As promised, today’s column is about stress fractures in the foot.

What are stress fractures? What causes them? And what can you do to prevent them?

A stress fracture is a tiny crack in a bone caused by repetitive stress or force, often from overuse.

The foot is one of the most complex parts of the body with 26 bones making up the foot.

A stress fracture typically occurs when people change their activities suddenly. For example, long walks at the beach when you have not been doing any kind of walking. Or, changing the surface you are walking or running on — from treadmill to road, for example.

Another cause is wearing the wrong shoes. Typically, shoes that are too worn with no support or are ill fitting can cause problems.

Overuse occurs when the weight-bearing bones and supporting muscles do not have enough time to heal between exercise sessions.

Symptoms of a stress fracture are:

• Pain that diminishes during rest
• Pain that occurs and intensifies during normal daily activities
• Swelling on top of the foot or on outside ankle
• Tenderness to the touch at the site of the stress fracture

Stress fractures most often occur in the second and third metatarsals of the foot where the bones are typically thinner and longer — on top of the foot. This area is also where the greatest impact occurs when pushing off to walk or run.

Make sure you have your doctor diagnose your ailment because there are many other medical issues that can cause the same symptoms.

Your doctor may prescribe modified activities, or wearing protective footwear such as a boot or stiff-soled shoe. In severe cases, a cast may be used.

To prevent stress fractures:

Eat a healthy diet rich in calcium and vitamin D. Wear the proper shoes (Ralph Bakers here in Salisbury is a great place were you can get your shoes fitted correctly). Start new activities slowly and increase the intensity gradually. Cross training helps. Add strength training to your workouts, and stop if an activity hurts or swelling occurs.

If you ignore stress fractures and continue to push yourself, the problem will not go away. It will only worsen, and it could even break completely. Talk to your doctor, and have them diagnose your problem and get a plan for recovery. When caught early, usually rest, ice, compression and elevation will take care of the problem.

Ester Marsh Associate Executive Director JF Hurley YMCA