Joe Biden's Foot Fracture Highlights Fragility of Those Bones

Joe Biden was playing with one of his German shepherds last weekend when he broke small bones in his foot.

It might sound unlikely that such an innocuous action could end in fractures, but experts say that it is common for people over 50 to suffer foot and ankle injuries doing everyday activities.

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It's often something simple, like tripping on a tree root while working in the yard or slightly twisting an ankle when carrying a laundry basket down a set of stairs. Sometimes just stepping off a curb will result in a hairline fracture in one of the foot's 26 bones, according to Anne Sharkey, a podiatrist who practices near Austin, Texas.

"It's like the straw that breaks the camel's back,” says Sharkey, who treats mostly seniors. “The bones and the joints are weakened over time, and then an incident occurs that turns it into an acute fracture."

As with the president-elect, the injury is often diagnosed as a sprain based on an X-ray. After a day or two, when the pain and swelling do not subside, a specialist will use a CT scan that reveals a small, hairline fracture.

This week Biden's press office released a statement from his doctor that the president-elect has small fractures in the middle of his foot. Such injuries are more common in football players and other athletes, Sharkey said. The most common hairline fractures are in the toes.

After an orthopedist diagnosed Biden's hairline fracture, he sent the president-elect home wearing a walking boot. The boot has become the standard treatment for a range of foot and ankle injuries because it compresses the injured foot to reduce swelling while keeping the bones in a fixed position. It also keeps the patient mobile enough to continue everyday activities. Biden's press team said he will be wearing the boot for several weeks.

Many people with hairline fractures wear boots for six to eight weeks, Sharkey said. The long end of that timeline is right after Inauguration Day. It is almost certain that Biden, 78, will be the first president to take the oath of office wearing a mask. There is a chance he will also be the first one to be wearing a walking boot.

Waning bone density can contribute

Biden broke the lateral and intermediate cuneiform bones, which are in the middle of the foot. The foot is a complex network of small bones connected by 30 ligaments. The feet bear weight with every step, and over time the stress accumulates and can result in an unexpected injury.