FOOT & ANKLE

Foot & Ankle Stress Fractures

A stress fracture is a small crack in the bone which commonly occurs from overuse and repetitive activity. It usually develops in weight bearing bones of the lower leg and foot. When the muscles of the foot are overworked or stressed they are unable to absorb the stress, and thus transfer it onto the bone, this results in a stress fracture under the pressure. Stress fractures in the foot and ankle are most common in the metatarsal bones. 

Symptoms

The most common symptom of a stress fracture in the foot or ankle is pain which usually worsens with activity and decreases with rest. Swelling, bruising and tenderness may also occur. 



Causes

Stress fractures result from a rapid increase in the intensity of exercise or sports activities. They can also be caused by impact on a hard surface, improper footwear and increased physical activity. In sports such as basketball, tennis or gymnastics there is greater risk of developing stress fractures due to the repetitive stress of the foot strike on hard surfaces causing trauma and muscle fatigue. 

Other possible causes of stress fractures include:

  • Bone insufficiency caused by certain long-term medications or conditions such as osteoporosis 
  • Poor conditioning due to insufficient breaks and overtraining
  • Improper technique 
  • Improper footwear for activity

Diagnosis

Diagnosis is made by medical consultation and examination, taking the patient's past medical history and physically inspecting the injured area. An X-ray, MRI or bone scan may be requested to confirm diagnosis.



Treatment

Non Operative Treatment

Stress fractures can be treated without surgery by implementing the R.I.C.E (rest, ice, compress, elevate) method. If indicated, anti-inflammatory pain medications may be prescribed to help reduce pain and control inflammation.

The goal of treatment is to allow the fracture to heal and reduce risk of re-injury by resting and limiting physical activities that involve the foot and ankle. 

Some ways to prevent stress fractures include:

  • Ensure you start new sport activities slowly and progress gradually
  • Cross-training: complete a variety of exercises as different activities require use of muscles in different ways
  • Maintain a healthy diet with calcium and vitamin D rich foods
  • Ensure proper footwear is worn


Surgery

Some stress fractures require surgery to heal properly or if the fracture breaks completely and displaces. In most cases surgery involves supporting the bones by inserting specialised pins, screws and/or plates to hold the bones of the foot and ankle together during the healing process.

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