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The Scoop on Stress Fractures

Updated: Aug 20, 2023

Lockdown + jumping around at home in your crocs got you suffering some shin and foot pain? See a physiotherapist and get it checked for a stress fracture.

Joining the daily jig of the charming and cheeky Joe Wicks has been a saviour for – literally – millions of people! His generosity in keeping us active, exhausting our children, and bringing a smile to our faces is something I will forever be grateful for. Team this however, with a new running plan, poor footwear and crappy-coronavirus-sleep and there may be an increase in risk to our lower limb bone health. This is called a stress response.

A what response?

Bones are amazing. Fact. They are constantly changing, little cells in the bone will break down and rebuild. Exercising, weight training and impact is an important factor for this process and encourages the bones to be strong. However, if we are loading the bones too much, too heavily, or too frequently then the rebuilding cells don't quite get a chance to finish repairing. The bones then starts to become inflamed and are at risk of a stress fracture. These are tiny little microfractures that can lead to bigger fractures and require rest.

During lockdown, we ditched our shoes and increased our at home workouts. Quite simply not wearing good trainers whilst bouncing around our living rooms means that more impact is being put through our feet and lower legs.

The simple fix is to break the rule of ‘no shoes indoors’; give your trainers a spritz with some disinfectant, pop down a mat and off you go!

How to spot a stress fracture

Often, stress fractures are sore points, around the size of a fingerprint, in the lower shin or foot (metatarsal bones), sometimes a little warm and inflamed and very tender to press. They often hurt at rest as well as when you are active. They get more sore with more weight bearing and will likely ache well into the evening, but feel a bit better in the morning.

Risk factors for stress fractures

  1. A very sudden increase in activity (IG at home workouts in your jimjams anyone?)

  2. Poor nutrition

  3. Changes in bone quality, eg. Osteoporosis

  4. Reduced sleep (hello modern life anxiety!)

  5. Poor footwear (Birkenstocks are gorgeous but not the best for jumping jacks)

What to do

Lower leg, shin, and feet pain could be a myriad of things and requires a look from chartered physiotherapist. After an assessment if your healthcare professional suspects a stress fracture they will likely send you for an Magnetic Resonance Imaging (MRI) scan. This is because an MRI is more sensitive for picking up stress fractures. An X-Ray will only see a larger bone fracture or an older healed fracture.

Initial management advice is; rest, ice, elevate, and avoid any aggravating activities. Depending on the scan results a confirmed stress fracture is likely to need a period of non-weight bearing. This may require crutches or an air-cast boot.

Why not to ignore pain

Firstly, ouch! Secondly, if there is a stress fracture in play, without appropriate management it could get worse and turn into a larger fracture which leads to a significant time off of activity. Optimising healing in the early stages is key.

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