What are Breaks, Fractures & Sprains of the Foot and Ankle?

  • Most stress fractures occur in the weight-bearing bones of the foot and lower leg
  • Rest is the key element to recovery from a stress fracture.
  • A stress fracture is an overuse injury

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.

Most stress fractures occur in the weight-bearing bones of the foot and lower leg. Studies show that athletes participating in tennis, track and field, gymnastics, dance, and basketball are at high risk for stress fractures. In all of these sports, the repeated stress of the foot striking the ground can cause problems.

Rest is the key element to recovery from a stress fracture.

A stress fracture is an overuse injury. 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.

The most common sites of stress fractures are the second and third metatarsals of the foot. Stress fractures are also common in the heel (calcaneus), the outer bone of the lower leg (fibula), and the navicular, a bone on the top of the midfoot.

Our Treatment Approach

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.

Apply an ice pack and elevate your foot above the level of your heart.Nonsteroidal anti-inflammatory medicines like ibuprofen or naproxen may help relieve pain and swelling, but may inhibit bone healing. Try not to put weight on your foot until after you see a doctor.

Nonsurgical Treatment

Treatment will vary depending on the location of your stress fracture and its severity. The goal of any treatment is to help you return to all the activities you enjoy.

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..

Protective footwear. To reduce stress on your foot and leg, your doctor may recommend wearing protective footwear.

Casts. 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.

Surgical Treatment

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.

Causes

Stress fractures usually occur when you increase your high-impact activity by:

  • Frequency (how often you exercise)
  • Duration (how long you exercise)
  • Intensity (your level of exertion)

People who do not exercise can also have stress fractures. If osteoporosis or other disease has weakened bones, normal daily activities may result in a stress fracture. This is called bone insufficiency. It is one of many factors that can increase your risk for stress fracture.

Conditioning

Doing too much too soon is a common cause of stress fractures.

Equipment and Environment

Improper sports equipment or a change of surface, such as going from a grass tennis court to one of clay, or a change from an indoor to an outdoor running track, can also increase the risk.

Technique

Errors in training or technique are another cause of stress fractures. Anything that alters the mechanics of how the foot absorbs impact when it strikes the ground may increase your risk for a stress fracture.

Bone Insufficiency

Insufficiency stress fractures result when the bone itself is weak. Conditions like osteoporosis reduce bone strength and density. This increases the risk of fracture.

Symptoms

  • 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
  • Possible bruising