Stress Fractures of Foot and Ankle

Stress Fractures of Foot and Ankle

What is a Stress Fracture?

• A stress fracture is described as a small crack in the bone which occurs from an overuse injury of a bone. It commonly develops in the weight-bearing bones of the lower leg and foot. When the muscles of the foot are overworked or stressed, they are unable to absorb the stress and when this happens the muscles transfer the stress to the bone which results in stress fracture.

Causes of Stress Fractures

• Stress fractures are caused by a rapid increase in the intensity of exercise. They can also be caused by impact on a hard surface, improper footwear, and increased physical activity.
• Athletes participating in certain sports such as basketball, tennis or gymnastics are at a greater risk of developing stress fractures. During these sports the repetitive stress of the foot strike on a hard surface causing trauma and muscle fatigue. An athlete with inadequate rest between workouts can also develop stress fracture.
• Females are at a greater risk of developing stress fracture than males, and may be related to a condition referred to as “female athlete triad”. It is a combination of eating disorders, amenorrhea (irregular menstrual cycle), and osteoporosis (thinning of the bones). The risk of developing stress fracture increases in females if the bone weight decreases.

Symptoms of Stress Fractures

• The most common symptom is a pain in the foot which usually gets worse during exercises and decreases upon resting. Swelling, bruising, and tenderness may also occur at a specific point.

Diagnosis of Stress Fractures

• Your doctor will diagnosis the condition after discussing symptoms and risk factors and examines the foot and ankle. Some of the diagnostic tests such as X-ray, MRI scan or bone scan may be required to confirm the fracture.

Treatment of Stress Fractures

Non-Surgical Method

• Most stress fractures can be treated without surgery. Initial treatment focuses on rest and limiting activities that place stress on the foot and ankle, allowing the bone time to heal. Returning to activity too quickly—particularly in children and adolescents—can delay healing and increase the risk of recurrent or more difficult-to-heal stress fractures.
• To protect the injured bone and reduce stress during recovery, your doctor may recommend supportive or protective footwear. In some cases, a cast or walking boot may be used to immobilize the foot and promote healing. Crutches may also be necessary to limit or completely avoid weight-bearing until the stress fracture has healed.

Surgical Method

• Surgery may be recommended if a fracture does not heal adequately with non-surgical treatment. During the procedure, your surgeon makes an incision in the foot to realign the broken bone fragments and secure them in the correct position. This is done using internal fixation devices such as pins, wires, plates, or screws to stabilize the bones while they heal.
• In some cases, this hardware is removed after healing is complete, while in others it is designed to remain in place permanently unless it causes symptoms.

Prevention of Stress Fractures

Some of the following measures may help to prevent stress fractures:

• New sports or physical activities should be started slowly and increased gradually over time to allow the body to adapt and reduce the risk of injury.
• Cross-training can help prevent overuse injuries by varying activities that place stress on different muscle groups. For example, alternating running with biking or swimming allows one set of muscles to recover while others are engaged.
• Maintaining a healthy, well-balanced diet is important for bone health. Foods rich in calcium and vitamin D should be included to support bone strength and healing.
• Children should always wear proper, well-fitting footwear designed for their specific sport. Worn-out or inappropriate shoes should be avoided, as they increase the risk of injury.
• If your child experiences pain, swelling, or discomfort during activity, sports should be stopped immediately and rest should be allowed for several days. Persistent symptoms should be evaluated by a foot and ankle specialist.