Stress Fractures of the Foot and Ankle

Foot fractures are more common than people think. We often see patients with foot fractures, also caused stress fractures (from non trauma or not from an acute injury).

The most common part of the foot that gets a fracture is the forefoot. A stress fracture is an overuse of the bone, and can be caused by poor nutrition, obesity, poor sleep and too much exercise too soon. Foot wear can also be a contributing cause.

Metatarsal stress fractures are the most commonly injured (forefoot) followed by the heel bone and the tibia and fibula bones in the ankle. 

Stress fractures are more common in sports people and athletes, and more common in women than men. Elderly populations are also more prone.

-If you have increased your training volume, training intensity or changed running or training surface you may get a stress fracture. Wearing shoes that reduce the foot’s ability to absorb stress can also cause a stress fracture.

Forefoot pain that gets increasingly worse when weight bearing or walking could be a stress fracture. Occasionally there will be a throbbing or bruising pain after exercising, or during the night. 

Many patients think that fractures of the foot are only caused by a direct insult or injury. However this isn't the case and most are caused by the factors mentioned above. The pain can come on slowly over days to weeks. Alleviated by rest, but certain to come back when getting back to weight bearing activities. 

You may have a stress fracture of the foot or ankle if you:

•  Experience pain when weight bearing
• Heat at the site of pain
•  If there is swelling of the foot or ankle (this could be the later stages of a stress response of the bone)
•  You see a bruise on your foot or ankle (also later stage)

Walking 'through the pain' will make a stress fracture worse and could lead to a complete fracture.

Stress fractures that are recent can often be missed on x -ray. This is because the bone callus hasn't had time to build up to see the injury. 

Ultrasound examination however is more sensitive to more recent injuries. South London Foot Clinic use ultrasound scanning during its examinations and will quickly be able to diagnose a stress response or a stress fracture of the foot or ankle. 

Healing from a stress fracture can take from four weeks to twelve weeks, depending on where in the foot the fracture is and how much damage has happened to the bone. 

Your treatment will be offloading, sometimes with a fracture boot and shockwave treatment (to speed up recovery).

Book an appointment with us if you think you might have a stress fracture. 

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