Foot Stress Fracture Test, Hop Test
The hop test or single leg hop test is utilized by, and only to be utilized by, health care practitioners to determine if an athlete is ready to return to sports after injury to the lower extremity. Under medical supervision and after a recovery period an athlete will be asked to stand on one leg and jump as high as possible three times to test the load on the lower extremity. If the athlete is able to do this without pain then they can be cleared to return to sports. The hop test, or foot stress fracture test, as it is called on the internet is not for other purposes.
“Hop tests are not really reliable as a diagnostic tool as the cause of pain can not be isolated. I recommend that if you suspect a stress fracture to rest until you can be evaluated by a physician.”
—Dr. Don Stewart, Foot and Ankle subspcialists, Orthopedic Surgeon
Causes of stress fractures in the lower extremity
Often times athletes and runners just don’t have the word quit in them. They push their bodies farther and harder than their bodies are sometimes ready for. In runners this could be as simple as adding miles too quickly or pushing their body as far as it will go and using pain as an indicator of when slow down. Unfortunately, with stress fractures the pain comes on suddenly. Everything may seem normal and they there is that wincing pain that makes you stop. If you are lucky it may just be shin splints, but at this point the damage may already be done. Some running sites will say that this is a good time to do a hop test, or a foot stress fracture test, but doing so will not give a clear isolation of the issue and could potentially make some conditions worse. It is recommended that a foot stress fracture test only be utilized by a healthcare professional.
There are some medical conditions that could cause or increase the chance of a stress fracture such as Osteopenia, or Osteoporosis. Both conditions involve lower levels of bone density that what would be considered healthy. Lower levels of bone density put individuals at increased risk of all types of fracture, stress fractures included.
Detecting a stress fracture
X-ray can be utilized to confirm a suspected fracture, but commonly enough it is possible for an X-ray to not to detect a hairline fracture. X-ray is the use of low levels of radiation to pass through the body and into a film or sensor. The varying levels of x-ray radiation that passes through the patient can be interpreted as a picture and used diagnostically to visualized bones.
Magnetic Resonance imaging, or MRI for short, is a diagnostic tool that uses a strong magnetic field and sensors to visualize soft tissue and bone. Unlike X-ray, MRI doesn’t use a radioactive element to take pictures of the patient. During a MRI there are many loud and repetitive noises as images are taken repeatedly and the depth of field is modified. A computer is uploading these images as they are taken and creates a 3-D file of the body part being scanned. A physician and radiologist are able to look slice by slice through the scanned area and use this 3-D image to produce a diagnosis of the affected area.
A bone scan involves the injection of a imaging solution into a patient. The solution contains compounds called radiotracers that gravitate towards damaged areas in bone, or cancers. These radiotracers put off low levels of gamma radiation that can be viewed with a gamma radiation viewing camera producing images to be used diagnostically. The radiation depletes from the body within days and a bone scan is considered to be just as safe as an X-Ray. Bone scans can be utilized to diagnose hairline fractures that may be hidden in patients that have pain that is not showing up on other means of imaging.
How to heal a stress fracture
If you suspect you have a stress fracture it is important to see a physician for a diagnosis and to confirm that nothing more serious is going on. If it is confirmed that you have a stress fracture resting the fracture for 4-6 weeks may be required in the addition to a boot and/or crutches. Fractures farther from the heel towards the toes have a gradient of blood flow and heal slower as the blood flow decreases. Some stress fractures towards the toes heal slowly or may even require surgical intervention when they don’t heal on their own. It is okay to still get cardio in with a foot stress fracture, but the impact should be low. Exercises such as riding a bike or swimming are less likely to cause issue.
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