Stress Fractures of the Foot & Ankle
A stress fracture is a small crack in a bone. Stress fractures of the foot & ankle, often develop from overuse, such as from high-impact sports like distance running or basketball.
Most stress fractures occur in the weight-bearing bones of the foot and lower leg. Studies show that athletes participating in tennis, track and field, gymnastics, dance, and basketball are at high risk for stress fractures. In all of these sports, the repeated stress of the foot striking the ground can cause problems.
Rest is the key element to recovery from a stress fracture.
A stress fracture is an overuse injury. When muscles are overtired, they are no longer able to lessen the shock of repeated impacts. When this happens, the muscles transfer the stress to the bones. This can create small cracks or fractures.
The most common sites of stress fractures are the second and third metatarsals of the foot. Stress fractures are also common in the heel (calcaneus), the outer bone of the lower leg (fibula), and the navicular, a bone on the top of the midfoot.
Cause & Symptoms
Stress fractures usually occur when you increase your high-impact activity by:
Frequency (how often you exercise)
Duration (how long you exercise)
Intensity (your level of exertion)
People who do not exercise can also have stress fractures. If osteoporosis or other disease has weakened bones, normal daily activities may result in a stress fracture. This is called bone insufficiency. It is one of many factors that can increase your risk for stress fracture.
Doing too much too soon is a common cause of stress fractures. For example, runners who are confined indoors for the winter may want to pick up where they left off at the end of the previous season. Instead of starting slowly, they try to match their previous mileage.
Because of the lower level of conditioning, muscles become fatigued faster. The result could be a stress fracture in the foot or ankle.
Those who are new to exercise and try to do too much too soon are also at risk.
Equipment and Environment
Improper sports equipment, such as shoes that are too worn or stiff, can contribute to stress fractures.
A change of surface, such as going from a grass tennis court to one of clay, or a change from an indoor to an outdoor running track, can also increase the risk.
Errors in training or technique are another cause of stress fractures. Anything that alters the mechanics of how the foot absorbs impact when it strikes the ground may increase your risk for a stress fracture. For example, a blister, bunion, or tendonitis can affect how you put your weight on your foot, and may require a bony area to handle more load than usual.
Insufficiency stress fractures result when the bone itself is weak. Conditions like osteoporosis reduce bone strength and density. This increases the risk of fracture.
Anyone with a medical problem or taking medication that decreases bone density is susceptible to stress fractures.
Female athletes who experience irregular or absent menstrual periods may also have decreased bone density. Studies show that female athletes are more prone to stress fractures than their male counterparts are. Many doctors attribute this to “female athletic triad.” This three-sided condition includes eating disorders, irregular menstrual cycle, and osteoporosis. As a woman’s bone mass decreases, her chances for getting a stress fracture increase.
Pain that develops gradually, increases with weight-bearing activity, and diminishes with rest
Pain that becomes more severe and occurs during normal, daily activities
Swelling on the top of the foot or the outside of the ankle
Tenderness to touch at the site of the fracture
Medical History and Physical Examination
During the first visit, your doctor will ask you about your work, your activities, and any medications you take. It is important that your doctor understands what your risk factors for stress fractures are.
After discussing your symptoms and medical history, your doctor will examine your foot and ankle.
Imaging tests may help your doctor confirm your diagnosis.
Stress fractures are difficult to see on X-rays until they have actually started to heal. Your doctor may recommend a bone scan or a magnetic resonance imaging (MRI) scan, which are more sensitive than an X-ray and can detect stress fractures early.
Great Lakes Physical Therapy
|The Physical Therapy team at Great Lakes Orthopedics offer a wide range of programs and specialized services to help our patients restore and maintain their physical strength, performance skills, and levels of function. Our well-trained, professional staff utilize the most progressive treatment options and techniques to ensure the best possible recoveries.|