A stress fracture is a small crack in a bone. Most stress fractures of the foot are caused by overuse, often during sports activities. Stress fractures are most common in foot bones including the metatarsals (in the lower mid foot), the talus (lower ankle), calcaneus (heel bone), and navicular (mid-foot). Stress fractures will not “heal on their own” without proper care.
Signs of a Stress Fracture
Usually, the first sign of a stress fracture in the foot or ankle is pain. This pain may not be immediately severe, but instead gradually worsens and becomes particularly acute during activity. Any of these may be signs that you have a stress fracture in your foot:
- Pain that lessens during rest/inactivity
- Swelling on the top of the foot or on the outside of the ankle
- Tenderness when the site of the fracture is touched
- Possible bruising
If you have pain, it is time to schedule an appointment with a podiatrist. Until your appointment, follow the RICE protocol (Rest, Ice, Compression, Elevation).
Treatment Options
Treatment will vary depending on the location of the stress fracture and its severity. Most stress fractures are treated nonsurgically.
- Nonsurgical Treatment: The focus here is on immobilizing the affected foot, usually in a cast or boot, for 6 to 8 weeks to allow time for your body to naturally heal. Immobilization can be combined with therapies such as use of anti-inflammatory medications, vitamin D, activity modification and wearing protective footwear such as a stiff-soled shoe.
- Surgical Treatment: While not the norm, a stress fracture may necessitate surgery for proper healing. Specialized pins, screws, and/or plates are most often used to hold the small bones of the foot and ankle together during the healing process. When a stress fracture is not properly cared for and leads to a break or displacement of the bone, surgery is often the only way to achieve proper healing.
Effective treatment of a stress fracture requires patience. It can be tempting to start back into activity too early, particularly because your foot may feel OK even when it has not fully healed. Reinjuring a stress fracture can lead to a break or create a chronic foot injury that takes even longer to fully heal.
Preventing Stress Fractures
To avoid a repeat stress fracture, follow these tips:
- Maintain bone strength: A poor diet and conditions such as osteoporosis can weaken your bones and make it more likely that you will suffer a stress fracture.
- Ease into exercise: Overexertion is the most common cause of a stress fracture. If you’re new to an activity, or out of practice, gradually increase the pace, intensity and duration.
- Wear the right shoes: Wearing “barefoot” or minimally cushioned shoes can lead to stress fractures. The same is true for old shoes that have lost their cushioning ability.
- Cross train: Mix up your activities so that you aren’t repeatedly placing a great deal of strain on a single area of your foot. Lower-impact activities such as swimming and cycling carry a much lower risk of injury.
