The Center for Podiatric Care and Sports Medicine

And On Your Left, Your Tour Guide’s Stress Fracture

Posted by on Wednesday, January 9th, 2013


There’s nothing better than a tour through Rome from a knowledgeable guide, a person who can usher you past the boring stuff right to the gems. Museum tours are also spectacular. Museums are the homes of masterpieces, those objects that inspire humanity, that show us how great a person can be. But they’re also huge and imposing. Miles of marble stretch before you promising treasures… and excruciatingly sore feet. But the guide saves you from the pain, marching you to the Van Goghs and Rembrandts, the Picassos and Degas. Of course, for the guide, your tour is just another day in the office. Years of marching down those unforgiving marble halls, up those endless coliseum stairs, and along those quaint cobbled streets, take their toll. Stress fractures, one of the most common repetitive use injuries, plague the world’s tour guides.




Up to 15% of all athletics injuries are stress fractures. They’re very common in runners (and in weight lifters who “train to failure”) but they can result from overuse of any kind, and use is cumulative. Stress fractures can occur throughout the foot, but are most common in the calcaneus and tarsal bones (followed by the metatarsals and finally the sesamoids). They occur when the muscles around the bones are too tired or weak to absorb impact, so the bones end up taking the brunt of the pressure. This is why overuse can lead to fractures: your poor muscles just can’t take it anymore!



While many tour guides get benefits like travel discounts, language lessons, and vacations in luxurious places, most don’t have medical and dental. Unless you’re a manager, travel agent, or otherwise salaried, you’re probably getting paid hourly, plus tips. So, if you find yourself with an aching foot, you may also find yourself ignoring it. But, as with almost any foot injury, the longer you wait to treat the problem, the worse it can get. Untreated stress fractures can heal improperly and may require surgery. So, if you’re experiencing swelling, bruising, or pain during activity (that resolves when you stop putting weight on your foot), contact The Center for Podiatric Care and Sports Medicine.


Note: If you hope to avoid stress fractures, do not wear unsupportive flip flops like this tour guide:


So, you’ve been out of work for a few weeks resting your foot and now you’re ready to leap back into action! How can you prevent another fracture?

  • This is an overuse injury so try not to overdo it. Take sitting breaks to describe the architecture. Your tour group won’t even notice.
  • You need good, supportive, well-cushioned shoes: again, and always.
  • Try to get varied exercise to boost the muscles in your feet, ankles and legs. Swimming and cycling are great low-impact aerobic exercises that will help to balance your strength.
  • Make sure you’re getting enough vitamin D and calcium in your diet. Stronger bones mean less risk of fracture. You probably didn’t need a podiatrist to tell you that.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.