Foot and Ankle Stress Fractures

What Is a Stress Fracture?

The technical term for a broken bone is “fracture” and refers to any kind of crack in the bone. Though the terms can be used interchangeably. Bone breaks come in two varieties: traumatic fractures, where the break is caused by large amounts of force, like breaking your leg in a car crash.

The other variety is stress fractures, where smaller amounts of force are applied repeatedly to the bone, the bone will break but won’t shift position. If a bone is slightly bent back and forth repeatedly, the bone will be weakened; this is called a stress reaction. This will eventually devolve into a stress fracture.

Stress Fracture Causes

The two most common causes of stress fractures are weakened bones and repeated activity. People with compromised bones, like those with osteoporosis, can get breaks from even a small amount of activity. These are known as insufficiency fractures and can also occur in women with irregular menstrual cycles, as that causes weak bones.

Repetitive stress on bones is also caused by constant activity. High-impact sports like track, basketball, soccer, gymnastics, and tennis all are common sources of stress fractures. These fractures usually happen in the feet and ankles, due to how much pressure is placed on them every day. Starting new physical activities or increasing the amount of activity you already do can cause stress fractures. Shoes with poor support, stiff old shoes, or foot deformities place excess pressure on the foot, leading to fractures.

What Bones Are Affected by Stress Fractures?

All the bones in your lower leg or foot can undergo stress fractures. The metatarsals, bones which connect the midfoot to the toes, are the most commonly afflicted. As well as heel bone and the bones in the ankle. Fractures in the navicular, a bone near the ankle, take a longer time to heal than others.

How to Tell If You Have a Stress Fracture

The primary symptom of a stress fracture is pain; thus, after a change in activity you’re having pain in a specific part of your foot or ankle, you might have a stress fracture. The pain will worsen when you begin the activity and get better with rest. As things get worse, the pain will come more quickly. Fractures tend to hurt in specific small areas, and it will hurt to touch these areas.

When Should You See a Doctor for a Stress Fracture?

The first thing to do is to stop performing the activity that’s causing the fracture. If the pain is still present after a few days, or immediately comes back after a long period of rest, you should see a doctor. Specifically, you should see a foot and ankle surgeon; they will examine your risk factors and likely recommend that you get an x-ray, bone scan, or MRI to discover the extent of the fracture.

How to Treat Stress Fractures

The best way to heal a stress fracture is to cease the activity that first caused the fracture. Stopping the activity and wearing protective footwear for four to six weeks should take care of the problem. But the healing time depends on the bones affected; the navicular and fifth metatarsal take noticeably longer to heal than other bones. The doctor may recommend you wear specialized footwear like stiff-soled shoes, wooden-soled sandals, or brace shoes. For those who still want to engage in athletic activity, swimming and bike riding are good alternatives.

Right after the fracture is discovered, the pain and swelling can be remedied with elevation and ice. There is also data that suggests NSAIDs like ibuprofen can slow bone healing and should be avoided. Acetaminophen is not an NSAID and is thus fine. After six weeks of rest, after the pain is gone, you’ll need to gradually ease your way back into physical activity.

Should You Get Surgery For a Stress Fracture?

Stress fractures will usually heal after rest, but if the fracture doesn’t heal after a while, your doctor may recommend surgery.

Stress Fracture Prevention

Here are some lifestyle tips to help prevent stress fractures: eat plenty of calcium and vitamin D, wear comfortable shoes, avoid nicotine, alternate your physical activities, and be sure to ease your way into new activities.