What is a stress fracture?
Stress fractures are small cracks or severe bruising within a bone, typically caused by repetitive force or overuse. They’re common in the foot and ankle, particularly among runners, athletes, dancers, and people who suddenly increase activity levels without proper conditioning. Unlike acute fractures, stress fractures develop gradually over time and may be difficult to detect at first.
The bones most commonly affected in the foot and ankle include:
- Metatarsals (long bones of the forefoot)
- Calcaneus (heel bone)
- Talus (ankle bone)
- Navicular (midfoot bone)
- Fibula (outer lower leg bone)
Early diagnosis and treatment are crucial to prevent a complete break and ensure proper healing.
What causes stress fractures?
Stress fractures can happen if you suddenly increase a high-impact activity. Walking or running for a much longer distance than you normally do can be a cause.. You can develop stress fractures if you switch from a soft surface to a hard or uneven one. They can happen if you don’t wear the proper shoes, or if you have poor training techniques.
Stress fractures typically occur when the muscles become fatigued and can no longer absorb the shock of repeated impacts. This places excessive stress on the bones, causing them to develop small cracks or fractures. Stress fractures can occur in any bone in the foot or ankle, but are most commonly found in the metatarsals, the long bones of the foot that connect the toes to the ankle.
Your risk could also be higher if you have weak bones because of a medical condition or because of a medication you take.
What are the symptoms of a stress fracture?
The symptoms of stress fractures can include pain, swelling, and tenderness in the affected area. The pain may be mild at first and gradually worsen over time. Stress fractures may also cause a dull ache that is felt during or after activity. In some cases, stress fractures may cause a noticeable limp or difficulty with weight-bearing.
What is the treatment for a stress fracture?
Treatment options for stress fractures of the foot and ankle typically involve rest, ice, and anti-inflammatory medications to reduce pain and swelling. In some cases, a cast or walking boot may be necessary to immobilize the affected area and promote healing. Physical therapy may also be recommended to help improve strength and flexibility in the affected foot or ankle. It is important to seek medical attention if you suspect you have a stress fracture, as early treatment can help prevent the injury from worsening and potentially causing long-term damage.
FAQs
Some people can walk with a stress fracture, especially early on, but doing so can worsen the injury. While pain may be tolerable at first, continued weight-bearing can cause the fracture to expand or lead to a full break.
Symptoms often include:
– A deep, aching pain that worsens with activity
– Tenderness to the touch
– Swelling in a localized area
– Pain that improves with rest but returns when weight-bearing resumes
– In some cases, bruising may be present
Diagnosis may involve:
– A physical exam focusing on tenderness and swelling
– X-rays, though stress fractures may not be visible in the early stages
– MRI or bone scan for more accurate detection if symptoms persist
Often, yes. A walking boot or stiff-soled shoe may be prescribed to reduce pressure on the foot and allow healing. In more severe cases, non-weight-bearing with crutches may be necessary.
Yes. Continuing to walk or exercise on a stress fracture can delay healing, cause the fracture to widen, and potentially lead to complete bone breakage or chronic pain.
Most stress fractures require 6 to 8 weeks of limited activity. Your provider may recommend complete rest or partial weight-bearing depending on the severity and location of the fracture.
A cast is typically reserved for high-risk fractures (like those in the navicular or fifth metatarsal) or cases that aren’t healing properly with conservative treatment. More often, a boot or stiff shoe is sufficient.
No. Cortisone is not recommended for stress fractures, as it may impair bone healing or mask pain, increasing the risk of worsening the injury.
