the foot.
Initially, a stress fracture will cause just a small, dull pain or a feeling of weakness in the foot. Most runners will not be concerned with this pain and will run through it, causing the injury to worsen. As a stress fracture progresses, the pain becomes sharp, deep and localized. If one continues to run despite the pain, eventually it can become unbearable to run or even put any weight on the foot.
Diagnosis of a stress fracture can be challenging, as there is often no exterior manifestation of the injury. There might be a small amount of swelling, but there is never any bruising. There are several injuries in the foot that could feel similar to a stress fracture, notably plantar fasciitis which causes pain on the tendon underneath the foot. The only real way to determine the cause of foot pain is to visit a doctor. The diagnosis of a stress fracture typically requires an x-ray or an MRI. While x-rays are usually the first step, they often won't reveal a stress fracture until after it has already started to heal. Most patients require an MRI to get a definitive diagnosis.
Once an athlete knows she has a stress fracture, the first step of rehab is to stop running entirely. Many runners who suffer from stress fractures of the foot require crutches or even immobilization devices, such as a walking boot, to allow the fracture to heal appropriately. It is important that an athlete recognize that the injury can take quite a bit of time to heal, potentially several months.
Trying to run too soon could lead to a reaggravation of the injury. Athletes with stress fractures of the foot can do zero-impact cross-training activities, such as swimming, until they are able to run again. When the pain has completely disappeared and the greenlight has been given by the doctor, an athlete may begin slowly returning to running.
Stress fractures are scary because they force us to take time off running. But at the end of the day, most fractures only take 6-8 weeks to heal and then we are able to get back to running. If we are careful not to jump back into running too quickly, a stress fracture need only be a minor setback in an otherwise healthy running career.