Stress fractures of the foot and ankle
Foot and ankle stress fractures are tiny surface hairline breaks in the bones. Stress fractures, unlike displaced or compound fractures, do not run through the entire bone. According to the American Academy of Orthopaedic Surgeons (AAOS), stress fractures occur when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone, causing a tiny crack called a stress fracture. Stress fractures of the foot and ankle are usually a result of continuous overuse Stressful exercise routines, running, basketball training and other sports are common causes of these fractures.
The most common areas for a stress fracture to occur are the second and third metatarsals of the foot. These metatarsal bones lead from the midfoot section to the toes. Stress fractures are also common in the midfoot, the heel and the outer bone of the lower leg. Continuous overuse that leads to stress fractures of the foot and ankle is defined by the intensity, duration and frequency of your exercise routine. People who do not exercise or participate in sports are still at risk for a stress fracture. Osteoporosis or other bone disease can weaken the bones and make them more susceptible to stress fractures.
In most cases, the only symptom of a stress fracture of the foot or ankle is pain in the affected area, especially after extended periods of exercise. The pain normally disappears after the exercise is over and then reappears once exercise begins again. If left untreated, a stress fracture gradually can change the way you walk. As your walking changes, painful calluses can form on the bottom of your feet.
Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly, such as doubling the distance you run or playing a sport longer or more often than usual. Causes of foot and ankle stress fractures can also include:
- The impact of an unfamiliar playing surface – For example, when a tennis player starts playing on a hard court instead of the usual soft clay court.
- Improper equipment – A runner may continue to wear worn or less flexible shoes instead of changing to new shoes with good support.
- Increased physical stress – A basketball player may suddenly get a substantial increase in playing time which results in a rapid increase in stress on the feet.
- Osteoporosis or other bone diseases – These can weaken the bones and make them more susceptible to stress fractures.
- Poor diet – A poor diet may affect the normal healing and remodeling process of your bones and may make them more susceptible to stress fractures.
A complete medical history and a physical exam are prerequisites to a complete diagnosis. During the physical exam, your doctor will check the injured area to pinpoint the origin of the fracture. Your doctor will also ask questions regarding what you were doing at the time of the injury and when you feel pain the most. An X-ray of the bone usually will not detect an acute stress fracture, so an MRI or a CT scan may be ordered for diagnosis. If calluses have formed around the stress fracture (e.g., in chronic cases), an X-ray can then be used to confirm the fracture.
Treatments for stress fractures of the foot and ankle consist of a combination of different techniques, however, the most important treatment is rest. You need to rest from the activity that caused the stress fracture and engage in a pain-free activity during the six to eight weeks it takes most stress fractures to heal. If a fracture does not heal with non-surgical treatment, surgical fixation of fractures of the foot and ankle may be required.
The multidisciplinary team of foot and ankle experts at Northwell Health Orthopaedic Institute treats stress fractures of the foot and ankle as well as a broad range of bone conditions that can occur at any stage of life.