On this Veterans Day, the team at Foot & Ankle Premier Specialists would like to thank all who have served our country. Foot injuries in active military and veterans often result in debilitating pain resulting in the need for treatment or even possible discharge from service. It is important to be educated on proper shoe gear and injury prevention mechanisms to avoid injuries such as stress fractures, ankle sprains, or tendonitis. This week, we will discuss the causes of and treatments for stress fractures of the foot.

Stress fractures are one of the most common injuries suffered by active duty military. These injuries are most often seen in training. However, multiple risk factors are involved in the occurrence of a stress fracture and can include: improper fit of boots, carrying heavy loads, intensity of training, and overall nutrition. 

Stress fractures are breaks in a bone after repeated instances of stress have been applied to the bone. This is different from an acute fracture, which is caused by a sudden traumatic incident. Stress fractures happen gradually and within the bone, making them hard to identify immediately on x-ray. If ignored, a stress fracture can become an acute fracture resulting in a prolonged recovery process.

Symptoms of a stress fracture include: swelling over the affected area, pin-point tenderness over the affected bone, pain increased by activity and relieved by rest, and bruising at the site of injury. The most common stress fractures in the foot occur in the 2nd and 3rd metatarsals. These metatarsals are the longest bones in the foot and experience increased load (i.e. stress) when walking or running. 

Most stress fractures are treated conservatively and do not require surgical intervention. The most important initial treatment is the RICE protocol which includes: rest, ice, compression, and elevation of the injured site. Activity modification is necessary with all stress fractures of the foot to prevent it from turning into an acute fracture. Last, protective footwear to distribute body weight more evenly is often required in the form of a walking boot or brace. In some cases, it is necessary to place the injured foot into a short leg cast to completely offload the area. The typical stress fracture heals in 6 to 8 weeks with the proper treatment program.

There are many forms of injury prevention to avoid the occurrence of stress fractures. It is important to maintain a well balanced diet containing plenty of calcium and vitamin D to promote bone health. Proper shoe gear that is professionally fitted is of particular importance for military members. Improper fitting of boots will result in the potential for ankle sprains, blisters, toenail injuries, as well as stress fractures. Finally, the most important factor in preventing stress fractures is the gradual increase of activity over time as strength and stamina increase. Injuries are often seen in training programs that progress too quickly. Studies show that extreme intensity programs are more likely to cause injury. 

Thank you to all past, present, and future veterans who have served their country and to their family members who supported them along the way. 

If you have any questions please feel free to contact our offices located in Hoboken, Bloomfield or Manhattan. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.