Has the pandemic made you a couch potato? How many of you have returned to the gym or began jogging outdoors to lose the weight that you gained from stress and working remotely? How many of you are feeling pain in your ankles since you have increased your activity? How many of you have pin-pointed tenderness in your ankle?
If you raised your hand, nodded your head, or silently said yes to any of these questions, then you may have an ankle stress fracture or on the verge of having one. Read the details below for more information.
What is ankle stress fracture?
● A stress fracture is a small crack in a bone or severe bruising within the bone.
● Caused by overuse or repetitive activity
● Common in athletes (runners, soccer, basketball)
● Pain comes on gradually and increase with weight bearing activity
● Point tenderness at the site of the fracture
● Key to recovery is temporary refrain from high impact activities
● Returning to activities too quickly can delay the healing process and increase the risk of a complete fracture.
● Stress fractures occur overtime
Causes
● Sudden increase in physical activity
● Exercise more days per week
● Increase in duration and intensity
● Wearing a new style of shoe can decrease your foot’s ability to absorb repetitive forces and result in stress fractures.
Signs and Symptoms
● Pain decrease at rest
● Pain associated with physical activity throughout the day
● Swelling on the outside of the ankle
● Tenderness to touch at the site of the fractures
● Possible bruising around the ankle
Assessment
● If you’ve had a fracture before, a physician or general practitioner may order lab tests to check nutritional deficiencies for low calcium and vitamin D.
● Order X-ray to search for fracture
● Order a Bone Scan or magnetic resonance imaging (MRI) if fracture is not seen on Xray but is suspected
Treatment
● Goal is to relieve the pain and allow the fracture to heal so you can return to your activities.
● Depends on the location of the stress fracture and its severity
● Most stress fractures are treated non-surgically.
❖ Non-surgical:
➢ Rest
➢ Ice
➢ NSAIDs
➢ May recommend crutches to keep the weight off your foot until the pain subsides.
➢ Modified activity:
● 6-8 weeks for stress fracture to heal
● Switch to activities that place less stress on your foot/ankle
● Protective footwear to reduce stress on your foot and leg
● Casting to keep bones in a fixed position and remove the stress on the injured ankle
❖ Surgery
➢ May be needed to heal properly
➢ Involves supporting the bones by inserting pins, screws, and plates to hold the small bones of the foot and ankle together during the healing process.
➢ Needed if the fracture breaks completely and displaces.
Recovery
● 6-8 weeks for a fracture to heal
○ More severe fractures take longer
○ Confirm healing with Xrays or CT if fracture was hard to see initially
○ Once healed and pain free can gradually return to activity
References
May T, Marappa-Ganeshan R. Stress Fractures. [Updated 2022 Jul 17]. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554538/
Pheelings media. (2022). [Photo]. Runner suffering ankle injury after sport outdoors in a city outskirts.
https://www.shutterstock.com/image-photo/runner-suffering-ankle-injury-after-sport-1646735317
Scott, E. (2022). Stress Fractures of the Foot and Ankle.https://www.hss.edu/conditions_stress-fractures-
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