Stress Fractures of the Foot and Ankle

Most stress fractures are caused by overuse and repetitive activity and are all too common in runners and athletes who participate in running sports including soccer and basketball. The weight-bearing bones of the foot and lower leg are especially vulnerable to stress fractures because of the repetitive forces they must absorb during walking, running, and jumping. A small crack in a bone, or severe bruising within a bone is called a stress fracture.

Stress fractures also occur in people who suddenly change their activities like starting a new vigorous exercise, increase the intensity of a workout, or change a routine workout surface like running on a treadmill rather than running outdoors. For people with osteoporosis, simply doing everyday activities can result in a stress fracture.

The most common symptom of a stress fracture in the foot or ankle is pain. The pain usually develops gradually and worsens during weight-bearing activity. Other symptoms may include:

  •     Pain relieved with rest
  •     Intense pain during normal, daily activities
  •     Swelling on the top of the foot or on the outside of the ankle
  •     Touch tenderness
  •     Possible bruising

It is important to seek medical help as soon as possible if you think that you have a stress fracture in your foot or ankle. Ignoring the pain can lead to very serious consequences. The bone may break completely. The goal of treating a stress fracture is to relieve pain and allow the fracture to heal. Treatment will vary depending on the location of the stress fracture and its severity and the majority of stress fractures are treated non-surgically.

Recovering from a stress fracture in the foot or ankle can be as simple as refraining from high impact activities for a period of time. It’s important to refrain from activity during this recovery period, otherwise the healing process will take much longer, and the risk for developing a complete fracture is much higher.

Some stress fractures require surgery to heal properly. Typically, this involves supporting the bones by inserting a type of fastener. This is called internal fixation. Pins, screws, and/or plates are most often used to hold the small bones of the foot and ankle together during the healing process. Following surgery, it takes up to 6 to 8 weeks for a stress fracture to heal. More serious stress fractures can take longer. Once the stress fracture has healed and you are pain free, your doctor will allow a gradual return to activity.

*Information for this article provided in part by AAOS OrthoInfo.

Dr. Schakel

Dr. Mark Schakel is a board certified orthopaedic surgeon specializing in problems of the foot and ankle and other orthopaedic and sports medicine injuries. Learn more …