Foot and ankle stress fracture

Person with stress fracture of the foot

​Stress fractures are tiny breaks in your bones caused by repeated, continuous stress to the area. They often occur in the feet or ankles of athletes whose sport requires large amounts of running like basketball, soccer or cross country. The bones in the mid-foot, or metatarsals, are especially vulnerable to stress fractures.

Stress fractures happen over time with repetitive action. They are different from acute fractures, which are caused by a sudden, traumatic injury.

Foot and ankle stress fracture symptoms

At first, a stress fracture may not have symptoms other than mild pain that goes away with rest. Over time, the pain will not go away but instead becomes stronger and centered on the affected area of your ankle or foot.

Other symptoms include:

  • Pain in the front of the ankle or foot, often after long or intense periods of activity

  • Pain that goes away after exercise but returns when exercise is continued

  • Swollen area on your foot or ankle that is tender when touched

Foot and ankle stress fracture diagnosis

Your doctor will complete a comprehensive physical and medical history to help diagnose an ankle or foot stress fracture. Traditional X-ray images may not show anything at first. However, X-rays are still very important to have done first in order to evaluate the overall structure of your foot and look for any abnormalities. If your physician suspects a stress fracture, often it is just treated as such.  If there is any question about the diagnosis, additional tests may be required.

Tests that diagnose stress fractures of the ankle and foot include:

  • Bone scan—a radiology procedure used to look at the skeleton to find areas of physical and chemical changes in bone.

  • Magnetic Resonance Imaging (MRI)—a detailed scan that generates thorough images of the bone interior and soft tissues.

Foot and ankle stress fractures treatment

We develop an individualized treatment plan designed with your specific situation in mind. The first step is often discontinuing, at least temporarily, the movement or activity causing the problem.

The RICE method can provide relief:

  • Rest the joint

  • Ice the affected area

  • Compress the area with an elastic bandage

  • Elevate the joint

If additional treatment is needed, it may include:

  • A cast or brace—to hold the injured area in place and provide stability.

  • Crutches—to help support your body weight while the stress fracture heals.

  • Over-the-counter pain relief—like ibuprofen and naproxen.

  • Physical therapy—to improve the quality of your movement.

  • Shock-absorbing shoes—to help reduce impact during exercise.

At The Christ Hospital Health Network, we emphasize noninvasive treatments for stress fractures that reduce pain and help you get back to your activities or sport.