Foot & Ankle

Foot & Ankle Stress Fractures

Stress fractures are small, hairline cracks in the bone that develop over time due to repeated stress or overuse. These fractures are most common in the weight-bearing bones of the foot and ankle, particularly the metatarsals (the long bones in the foot) and calcaneus (heel bone).

• Improper Footwear: Shoes that do not offer adequate support or cushioning can increase the risk of stress fractures by allowing too much strain on the bones of the foot .
• Bone Weakness: Conditions like osteoporosis or poor bone density make the bones more vulnerable to fractures. Individuals with osteoporosis, for example, are more likely to suffer from stress fractures due to their bones' reduced strength .
• Poor Technique or Biomechanics: Imbalances in foot mechanics, such as overpronation (when the foot rolls inward) or inadequate shock absorption, can increase stress on specific areas of the foot and ankle, increasing the risk of fractures .
• Previous Injury: A history of foot or ankle injuries, such as sprains or fractures, may increase the likelihood of developing stress fractures in the future, especially if the affected area hasn’t fully healed or rehabilitated properly .
  

Symptoms of Foot & Ankle Stress Fractures

Recognising the symptoms of a stress fracture early is essential for prompt diagnosis and treatment. Common signs of a foot or ankle stress fracture include:

• Pain that Increases with Activity: Pain that starts gradually and worsens with physical activity, particularly weight-bearing movements like walking or running.
• Swelling: The area surrounding the fracture may swell and become tender to the touch.
• Bruising: Bruising may appear, especially in the initial stages of the injury.
• Pain with Weight-Bearing: It may become difficult or painful to walk or stand on the affected foot or ankle.
• Localised Tenderness: Pain that is focused on a specific point on the bone, which worsens when pressure is applied.

If you experience any of these symptoms, it’s important to seek medical attention promptly. Early diagnosis and treatment can prevent the injury from worsening and lead to a faster recovery.

Diagnosis of Stress Fractures

Dr. Ryan du Sart will conduct a thorough examination to assess the extent of the injury and confirm the diagnosis. This includes evaluating the patient’s symptoms, medical history, and gait. To confirm a stress fracture and rule out other conditions, Dr. du Sart may recommend the following imaging tests:

• X-rays: While X-rays can detect visible fractures, they may not identify stress fractures in their early stages. They help rule out other conditions, such as fractures or bone infections.
• MRI or Bone Scan: In cases where the fracture is not visible on an X-ray, an MRI or bone scan is the gold standard for detecting stress fractures. These imaging techniques can provide a more detailed view of the bone and soft tissues, helping to assess the severity of the injury.
• Ultrasound: Used less frequently, ultrasound can sometimes help assess the condition of the tendon and surrounding tissues, especially if there is soft tissue involvement.
  

Treatment Options for Foot & Ankle Stress Fractures

Treatment for stress fractures typically depends on the severity of the fracture and the patient’s activity level. Dr. du Sart offers both non-surgical and surgical options to treat foot and ankle stress fractures, depending on the specific needs of the patient.

Non-Surgical Treatment

Most stress fractures can be treated non-surgically with the following approaches:

• Rest and Activity Modification: Limiting or avoiding high-impact activities is critical to allow the bone to heal. Dr. du Sart will recommend avoiding running, jumping, or walking long distances during the initial healing period.
• Ice and Elevation: Applying ice and elevating the affected foot above the heart level can reduce swelling and manage pain.
• Immobilisation: A walking boot, cast, or brace may be used to immobilise the foot or ankle and prevent further stress on the bones while healing.
• Pain Management: Over-the-counter pain relievers such as paracetamol or anti-inflammatory drugs may help manage pain and reduce swelling.
• Physical Therapy: After healing has progressed, physical therapy is essential to restore strength, flexibility, and range of motion. Dr. du Sart will recommend a rehab program to help regain function and prevent re-injury.
  

Surgical Treatment

In some cases, surgery may be necessary if the stress fracture is severe, displaced, or does not respond to conservative treatment. Surgical options may include:

• Internal Fixation: This procedure involves using screws, plates, or rods to stabilise the bone during the healing process. This approach is used in cases where the fracture is displaced or has difficulty healing naturally.
• Bone Grafting: In cases where the bone is severely damaged or weakened, bone grafting may be used to promote healing by adding new bone material to stimulate repair.

Dr. du Sart will assess the specific needs of each patient and discuss the most appropriate surgical approach if required.

Recovery and Rehabilitation

The recovery time for foot and ankle stress fractures varies based on the severity of the fracture and the chosen treatment. For most patients, recovery includes:

• Initial Immobilisation: Patients will typically need to wear a cast, walking boot, or brace for 4–6 weeks to protect the injured area while it heals.
• Gradual Weight-Bearing: After the immobilisation phase, Dr. du Sart will guide you through a progressive weight-bearing program, often starting with crutches or a walking boot.
• Physical Therapy: Rehabilitation exercises will help restore strength, flexibility, and balance in the affected foot. These exercises are crucial for preventing future injuries and improving overall function.
• Return to Activity: Once healing is complete and strength has been restored, Dr. du Sart will advise on a gradual return to sports or high-impact activities, often taking several months depending on the severity of the injury.

Preventing Future Stress Fractures

While some stress fractures are unavoidable, the following strategies can help reduce the risk:

• Proper Footwear: Ensure you wear shoes that provide adequate support and cushioning, especially during physical activities that involve high impact.
• Gradual Increase in Activity: Avoid rapid increases in exercise intensity or duration. Gradually building up stamina allows the bones to adapt to increased stress.
• Cross-Training: Participating in a variety of low-impact activities can help reduce the repetitive stress on the same muscles and bones.
• Strengthening Exercises: Strengthening the muscles surrounding the foot and ankle helps absorb impact and reduces strain on the bones .

Why Choose Dr. Ryan du Sart?

Dr. Ryan du Sart is a fellowship-trained orthopaedic surgeon with extensive experience in diagnosing and treating foot and ankle stress fractures. With a focus on personalised, evidence-based care, Dr. du Sart ensures that each patient receives the most appropriate treatment, whether through non-surgical management or surgical intervention.

Schedule a Consultation

If you suspect a foot or ankle stress fracture or are experiencing persistent pain after increasing physical activity, don't delay in seeking treatment. Early intervention is key to a full recovery.

Phone: (08) 9779 9767

Email: admin@ryandusart.com.au

Locations:

6 Higgins Street, South Bunbury, WA 6230

20 Prince Street, Busselton, WA 6280

References:

1. American Academy of Orthopaedic Surgeons (AAOS). (2020). Stress fractures.https://www.aaos.org
2. Cleveland Clinic. (2021). Stress fractures.https://my.clevelandclinic.org/health/diseases/15299-stress-fractures
3. British Journal of Sports Medicine (BJSM). (2020). Management of foot and ankle stress fractures.https://bjsm.bmj.com
4. Royal Australian College of Surgeons (RACS). (2020). Foot and ankle injuries.https://www.surgeons.org