Stress fracture of the foot

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What is a stress fracture?

A stress fracture is a small crack or break in your bone. Most stress fractures occur in the bones of the feet. The break is more of a thin crack that can develop from repetitive force and overuse. This happens because our feet carry all our weight daily and take all the stress from other bones.

The most common stress fractures are the second and third metatarsals in the foot, but you can also get a stress fracture in your heel. It is known that these type of fractures make up 2% of injuries to sportsmen and women.

What bones in the foot and ankle are affected by a stress fracture?

You can experience a stress fracture in any of the bones in the lower leg, ankle, and foot. The most common are:

  • metatarsals
  • calcaneus
  • navicular
  • bones that make up your ankle joint, tibia, and fibula

What are the symptoms of a stress fracture?

A few of the symptoms that you will feel include:

  • Pain and/or weakness in your foot where the fracture is located
  • Pain deep within the foot itself
  • Tenderness at the site of the fracture
  • Some swelling on top of the foot or the ankle
  • Pain that occurs during or after normal activity
  • Pain that is brought on by doing certain activities and relieved by resting it

It is vital that you get your stress fracture treated promptly. Otherwise, your pain could become more severe and the fracture could then become displaced, making it a much more serious injury. You can also develop arthritis if you leave the fracture to heal without proper care and supervision.

What are the common causes of a stress fracture?

There are other reasons why we may get a stress fracture. These include:

  • Your muscles can become tiered from repeated impact that transfers the impact to the bone
  • Change in your activities, such as increased exercise. Also, starting a job where you are standing up for most of the day can add increased pressure on your feet
  • Women with osteopaenia or osteoporosis are at higher risk of a stress fracture
  • Bad techniques in the gym or other sporting activities
  • Changes in surfaces, such as running on a treadmill and then running outside on a harder surface
  • Repetitive activities in certain high-impact sports, such as long-distance running, tennis, gymnastics, and more
  • Not wearing proper support footwear or insoles
  • Existing foot issues such as tendonitis and bunions can affect how your foot strikes the ground when you walk
  • Low vitamin D and calcium
  • Wearing bad shoes. High heels place a lot of pressure on the toes

How is a stress fracture diagnosed?

When seeing your doctor or physiotherapist for the first time they will:

  • Take a full medical history
  • Ask about your daily activities
  • Ask what sports you play
  • Ask about your working environment and your activities at work
  • Check the medications you may be taking for other conditions

A stress fracture can be difficult to diagnose as they are not always picked up on an X-ray, especially if the crack is very small. An MRI scan may be a better option for diagnosis as it is much more sensitive than an X-ray and can spot stress fractures more easily.

How long does it take to recover from a stress fracture?

Everyone is different, but bones usually take up to 12 weeks to heal. After resting for a few weeks and the pain has subsided, you can gradually ease yourself back into physical activity and sports following professional medical guidance.

If you start running again, you can easily re-fracture the site of injury. Patience is key. Your doctor may recommend physiotherapy during your healing process to ensure you don’t lose strength and mobility in your foot and ankle.

Will I need surgery to fix the stress fracture?

Surgery for this type of fracture is rarely needed and is usually only recommended after all conservative and non-surgical approaches have failed.

How is a stress fracture treated?  

The following are some suggestions that your doctor may recommend for you:

  • Immediately stopping any activity that causes you pain
  • Ice the painful area a few times a day
  • Stop all exercise for six weeks to give your body a rest
  • In a laying position keep your foot raised above your heart to help with swelling
  • Anti-inflammatory medications will help your pain and reduce inflammation
  • Footwear is very important. Only wear protective shoes to reduce stress on your foot
  • Your doctor may suggest putting your foot in a cast to protect your bones during healing
  • If your doctor thinks that staying off your foot for a short time is a good idea, they will ask you to use crutches to enable healing

It is not common, but some stress fractures may require surgery to help your bone heal.

How to prevent another stress fracture

Unfortunately, accidents can happen at any time and cause a stress fracture. Some suggestions to help you prevent further injuries:

  • Following a good diet to ensure you get calcium and Vitamin D, both of which help bone density
  • Wearing good shoes is very important. Make sure they are supportive and well-padded
  • Do not smoke as this leads to problems with your body’s natural healing
  • Mix up your exercise regime. Alternate between different activities to take the pressure off some of your bones
  • When you start a new form of exercise slowly ease into the time, speed, and distance

How physiotherapy can help you recover from a stress fracture

We will do whatever we can to get you on the fastest route to recovery. Some of the treatment methods we use include:

  • Mobilisation
  • Strengthening exercises
  • Myofascial trigger point release
  • Pilates
  • Cross-friction massage
  • Stretching and range of movement exercises
  • Acupuncture
  • Functional exercises
  • Kinesio-taping

Ready to recover?

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