Stress fracture very common injury among athletes

DOCTOR ON CALL / Dr MUIRIS HOUSTON:I RUN regularly as part of training with my school team. I was getting pain in my instep and was surprised when an X-ray showed a fracture in one of the foot bones. I definitely didn't hit my foot off anything, so how did the bone break?

YOU HAVE suffered a stress fracture. Very common in athletes, stress fractures also occur in soldiers and dancers. They account for almost 60 per cent of all bony foot problems.

The metatarsal bones are five long bones which link the ankle bones to the bones in the toes. The second and third metatarsals - the middle bones - are most prone to stress fracture, but any one of the five metatarsal bones can be affected.

Usually you will notice some tenderness or swelling over the fracture point, but what often causes athletes to seek help is the increasing pain they feel when they engage in activities involving repeated impact on the foot.

Wayne Rooney, David Beckham and Michael Owen are among the top-flight footballers to have suffered a stress fracture.

The majority of these fractures heal with conservative treatment over time, but some may require surgery to reset the bone. Most athletes can return to impact exercise six to eight weeks after the surgery, with a return to full fitness expected in about 10 weeks.

You can maintain some fitness by taking part in low or non-impact exercise such as swimming or cycling. You may be advised to wear a walking cast or strapping for the first two to three weeks.

In the acute phase of the injury, rest, applying cold packs, painkillers and elevation of the foot should help promote recovery.

And while this did not apply in your case, occasionally a stress fracture cannot be detected on a plain foot X-ray for three or four weeks.

Sometimes a bone scan is required in order to make an early diagnosis.

Excessive training and inadequate rest periods between training sessions can precipitate a stress fracture, so pace yourself when you get back to running. It might be best not to run on hard surfaces such as concrete or paving, as the impact of the surfaces on your foot is greater than if running on grass.

As your injury is an uncomplicated stress fracture of a metatarsal bone, there should be no reason why, with careful rehabilitation, you will be unable to return to the school team.