The Dreadmill: Common Causes of Stress Fractures

We all know what fractures are. Many of you have probably fractured a bone or two in
your lives. You fall out of a tree or get violently tackled on the football field and suddenly
you’re in the hospital and the doctor is telling you you’ve got a broken bone. While this
is easily understood by most, when prefaced by the term “stress”, people are often
confused when they’re told they have a fracture. It’s not uncommon for podiatrists to
hear this response after telling a patient they have a stress fracture: “but doctor, I don’t
remember any trauma to my foot”. While they may not recall any specific traumatic
event causing the fracture, the patient indeed suffered trauma significant enough to
cause a fracture, it just wasn’t the type of “trauma” everyone thinks of when discussing
fractures.

A stress fracture is a very small fracture in a bone, and is sometimes referred to as
a “hairline fracture”. These fractures can occur anywhere in the body’s 200+ bones;
however, by far and away the most common place to suffer a stress fracture is in the
foot. This is because the feet bear the weight of the entire body. Often times, stress
fractures are related to “overuse”, usually resulting from sports, overtraining, or sudden
increases in activity without proper conditioning. Sports like running, basketball, football
and even tennis are common activities where athletes develop stress fractures. While
participation in some activities put you at an increased risk for the development of stress
fractures than others, it is important to realize any physical activity where the foot is put
under high stress or subjected to repetitive forces and high impact landings can lead to
a stress fracture.

One common activity is running on the treadmill, or rather the “dreadmill”. When running
on a treadmill, at the same speed and the same incline setting for long periods of
time, you’re essentially taking your foot and slamming it over and over again on a hard
surface in the exact same spot. This is a good way to cause a stress fracture in your
foot. To prevent this, if you must use a treadmill, try changing the speed and incline
you run at frequently, so as to mimic running outside more closely. This way you’ll
constantly be adjusting how your foot strikes the ground, which dampens the stress
placed on any one spot in the foot.

Stress fractures are more common in women than men, for one main reason:
osteoporosis. This is compounded by two other common conditions in women: eating
disorders and irregular menstrual cycles. These two conditions contribute to the
development of osteoporosis, which can occur very early in life and should not be
considered a problem only in older women. Now, this is not to say men aren’t also
susceptible to stress fractures, because they can get them, it’s just important for women
to be aware of the increased risk of stress fractures.

The most common locations in the foot for a stress fracture are the second and third
metatarsals (long bones of the foot which run between the midfoot and the toes). They
can also occur in the heel and in a bone located at the top of the midfoot and in front
of the ankle called the “navicular”. Stress fractures in this funny sounding bone are

particularly difficult to heal because of inadequate blood supply.

Some common symptoms you may experience should you suffer a stress fracture are
pain that starts gradually, gets worse with weight-bearing activities and slowly gets
better with rest, possible swelling, tenderness to touch and possible bruising.

If you have a painful area in your foot, you can’t remember doing anything to hurt it
in the recent past, and you frequently participate in physical activities like the ones
described above or you’ve just started exercising more often, you should consider
seeing a podiatrist. He/she can perform a few simple tests in the office to rule out other
possible causes and will be able to pick up on a stress fracture, should that indeed be
what is causing you problems. Your doctor will be able to give you the proper treatment
and help you get back to your normal activities as soon as possible.


Bruce Werber DPM, FACFAS
InMotion Foot & Ankle Specialists
Associate Professor Midwestern University

InMotion Foot and Ankle Specialists
10900 N. Scottsdale Road Suite 604Scottsdale, AZ 85254
office phone 480 948-2111
inmotionfootandankle@gmail.com

www.inmotionfootandankle.com