Foot & Ankle Stress Fractures

by Dr. Emily Splichal, DPM MS 

A stress fracture is one of the most common overuse injuries treated by a podiatrist.  Although most people associate this condition with runners and athletes, a stress fracture can affect anyone experiencing repetitive impact forces.

When we walk, run or jump the foot experiences impact forces in the form of vibrations. These vibrational forces are absorbed or damped by the muscles of the feet and lower leg.   Fatigue and overload can cause these vibrations to create inflammation and small hairline breaks in the bone.

In the foot, the most commonly stress fractured bones are the metatarsals which are the long bones in the midfoot which create the ball of the foot and arch.    High arches, osteopenia and weak feet can all contribute to stress fracture risk.

Symptoms of Stress Fractures

Although symptoms may vary slightly depending on which bone is fractured, the most common symptoms for metatarsal stress fractures include:

• Pain or tenderness on the top of the foot that worsens during and after physical activity
• Swelling top of your foot localized to the area of the stress fracture
• Redness at the site of the stress fracture, typically about the size of a quarter

Diagnosing a Stress Fracture

Due to the nature of stress fractures they are often difficult to visualize on Xray, making it more of a clinical diagnosis.  When a patient presents with the symptoms above and has had a recent increase in activity or stress to the foot, typically a stress fracture diagnosis can be made.  

In some cases where there is still uncertainty, the podiatrist may order an MRI to ensure an accurate diagnosis of a stress fracture. 

Treatment for a Stress Fracture

Like all fractures, recovering from a stress fracture will involve some degree of immobilization such as a camwalker or fracture boot. Depending on the severity of the stress fracture the immobilization period may be between 2- 6 weeks on average. 

In rare cases the stress fracture may not heal as easily and may require prolonged immobilization, use of a bone stimulators and red light or laser therapy. 

Preventing Stress Fractures

Strong foot muscles and balancing foot stress with recovery are two of the most effective ways to prevent a stress fracture in the foot.   

Foot muscles can be strengthened with foot exercises such as short foot or by taking barefoot workouts such as yoga or Pilates.   And foot recovery should be integrated in the form of releasing the feet every night with a golf ball or Neuro Ball.