Feet
> Stress
Fracture > Treatments
Support
and Relative Rest
Home Recovery
A stress fracture in
your second metatarsal is a good example of the type
of stress fracture that may be treated symptomatically.
In this case, your physician prescribes enough support
and rest so that you can walk around without feeling
pain. Everyone’s specific treatment is slightly
different, based on pain tolerance and the body’s
natural ability to heal. But in general, a stress fracture
in a bone such as the second metatarsal heals in about
eight weeks. Many patients get initial pain relief by
wearing a brace called a cam walker. A cam walker is
a removable boot, made of nylon straps that fasten around
your calf and foot. Most cam walkers have an adjustable
hinge at the ankle that can be set to allow the range
of motion your physician prescribes. The sturdy bottom
of the cam walker is rocker shaped, which enables you
to walk. You should be able to walk around pain-free
in a cam walker, but you should avoid any strenuous
activities or long duration walks. You typically will
wear the cam walker for three to four weeks, at which
point you should be able return to normal shoe wear
without pain. If pain persists, the cam walker may need
to be worn for an extended time period. When you can
walk in normal shoes without pain, you begin a period
of relative rest, which lasts until your foot can withstand
the stress of the activity that caused the stress fracture.
Relative rest means that you need to keep your activity
level below your level prior to injury. For example,
if your were running two miles a day when the injury
occurred, you should run less than two miles a day when
you return to activities. How much less you run is relative
to the pain and symptoms you feel in your foot. Some
people may be able to run as far as a mile without pain,
but others may only be able to walk a mile.
Formal physical therapy may not be
necessary after a stress fracture. Many patients can
adequately restore motion and strength in their foot
with a regular cardiovascular exercise program. Most
patients can return to sports and activities one to
two months after the injury. Begin exercising with short
walks and increase the duration and intensity as pain
allows. You may be able to use stationary cycles without
causing much pain in your foot one to two weeks after
the injury. When your pain is gone, start with light
jogging before sprinting, jumping, and cutting. Gradually
return to activities with pain as your guide. Understand
that your level of activity prior to the injury was
somewhere above your foot’s threshold to withstand
the forces and stress of that activity. Though it is
difficult to determine your precise threshold for a
stress fracture, it will likely be somewhat below your
previous activity level. Increase your workouts slowly,
and if pain returns, decrease the intensity and duration
of your walks, runs, or other physical activities.
As you continue increasing your activity
levels after suffering a stress fracture, your foot’s
muscles and tendons can become stronger. With proper
training, by the time you return to your previous activity
level, your foot can be stronger than it was prior to
injury, and most patients can return to activities at
full strength without risking future injuries. Your
physician may prescribe orthotic shoe inserts if your
stride is putting abnormal stress on your feet. Orthotics
can help distribute weight evenly through your feet
when you have problems such as leg-length discrepancies,
flat feet, or rigid arches. To avoid reinjury, it is
important to wear the proper shoes for the type of activity
you perform. Shoe manufacturers design shoes to withstand
the forces put on your feet during the motions you encounter
in a specific sport. Basketball shoes are designed to
withstand cutting and jumping on hard courts; running
shoes are made to withstand a sustained, rhythmic pounding,
and cleats to prevent imbalances on soft ground. You
also should remember the activity level that caused
your stress fracture. You have the advantage of knowing
the amount of repetitive strain your foot can withstand.
If you decide to increase your workouts above the level
of intensity or duration that caused the injury, be
sure you have stretched and strengthened the muscles
in your legs and feet to a higher degree of fitness.
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