Northside Hospital - Stress Relief

Stress Relief

By Alonzo Sexton, M.D.

What is a stress reaction?
Stress reactions are the first sign of developing a stress fracture. During the stress-reaction stage, the bone structures break down and become weaker. This means that you’ve suffered some type of trauma or injury in an area of the foot because your body is unable to handle the amount of stress placed upon that area.

What is a stress fracture?
It’s when the structure of the bone has been compromised by either a crack or a fracture. Stress fractures can occur when people change their activities, such as suddenly increasing the intensity of workouts or changing the workout surface (i.e. treadmill vs. pavement). Additionally, those who have osteoporosis or other diseases that weaken the bones can incur stress fractures just by doing normal, everyday activities.

What’s the main difference between the two?
Stress reactions and stress fractures are along a spectrum of overuse injuries. Stress reaction occurs first, followed by a stress fracture if steps are not taken to stop overloading the foot.

Symptoms usually include:

  • Pain that may diminish during the resting period.
  • Pain that occurs and intensifies during normal, everyday activities.
  • Swelling on the top of the foot or outside of the ankle.
  • Tenderness at the site of the fracture.
  • Bruising.

What are the treatments for each?
Contact your doctor as soon as possible if you feel that you may be suffering from a stress reaction or fracture. Ignoring the pain may lead to agonizing consequences.

Treatment for stress reactions and stress fractures are relatively similar. We normally advise stopping all weight-bearing activity and place the foot in a walking boot, which can be made non-weight bearing with crutches depending on the severity of the injury. Abstaining from high-impact activities for an ample period of time is the No. 1 key to recovery. A stress fracture or stress reaction in the foot can take from 4-6 weeks to heal in a walking boot. However, the total healing time can vary.

The RICE protocol can provide some relief until you are able to see a doctor. RICE stands for rest, ice, compression and elevation.

How can I avoid the injury?
Maintain a proper diet and add calcium and vitamin D to ensure good bone health, which can prevent future injuries. For those who are very active, having a coach or just knowing the proper way to train can help prevent stress fractures and stress reactions.

Also, take care to increase volume (distance, number of days) gradually to avoid overloading bones of the lower extremity.

Dr. Alonzo Sexton is a member of the Northside Hospital Sports Medicine Network with offices in Atlanta, Alpharetta and Forsyth. He is board-certified in orthopedic surgery, and specializes in the operative and non-operative treatment of sports injuries and musculoskeletal disorders, serving each patient with personalized care and the latest treatment modalities in sports medicine.


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