Stress Fractures of the Foot and Ankle

A stress fracture of the bone or ankle is a break in the foot or ankle bones. It is also called a hairline fracture. These breaks often happen because of repeated stress on the foot bones over time from things like running, sports, or other kinds of exercise The two most common kinds of stress fracture are a metatarsal (foot bone) fracture and a talus (ankle bone) fracture.

Stress fractures of the foot and ankle are bone breaks that happen in the foot or ankle. These bones help support the rest of your body while you are standing, walking, running, or exercising and can take a lot of pressure. However, if they are put under too much pressure, they can fracture (break).

There are 3 different kinds of breaks:

• Compound fracture. The broken bone is pushed through the skin. This is called an open fracture or compound fracture.
• Partial fracture. The fracture goes only part way through the bone.
• Stress fracture. Small cracks form in the bone dur to repeated pressure. A stress fracture is also known as a hairline fracture.

Stress fractures most commonly happen in the bones in the foot or the ankle. These include:

• Metatarsal [meh-tuh-TAHR-suhl] fracture. The metatarsal bones are the long bones in your foot that connect your ankle to your toes. They help you balance when you stand and walk, and help support the weight of your body. You have five metatarsal bones in each foot.
• Talus [TAHL-us] fracture. The talus is a small bone that is between the heel bone and the tibia [TIH-bee-uh) and fibula [FIB-yoo-luh], the two bones in your lower leg.

Even though you might not notice a stress fracture right away, it is a serious medical condition that can cause permanent damage to your foot or ankle if not treated.

The symptoms of stress fractures of the foot and ankle can be similar to symptoms of dislocated joints or ankle sprains. However, you should still see a doctor for any of these conditions. Even if you don’t have a fracture, your doctor can prescribe treatment that will help you heal faster and with fewer long-term effects. Common symptoms of a foot fracture include:

• A foot bone that is out of place
• Swelling, bruising, or bleeding
• Intense pain around the injured part of your foot • Numbness and tingling • Difficulty moving your foot or toes • Pain when you try to put weight on the foot

Usually, these symptoms will be worse near the bone that is broken, but you can also feel pain or other symptoms in nearby areas of the body, like the ankle, toes, or arch of the foot.

Stress fractures can happen over a long period of time, so you might not notice all these symptoms right away. Sometimes, these symptoms will start out minor and get worse over time, or they might go away and come back worse than they were before.

If you think that you have a broken bone, you should get medical treatment right away. Keeping the bone still and weight off the injured foot or ankle can keep your injury safe while waiting for medical help.

There are many causes for stress fractures in the foot and ankle. Anything that puts too much stress on the bones in the feet can cause a fracture, even if that stress happens over a long period of time. Common causes include:

• Repetitive exercise that puts stress on your feet or ankles, like running
• Sports where you kick or jump frequently, like soccer or basketball
• Stress from impact sports like football and gymnastics

Sometimes, these causes can weaken your bone, which makes it easier to break in a situation where it normally would not.

Because hairline and stress fractures are small, your doctor might not be able to tell that you have a foot or ankle fracture just by looking at the part of your foot that is injured. Your doctor will most likely request an imaging test, like an x-ray (a test that passes beams of low-level radiation through your body) to take pictures of the injured area and find out whether you have a bone fracture. X-rays can also rule out a diagnosis of a dislocated joint, which is a common injury of the ankles.

If you think that you might have a foot or ankle fracture, you should see a doctor as soon as you can. Your doctor might treat your foot fracture in different ways depending on the kind of break you have and how serious it is. Some treatments include:

• Rest. Even if you don’t need surgery or reduction (setting a broken bone), you will probably need to stay off of the injured foot while it heals. Your doctor might use a cast or splint to keep the foot from moving during this period.
• Medicine. Anti-inflammatory medicines like ibuprofen can help decrease pain, swelling, and inflammation around the foot or ankle fracture.

There are also some first aid steps you can take before you see a doctor to help keep your injured foot safe and reduce pain. The letters RICE can help you remember what to do:

• Rest. Stay off your foot until it can be looked at by a doctor. Don’t walk, run, or play sports, because this can make your injury worse.
• Ice. Put ice on the foot as soon as possible. You should use the ice on your foot for 15 to 20 minutes every 3 to 4 hours, especially for the first two days after you are injured. This can decrease inflammation and pain. Be sure to place a towel between your skin and the ice.
• Compression. Wrap a bandage around the foot or ankle. You should keep the bandage snug, but don’t wrap it too tight because this can cut off blood flow to the foot.
• Elevation. Put your foot on a couple of pillows to keep it above your heart and chest. This can help decrease swelling.

Stress fractures in the foot and ankle are often caused by physical activity like running, sports, and other kinds of exercise. You can prevent fractures and other injuries to your foot by taking these steps:

• Warm up and stretch before you exercise.
• Wear the right shoes for the kind of exercise or sports you are doing.
• Replace athletic shoes every year, and replace running shoes every 300 to 400 miles.
• Don’t run or walk on uneven surfaces.
• Take breaks and don’t exercise too much.