Stress Fractures – Foot & Ankle

Stress fractures are a type of overuse injury characterized by tiny cracks in the bone. When muscles are fatigued and cannot absorb repeated impact, the shock is transferred to the bones. Weak bones caused by osteoporosis may also be more vulnerable to stress fractures. These fractures can occur from normal daily use or from sports activities.

Stress fractures most often occur in the bones of the foot and lower leg. The second or third long bones between the toes and the mid-foot are the most often effected. Stress fractures sometimes appear in the heel, the outer bone of the lower leg and the navicular, on the top of the foot.

One of the most common occurrences of stress fractures happens in runners who have been confined indoors during an off season and then, return to running without proper conditioning.

Improper foot gear is another reason that athletes get stress fractures. An old and well-worn shoe can alter the dynamics of the foot and contribute to stress fractures. Athletes that change surfaces, like going from a grass tennis court to a hard court, or from an outdoor running track to an indoor track, can increase their risk for stress fractures. Other conditions, such as flatfoot or bunions, can alter the mechanics of the foot making it more susceptible to stress fractures.

SYMPTOMS 

• Pain that develops gradually and is relieved with rest
• Tenderness
• Swelling on top of the foot or outside the ankle
• Possible bruising

TREATMENT

Most stress fractures will heal if activity level is reduced and protective footwear is worn for two to four weeks. A stiff-soled shoe, or sandal, or a removable leg brace shoe may be needed to provide support. Athletes are usually advised to switch to a sport that puts less stress on the foot and leg while the bone heals, such as swimming and bicycle riding.

For stress fractures in the outer side of the foot or in the navicular or talus bones that take longer to heal, a cast may be applied to the foot or the use of crutches may be recommended until the bone heals. In some cases, surgery may be necessary. The orthopedist may insert a screw into the bone to ensure proper healing.