Stress fractures differ from regular fractures in that they are cracks in the bone opposed to a complete break through the bone. Stress fractures are very common in the foot and lower extremity due to the mechanical load from our bodies. In the foot they are most commonly seen in the second and third metatarsals. Overuse and repetitive forces cause stress fractures. This overuse can be from a runner who increases their mileage too quickly or from any increase in activity or change in activity.
People who suffer from stress fractures generally have pain in a very specific spot on their foot, ankle, or leg. Diagnosis can be a little tricky in that stress fractures are not seen right away on x-rays. This takes a couple of weeks to visualize and by the time it is seen on x-ray, the stress fracture has already started to heal. The healing of the stress fracture seen on x-ray is called callus formation. To get more of a definitive diagnosis of a stress fracture right away your doctor can order an MRI or bone scan.
Treatment for stress fractures is rest. If a patient was to continue their increased activity while having a stress fracture this could result in a complete fracture and would increase the recovery time. Sometimes your doctor may put you in a surgical shoe or walking boot in order to decrease the stress. Ice and elevation are also important for the recovery process. For those who wish to keep their conditioning up while recovering from a stress fracture, aqua jogging and swimming can be good options.
–Dr. Colleen Law
How many times have you heard it said, when someone thinks they may have broken a toe, “No sense going to the doctor, there’s nothing they can do for a broken toe.” That’s a myth! In fact, not treating a fractured toe correctly can lead to serious complications including: a deformity of the bone structure which may limit mobility or make it hard to find comfortable shoes, arthritis, chronic pain, and possibly long-term dysfunction requiring surgery to correct. At Blue Ridge Foot & Ankle Clinic, we want you to know the facts about toe fractures. Toe fractures, or breaks fall into two categories.
Also known as acute fractures, traumatic fractures are the result of a direct impact or blow, such as dropping something heavy on your toe or stubbing it really hard—you usually know when it happens. You may hear a breaking sound at the time the incident occurs and have serious pain on impact that lasts a few hours (the pain may go away after several hours but that does not mean the toe isn’t fractured). There may be bruising and swelling the next day and the toe may appear misshapen or out of place.
Stress fractures may not be so obvious. These small, hairline breaks have symptoms that can come and go. There may be pain at the site when touched and swelling of a particular area without bruising. Pain usually comes after activity but goes away when resting. Oftentimes stress fractures result when athletes over do it and try to increase their activity level too quickly. They can also be caused by improper footwear, deformities in foot structure, or certain diseases like osteoporosis.
Diagnosis and Treatment
Just because you can still walk on your foot is not proof that your toe isn’t broken. If you experience any of the symptoms above, it’s important that one of our board certified podiatrists examine your toe promptly. Dr. Kevin P. Murray and Dr. Stewart M. Chang will first conduct a thorough exam of your toe and foot, which may include digital x-rays. Depending on the type and severity of the fracture, several treatment options are available:
- Splinting the toe to keep it in a fixed position until it heals
- “Buddy taping” the broken to another toe is sometimes appropriate
- Wearing rigid or stiff-soled shoes to protect the toe from further damage and keep it in the proper position
- Surgery may be required if the break is severe or the bone is badly displaced.
If you believe you may have a fractured toe, don’t delay. Make an appointment today at one of our two conveniently located offices in Fishersville or Charlottesville.
Perhaps you have never heard of a sesamoid, but at Blue Ridge Foot & Ankle Clinic we see many people who are experiencing foot pain as a result of sports and leisure activities that put pressure on the ball of the foot, such as basketball, running, football, golf, tennis, or ballet, which can result in a sesamoid injury.
What are Sesamoids?
A sesamoid is a bone embedded in a tendon. In the foot, the sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. Sesamoids act as a pulley for the tendons, helping the big toe move normally and also providing necessary leverage for the big toe when it pushes off during walking and running. These sesamoids are also the weight-bearing surface for the long bone connected to the big toe, called the metatarsal bone.
Sesamoid injuries can involve the bones, tendons, and/or surrounding tissue in the joint. There are three main kinds of sesamoid injuries:
- Turf Toe: This injury of the soft tissue surrounding the big toe joint usually occurs when the big toe is extended beyond its normal range. You may feel a “pop” at the moment of injury and will usually feel a sharp pain, followed by swelling.
- Fracture: A break in a sesamoid bone can either be acute–caused by a trauma or impact to the bone–which results in immediate pain and swelling at the site of the break; or chronic–due to repetitive stress or overuse–which is characterized by ongoing pain that increases with activity and is relieved with rest.
- Sesamoiditis: This injury is a chronic inflammation of the sesamoid bones and tendons that is usually caused by overuse and activities that put increased pressure on the sesamoids. Its symptoms are a dull, longstanding pain beneath the big toe joint that usually worsens with particular activities or certain shoes.
Diagnosis and Treatment
Our board certified foot and ankle surgeons, Dr. Stewart M. Chang and Dr. Kevin P. Murray are experts in the central VA area in diagnosing sports related injuries. After a thorough examination of the foot and big toe area, the doctor may evaluate your walking and the wear pattern of your shoes. Digital x-rays, which can be done in either our Charlottesville or Fishersville office, may also be ordered. Once the diagnosis is confirmed, there are a variety of non-surgical treatments available, with surgery reserved for those people who do not respond to those treatments.