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A stress fracture is a fissure in the bone. Most commonly occur in a weight bearing bone in the foot when they are exposed to more than usual stress. 

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Pain is the most common symptom of stress fracture. Pain and swelling that get worse with physical activities and relieved by rest. 

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  • Overuse is the most common cause for stress fracture.

  • Non-supporting shoe wear.

  • Intense exercises that include repetitive activities such as running and jumping. ​

  • Osteoporosis that leads to bone weakening that may not be able to handle simple changes in activity may develop stress fractures.

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Your doctor will obtain your medical history, examine your foot and inspect your shoe wear. A series of X-rays is ordered to confirm diagnosis. If the bone fissure is small it may not show on the X-rays. An ultrasound or MRI might be helpful to confirm diagnosis as stress fractures commonly shows a collection of blood from the broken bone (subperiosteal hematoma).

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  • Rest: Since stress fractures are mainly caused by overuse or repetitive exercise, a period of rest is needed to allow bone to heal. It is noted that bone healing period takes 6 to 8 week. A low impact exercise can be introduced during the healing period such as swimming and biking.

  • A hard sole shoe such as surgical shoe and in some cases a walking boot is used for daily walking. This is in order to decrease the impact of weight bearing forces on the fractured bone.

  • Over-counter or prescription for Calcium and vitamin D supplements are very helpful for bone to heal.​

  • If bone failed to heal with the conservative measures mentioned above the condition called non-union and surgery might be considered. Surgical intervention is usually involve internal fixation  wit screws and some time bone graft is added to the fracture surface to enhance bone healing.

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Failure of the fractured bone to heal (nonunion) or bone healing in abnormal position (malunion) and recurrent fractures.

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  • Proper shoes with rigid or semirigid sole for the type of exercise

  • For Athletes whom had a period of lay-off, a gradual slow return to exercises is advised.

  • Stretching and warming up gradually before running or walking.

  • Stretching and strengthening the muscles in the calf is always advised.

  • Gradual increment of running or walking distance. Avoid incrementing of greater than 10 percent per week

  • Avoid strenuous sprinting exercises.

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