Staying Home and Stress Fractures

A stress fracture is a crack in a bone, most commonly caused by repetitive activity and overuse.  They may occur when a person changes their exercise routine, takes up a new form of exercise, or has a sudden increase in physical activity.  A change in terrain or workout surface can be significant, as are conditions associated with weakened bones, such as osteoporosis or inadequate levels of Vitamin D and calcium.

Weight bearing bones in the foot are at high risk of stress fracturing due to the way they absorb forces repetitively during activities.  Even a new shoe can reduce the ability of the foot to absorb weight bearing force and result in a stress fracture.  When worn for an extended period of time, shoes with a very high heel or insufficient cushioning can cause this injury.  Within the foot the metatarsal bones are the most common site of a stress fracture.  This is the region in the foot where there is the most pressure when pushing off while running, but also for most people even when standing.

In truth, anything that significantly changes the mechanics by which a foot absorbs impact can increase risk of a stress fracture occurring.  Over the past 6-7 weeks, most Americans have been forced to change all aspects of their normal life.  We are home all day; working and caring for loved ones.  Some people have seen this as an opportunity to increase activity levels.  Others have stayed inside their homes and have had little exposure to sunlight and the Vitamin D that would be provided on an outdoor walk.

Throughout recent telemedicine visits, Foot & Ankle Specialists of the Mid-Atlantic doctors have found that the vast majority of people have two things in common; people do not wear shoes in the house and are now home most of the day.  They are climbing stairs, running after kids, trying new workout videos, cooking meals- all barefoot or in non supportive slippers.  The symptoms many report are of pain, swelling and sometimes bruising to the top of the foot.  This may seem surprising, as there is no preceding incident or event to go along with the injury.  But really the factors are all present; change in activity, less Vitamin D, change in mechanics or lack of shoes to absorb impact and weight bearing forces.  Staying at home is in fact leading to stress fractures in the foot.

When recognized and treated properly, a stress fracture may take 6-8 weeks to heal.  If untreated the stress fracture may get worse and become a complete break in the bone, in some cases even requiring surgical intervention.  Obviously everyone hopes to avoid such an injury.  In normal times, the message would be focused on progressing gradually into new or more intense activity.  But today the message really is simple- wear shoes while at home.  Choose supportive shoes or add a supportive insole into the shoes.  If you normally wear orthotics, wear them in the shoes that you are now wearing all day within your home.  Focus on a continued balanced diet and expose yourself to Vitamin D in the form of sunlight.  During this challenging time take care of your whole self, including your feet.



Dr. Erika Schwartz works in our Chevy Chase, MD and Washington, DC (K Street) offices for your convenience.

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