Many stress fractures of the ankle and foot are overuse injuries. They occur over time when repetitive forces result in microscopic damage to the bone. The repetitive force that causes a stress fracture is not great enough to cause an acute fracture — such as a broken ankle caused by a fall.
Hairline stress fractures usually occur when people change their activities — such as by trying a new exercise, suddenly increasing the intensity of their workouts, or changing the workout surface (jogging on a treadmill vs. jogging outdoors). In addition, if osteoporosis or other disease has weakened the bones, just doing everyday activities may result in a stress fracture. However, anyone can incur this ailment so if you feel foot pain be aware of this condition so you may take proper action and see your doctor.
If you have a stress fracture, you must refrain from high impact activities for an adequate period of time. Returning to activity too quickly can not only delay the healing process but also increase the risk for a complete fracture.
Stress fractures occur most often in the second and third metatarsals in the foot, which are thinner (and often longer) than the adjacent first metatarsal. Also it’s common in the calcaneus (heel); fibula (the outer bone of the lower leg and ankle); talus (a small bone in the ankle joint); and the navicular (a bone on the top of the midfoot).
Interestingly, your bones are in a constant state of turnover—a process called remodeling. New bone develops and replaces older bone. If an athlete’s activity is too great, the breakdown of older bone occurs rapidly — it outpaces the body’s ability to repair and replace it. As a result, the bone weakens and becomes vulnerable to stress fractures.
The most common symptom of a stress fracture in the foot or ankle is pain. The pain usually develops gradually and worsens during weight-bearing activity. Other symptoms may include:
- Pain that diminishes during rest
- Pain that occurs and intensifies during normal, daily activities
- Swelling on the top of the foot or on the outside of the ankle
- Tenderness to touch at the site of the fracture
- Possible bruising
See your doctor as soon as possible if you think that you have a stress fracture in your foot or ankle. Ignoring the pain can have serious consequences. The bone may break completely.
Until your appointment with the doctor, follow the RICE protocol. RICE stands for Rest, Ice, Compression, and Elevation. In addition, nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen or naproxen can help relieve pain and reduce swelling.
Treatment and Recovery
Seeing a medical doctor (podiatrist) is the only way to definitely get the right diagnosis and treatment. They can perform imaging to see your bones and determine the right steps to take. In most cases, it takes from 6 to 8 weeks for a stress fracture to heal. More serious stress fractures can take longer. Returning to activity too soon can put you at risk for larger, harder-to-heal stress fractures and an even longer down time. Reinjury could lead to chronic problems and the stress fracture might never heal properly.