Stress Fracture (Foot/Ankle)

What is a Stress Fracture?

A stress fracture is a small crack in a bone, usually from repetitive overuse rather than a single injury. In the foot and ankle, common sites are the metatarsals, navicular, and tibia.

Common Symptoms

• Localized pain that worsens with activity

• Tenderness over a specific bone

• Swelling in some cases

• Pain that lingers even at rest in advanced cases

Physical Therapist Diagnosis

A PT evaluates pain patterns, palpates for tenderness, and assesses loading tolerance. Imaging (X-ray, MRI, or bone scan) is often used to confirm diagnosis.

Why it Happens

Stress fractures occur from repetitive loading beyond the bone’s capacity. Risk factors include sudden training increases, poor footwear, low bone density, or biomechanics issues.

Why it Doesn’t Always Heal on Its Own

Bones can heal with rest, but if activity continues, the fracture may worsen. Without rehab, underlying factors (like mechanics or strength deficits) remain uncorrected.

Ideal Physical Therapy Treatment

Rehab includes protection during healing, followed by gradual loading and strengthening.

Key strategies include:

• Activity modification or offloading to allow healing

• Manual therapy for surrounding joint mobility

• Strengthening of foot, ankle, and hip muscles

• Gait retraining to reduce stress

• Education on training progression and footwear

Expected Outcomes

With proper management, most stress fractures heal within 6–12 weeks.

Key Takeaway

Stress fractures heal with rest, but addressing biomechanics and training errors prevents recurrence.