Stress Reaction/Fracture

Typical Symptoms

Stress reactions/fractures can lead to localised pain and swelling symptoms in the foot. It can be made worse with weight-bearing may present acutely, but there need not be any contact to start the pain symptoms.

Ankle injury after too hard training

What causes it?

Stress reactions/fractures are due to overload of a bone in the foot, usually from altered biomechanics. This can be the primary problem or sometimes when offloading from an other pathology, the stress reaction/fracture can develop.

With the stress reaction, there will bruising in the bone with a break in the cortex (outer layer), whereas with a fracture a break will be noted.

How can I help myself?

It is helpful to reflect on when the symptoms first started to therefore perhaps understand where the repeated load came from and hence the mechanism of injury.

If there is considerable swelling and pain, offloading with crutches and immobilising the ankle/foot can help as will following PRICE guidelines. Analgesia such as anti-inflammatories can also help reduce pain symptoms.

When to seek help?

If your symptoms are quite significant and you are unable to weight bear, it would be good to have your ankle/foot assessed as soon as possible.

What are the treatment options?

Once your clinician assesses you with a thorough history and examination, they may undertake an X-ray to look for a fracture. If no fracture is evident on the X-ray, but it is suspected, then your clinician might investigate further with an MRI or CT scan.

Rehabilitation with a physiotherapist and a gait analysis with a podiatrist forms the core of treatment and for some, blood tests to look for bone health may be undertaken. If symptoms are persisting or there is concern about healing, some clinicians may offer extracorporeal shockwave therapy or opt for a surgical input.

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