Stress Fracture

A stress fracture is a small crack in a bone. Stress fractures often develop from overuse, such as from high-impact sports like distance running or basketball. When muscles are overtired, they are no longer able to lessen the shock of repeated impacts. When this happens, the muscles transfer the stress to the bones. This can create small cracks or fractures.

How is a stress fracture diagnosed?

You should see a doctor if you have:

• Pain that develops gradually, increases with weight-bearing activity, and diminishes with rest
• Pain that becomes more severe and occurs during normal, daily activities
• Swelling on the top of the foot or the outside of the ankle
• Tenderness to touch at the site of the fracture
• Bruising

Your doctor will do examine you foot and ankle.  Imaging tests may help your doctor confirm your diagnosis. Stress fractures are difficult to see on X-rays until they have actually started to heal. Your doctor may recommend a bone scan or a magnetic resonance imaging (MRI) scan, which are more sensitive than an X-ray and can detect stress fractures early.

How is a stress fracture treated?

Self Care

For immediate care following an injury follow the PRINCE treatment model:

• Protect your ankle with a supportive brace. Use crutches until the pain subsides.
• Rest your ankle.
• Ice your ankle several times a day for 10 to 20 minutes.
• Nonsteroidal anti-inflammatories (NSAIDs) help with pain relief and swelling reduction.
• Compression with an elastic compression wrap also helps reduce swelling—but it does not offer support when walking.
• Elevation. Raise your ankle above the level of your heart to reduce swelling and bruising.

If you suspect a stress fracture in your foot or ankle, stop the activity and rest. Ignoring the pain can have serious consequences. The bone may break completely.

Nonsurgical Treatment

Treatment will vary depending on the location of your stress fracture and its severity.

• Rest. Take a break from the activity that caused the stress fracture. It typically takes 6 to 8 weeks for a stress fracture to heal. During that time, switch to aerobic activities that place less stress on your foot and leg. Swimming and cycling are good alternative activities. Remember, however, that you should not do any physical activity on the involved foot or ankle until you consult a doctor.
• Protective footwear. To reduce stress on your foot and leg, your doctor may recommend wearing protective footwear. This may be a stiff-soled shoe, a wooden-soled sandal, or a removable short-leg fracture brace shoe.
• Casts. Stress fractures in the fifth metatarsal bone (on the outer side of the foot) or in the navicular or talus bones take longer to heal. Your doctor may apply a cast to your foot to keep your bones in a fixed position and to remove the stress on your involved leg. Casts are a type of external fixation. To keep weight off your foot and leg, your doctor may recommend that you use crutches until the bone heals.

Surgery

Some stress fractures require surgery to heal properly. In most cases, this involves supporting the bones by inserting a type of fastener. This is called internal fixation. Pins, screws, and/or plates are most often used to hold the small bones of the foot and ankle together during the healing process.

For more information or to make an appointment please call
1-877-233-WELL (9355).