I wanted to spend some time today addressing a common athletic foot injury that I see very commonly in women. The injury that I frequently see is a metatarsal stress fracture. This short blog will give you valuable information of how to recognize and treat this common sports related injury.
Typically a metatarsal stress fracture will presents acutely with pain and swelling on top of foot just at the base of the lesser toes. The most common symptom is pain and swelling to the dorsal forefoot with or without trauma. Stress fractures often result from increasing the amount or intensity of an activity too quickly. This could be due to increasing the amount of mileage associated with walking or running while training for a road race. Other factors found more commonly in women would be poor bone density (osteoporosis), low body weight, and menstrual disturbances.
Oftentimes I will see patient's that present with pain four weeks prior and they may have initially had a X-ray that was negative for a stress fracture. When we see a patient for the first time four weeks after the symptoms manifested we then take a repeat X-rays which shows a stress fracture. It may take 10-14 for a stress fracture to be visible on X-ray examination. Typically bone callus on both sides of the metatarsal will confirm the stress fracture is healing. If a metatarsal stress fracture is not promptly treated with immobilization with a cam walker and reduction of activity this could lead to further swelling/pain and possible delayed healing of the fracture.
Stress fractures take 6-8 weeks to heal and are treated with either a surgical shoe or cam walker boot. We do advocate low impact non-weight bearing activity to keep patient's active such as swimming or biking during the healing phase.
A protein deficiency, along with an overall calorie-deficient diet can relate to associated medical problems. One of these could include loss of regular menstrual cycles. Estrogen levels decline when menustration stops. This drop in estrogen leaves the bones in the body more prone to a stress fracture.
I usually recommend that women over 40 follow up with their family doctor for a bone density test. Certain blood work can be ordered such as determination of calcium, potassium, and magnesium levels which are vital for proper bone health.
If you have noticed increased pain and swelling on the top of your foot this could be a stress fracture. This is not normal and it is essential that this be treated to ensure the fracture heals correctly.
Dr. Brown and Dr. Saffer have all the available clincial and diagostic tools to diagnosis this condition correctly and can expedite the healing of this common sports related foot injury.