American College of Foot and Ankle Surgeons urges safety.   
 

As temperatures dip across the United States, the prospect of a long winter and slippery conditions is at the forefront of everyone's mind. But as we unpack winter clothes and restock our snow removal essentials, awareness of cold weather -related injuries—and appropriate treatments—is an equally important precaution. 

Throughout the winter months, some hospitals report up to a 500 percent increase in emergency room visits, in part due to injuries from slips and falls. Stress fractures, a hairline crack in a bone of the foot, are one of the more common winter-related injuries and can make seemingly easy activities like walking very painful. If left untreated, these injuries can lead to a complete break in the bone.

Stress fractures are often ignored by people who do not make the connection between a recent activity or accident and related foot pain. According to the American College of Foot and Ankle Surgeons, stress fractures can occur in a wide variety of seemingly benign circumstances. Athletes are commonly afflicted, as repetitive weightbearing activities, such as running, gymnastics and other sports, are often sources of stress on the foot. But in the winter months, slippery walking conditions and seasonal sports like ice skating, snowboarding and sledding are some of the leading causes of foot-related injuries.  

Even standing on a hard floor for too long can produce a stress fracture. "I've treated several patients with stress fractures in November after they volunteered at the polls and stood on a hard surface for hours," says Timothy Swartz, DPM, FACFAS, a Fellow of the American College of Foot and Ankle Surgeons and Chief of Podiatric Surgery at DCSM Kaiser Permanente, in the Washington, DC area.

It's important to be aware of the signs of a stress fracture, especially following a potentially stressful activity or fall, and to seek appropriate care.  Pain, swelling, redness and possibly bruising can all be signs of a stress fracture. "The pain typically occurs on the top of the foot," says Dr. Swartz. "The symptoms usually pop up quickly and then subside if the person stops the activity."

Although the foot may feel better with rest, pain often comes back once activity is resumed. "At that point, people with stress fractures may experience a deep, aching pain that's extremely bothersome," Dr. Swartz says. For those who still have symptoms after resting, icing and using anti-inflammatory medication at home, it's important to see a specialist. Foot and ankle surgeons can quickly diagnose stress fractures through a physical examination and, if medically indicated, imaging studies.

"Beginning treatment as soon as possible is very important and may shorten your recovery time," says Dr. Swartz. "Treatment can take four to six weeks if you catch the problem early." During this time, it's important to rest the foot and possibly wear a surgical shoe or cast boot. In a small percentage of patients, surgery may be needed to stabilize the fracture.

It's not unusual for stress fractures to recur in some people. This is especially true among those who have a certain foot shape or fragile bones. "Whether it's a first-time occurrence or a recurrence, proper treatment of a stress fracture is important, and that includes giving your foot the full rest that it needs," says Dr. Swartz.