A Stress fracture is generally an overuse injury. It occurs when muscles become fatigued or overloaded, and cannot absorb the stress, shock, and repeated impact. Fatigued muscles transfer that stress to the nearby bone and the result is a small crack or fracture.

What Causes a Stress Fracture of the Foot?

Stress fractures in the bones of the foot are usually caused by over-training or overuse. They can also be caused by doing too much on hard surfaces, such as running on concrete or wood floors. Increasing the time or intensity of exercise too rapidly is another cause, as well as wearing improper footwear.

Women seem to be at greater risk than men are. This may be related to a condition called the “female athlete triad”.  This is a combination of poor nutrition, eating disorders, and amenorrhea (infrequent menstrual cycles), that predisposes to osteoporosis ( thinning of bones ).

It should also be mentioned that stress fractures could occur for no known reason.

Diagnosing Stress Fractures

Many times the foot is swollen and painful without any history of injury. Standard X-rays will usually not show the fracture until2-3 weeks after the original symptoms. A bone scan, CT scan, or MRI may be necessary to detect the stress fracture in the early stages.

Treating Stress Fractures

The best treatment is rest. It may take anywhere from 6-8 weeks for complete healing to take place. Sometimes an anti-inflammatory medication (Ibuprofen, Aleve, or stronger ) is needed. In more serious cases, an off-loading surgical shoe or walking boot is advised. In very serious or painful cases, a fiberglass cast may be needed.

Differential Diagnosis:

Stress fractures can also give the same symptoms as bursitis, arthritis, tendonitis, and gout. Sometimes a blood test will be able to help.

Your Podiatrist will be able to diagnose and evaluate your specific condition and recommend the proper treatment.

Barefoot Running appears to be the new fad. It was made very public when in 1960, Ethiopia’s Abebe Bikila, won the Olympic marathon in world record time, while running without shoes.

Of late, many runners have taken to the streets, grass tracks, sandy beaches, to name a few surfaces, without shoes.

Is there a benefit to running without shoes?

According to a 2010 study published in the journal Nature, runners who wear shoes tend to strike the ground with the heels of their feet first. This gait, called a heel-strike, generates a force up to three times the body’s weight, which can lead to injuries such as Achilles tendinitis and stress fractures. In contrast, barefoot runners land on the balls of their feet, generating less impact when their foot strikes the ground.

“We’ve oversupported our feet [in running shoes] to the point that our foot doesn’t have to do what it’s designed to do,” explains Irene S. Davis, PhD, PT, professor of physical medicine and rehabilitation at Harvard Medical School.

Ditching your shoes means the muscles in your calves and feet will have to work harder to accommodate to a different foot strike and shorter stride; it takes time for new barefoot runners to build up those muscles.

If you have a history of foot problems, check with your doctor before going barefoot. If you decide to ditch your running shoes, there are a few things you should know:

Start slow. You are more likely to suffer injuries if your foot and leg muscles are not properly conditioned for running barefoot. Start with walk-jog intervals, walking for nine minutes, running for one minute, and repeat, working up to longer distances. In addition, the skin on your feet needs to thicken to get used to barefoot running.

Think twice. Many podiatrists feel running barefoot is dangerous. “Most of my patient’s are not world class runners,” says Stephen Pribut, D.P.M., sports podiatrist from Washington, D.C. “ It doesn’t make sense to risk getting stones, twigs, and glass in your feet.”

Know when to say no. Runners who have any loss of feeling in their feet ( neuropathy ), including people who have diabetes, should wear sneakers.

There are available some new-type shoes, such as Vibram Five Fingers TM, that supposed help protect the foot, while giving the advantage of running barefoot.

The theory is still being debated and there is no real data available to make any educated evaluation of whether running barefoot is better than running in shoes. You must use your own judgment and above all be safe. Even Abebe Bilila wore shoes 4 years after his barefoot victory in Rome and still won the Tokyo Olympic Marathon.