Stress Fractures of the Foot and Ankle

A stress fracture is a small crack in a bone or severe bruising within a bone. It usually occurs in the second and third metatarsals in the foot which are thinner. These weight-bearing bones are especially vulnerable to stress fractures because of the repetitive forces they absorb during activities such as walking and running.


The most common symptom of stress fractures of the foot and ankle is pain that develops gradually and worsens during weight-bearing activities. Other common symptoms include:

  • Pain that decreases with rest
  • Pain that occurs and intensifies during normal, daily activities
  • Swelling or bruising on the top of the foot or on the outside of the ankle
  • Tenderness to touch at the site of the fracture



Some common causes of stress fractures of the foot and ankle include:


Bone insufficiency
Osteoporosis, for instance, decreases bone strength and density – resulting in you being more likely to experience a stress fracture.


Poor conditioning
A sudden increase or repetitive physical activity, without adequate training, may not give your body adequate time to recover, resulting in stress fractures.


Abnormal loading of the foot
Foot deformities as seen in diabetic patients, or blisters in foot can affect how you put weight on your foot when you walk or run. This may require an area of bone to handle more weight and pressure than usual, which can result in a stress fracture.


Change in surface
Going from a grass court to a hard court while exercising, for example, can also increase the risk of a stress fracture.


Improper equipment
Wearing flimsy shoes that have lost their shock-absorbing ability may contribute to stress fractures.


Your orthopaedic specialist will start off by asking you about your medical history and general health, as it is important to understand your risk factors for a stress fracture. A physical examination will then be performed to check your foot and ankle, looking out for focal tenderness and swelling over the area of the stress fracture.


You may also be required to undergo an X-ray or MRI scan to confirm the diagnosis.


The main goal of treatment for stress fractures of the foot and ankle is to relieve pain, and to reduce loading of the fracture so that it can heal. Non-surgical treatments work most of the time, and they include anti-inflammatory medication, reducing impact activities, and wearing protective footwear. In severe cases, using crutches, walking boots or casting may be needed to offload the fracture.


If the fracture remains persistently painful, and imaging shows lack of healing, surgical fixation of the fracture may be required.


Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you are suffering from stress fractures of the foot and ankle and let us help you enjoy a better quality of life.