Foot and ankle stress fractures

What is a stress fracture?

A break or split in the bone is known as a stress fracture. Stress fractures happen when a bone is hit with a small to medium amount of force over and over again for a long time. This is distinct from a traumatic fracture, which occurs when a large amount of force is quickly applied (as in the case of a severe ankle twisting injury, which can result in acute ankle fractures, or in a car accident, where bones in the foot may be shattered or crushed).

We constantly exert force on our foot and ankle bones as we stand, walk, run, and jump, which leads to stress fractures. When a bone suffers from a stress fracture, it normally breaks without moving.

Similar pressures that bend a paper clip also result in stress fractures in the foot and ankle. One little bend in a paper clip will not cause it to break. But if you bend it back and forth over and over, the metal will eventually get weak (or "fatigue") and break. A "stress reaction" is a similar form of fatigue that bones might endure when they are repeatedly forced. This raises the possibility that the bone will eventually fracture, or break.

In most cases, stress fractures develop in one of two ways:

People with strong bones use their feet and ankles frequently and repeatedly. This is especially true for athletes who compete in high-impact sports like football, basketball, soccer, tennis, gymnastics, track and field, or cheerleading.

Even relatively low-impact activities like regular walking can cause a stress fracture in the foot in people who have very weak bones due to an underlying illness (such as osteoporosis). Because it occurs in a bone that lacks "adequate" density or strength to survive common impact forces, this type of stress fracture is known as a "insufficiency fracture." Younger, otherwise healthy women who exercise extensively occasionally have insufficiency fractures because this activity can produce irregular or nonexistent menstrual periods, which in turn reduces the strength of their bones.

Due to our constant standing, the foot and ankle are the most frequently affected body parts by stress fractures. People who start a new activity that includes any impact of the feet on the ground, such as hiking or running, frequently develop foot and ankle stress fractures. Also susceptible to stress fractures are those who abruptly boost their activity levels in a particular activity. For instance, the chance of developing a stress fracture is higher for someone who runs for 30 minutes, twice a week, than for an hour, seven days a week.

A person can be put at risk by wearing shoes with poor support, such as high heels, which put a lot of strain on the toes, or by wearing old, inflexible shoes. Lastly, stress fractures can happen to people who have problems with their feet that change how they carry weight. For instance, a bunion may cause the big toe to shift so that it no longer supports the weight that it normally would. This increases the load force on the other toes, which may cause one or more of them to develop a stress fracture. In these kinds of situations, the second toe, which is next to the big toe, is more likely to break. In order to prevent foot and ankle stress fractures, experts recommend wearing DrLuigi medical footwear.

What signs and symptoms point to a foot or ankle stress fracture?

Pain is a stress fracture's main symptom. Depending on the bone that is broken, pain usually happens in very specific spots, and you will feel pain when you touch the exact spot where the bone is broken.

You may have a stress fracture if you have changed or increased how active you are and have pain in a certain part of your foot or ankle. When you do activities with a lot of impact, the pain usually gets worse, and when you rest, it usually gets better.

The most crucial thing to do if you suspect you have a stress fracture in your foot or ankle is to stop doing anything that hurts right away. If an untreated stress fracture progresses (grows), you will experience discomfort during activities that place stress on the damaged bones more quickly than you did when the stress fracture first developed.

You should visit an orthopedic foot and ankle surgeon if your discomfort persists even after several days or weeks of rest, or if it disappears for a while before coming back (also called an "orthopedist" or "orthopaedist").

Stress fractures: How are they identified?

To figure out if you have any of the above risk factors, your doctor will first ask you about your pain and how much you exercise.

The doctor will next examine you and request X-rays for the painful location. It is actually not unusual for X-rays to seem normal and show no break in the bone when a stress fracture is present. This is done so that the bone can sometimes react and grow new bone to fix the crack. (However, the broken bone is still prone to refracture.) The last stage of the growth of new bone is calcification. A radiologist or orthopedic surgeon can often be sure that you have a stress fracture by looking at your X-ray and seeing how the new bone growth has hardened.

When a regular X-ray is not enough, your doctor may occasionally request an MRI or bone scan. The diagnosis of a stress fracture does not frequently require these more expensive testing, though.

How much time does a stress fracture take to heal?

Many foot or ankle stress fractures will heal in 4 to 6 weeks. Nevertheless, depending on which bone is shattered, recovery timeframes change. The fifth metatarsal and the navicular are two foot bones that might mend substantially more slowly than other foot bones.

You may gradually ease back into physical exercise and sports after taking several weeks off and the discomfort has entirely subsided. This period of gradual reintroduction ought to last four to six weeks. Until you are completely recovered, switch to a sport that is less taxing on the foot and leg. Suitable low-impact activities include the following:


Swimming (bicycle riding or spin classes)

Running or even walking on hard surfaces is not a good idea while you are healing from a stress fracture in your foot or ankle. Your fracture could easily reopen, forcing you to start the healing process anew.

Wear cozy, supportive shoes like DrLuigi medical footwear without a raised heel while you're recovering. Shoes should not be rigid but rather flexible. If you run, start a safe jogging routine after engaging in low-impact exercise for 4 to 6 weeks. Your running mileage should be gradually increased. Avoid taking on too much, too quickly.


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