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Stress Fracture

A stress fracture of the lower limb is a small crack in a bone that occurs due to repetitive force or overuse, rather than from a single traumatic
event. It is commonly seen in weight-bearing bones, such as those in the foot, ankle, shin, and thigh.

Symptoms

Common symptoms of a plantar plate injury include:
  • Localised Pain: Pain that worsens during activity and improves with rest.
  • Swelling: Mild swelling around the affected area.
  • Tenderness: Sensitivity to touch in the area of the fracture.
  • Bruising: Possible bruising, though this is less common than with acute fractures.

What causes it?

Friberg’s infraction can result from:

Repetitive Activity

High-impact sports, such as running, jumping, or dancing, especially when increasing intensity or duration too quickly.

Improper Footwear

Wearing shoes that do not provide adequate support or cushioning.

Poor Technique

Improper form during physical activities can increase stress on the bones.

Bone Health

Conditions like osteoporosis or other factors that weaken bones may increase susceptibility to stress fractures.

Sudden Changes

Changing surface types (e.g., running on hard surfaces) or increasing activity level without proper conditioning.

How is it diagnosed?

Diagnosis typically involves:
  • Medical History: Discussion of symptoms, activities, and any recent changes in exercise routines.
  • Physical Examination: Assessing pain, swelling, and tenderness.
  • Imaging Studies: X-rays may not always show stress fractures initially, so MRI or bone scans may be used for a more accurate diagnosis.

How is it Treated?

Treatment options typically include:

Rest

Avoiding activities that put stress on the affected bone.

Ice

Applying ice to reduce swelling and pain.

Footwear Modifications

Wearing supportive shoes or orthotics to relieve pressure.

Gradual Return to Activity

Slowly increasing activity level once symptoms improve, guided by a healthcare professional.

Physical Therapy

Exercises to strengthen surrounding muscles and improve flexibility.

Recovery

Recovery time for stress fractures can vary, typically ranging from several weeks to a few months, depending on the severity of the fracture and adherence to treatment. It’s important to follow a healthcare provider’s guidance to prevent re-injury.

Frequently Asked Questions

Here are some frequently asked questions about plantar plate injuries:

What is a stress fracture?
A stress fracture is a small crack in a bone that occurs due to repetitive force or overuse, often seen in weight-bearing bones of the lower limb.
Common causes include repetitive activities (like running or jumping), improper footwear, poor technique, sudden increases in activity level, and conditions that weaken bones, such as osteoporosis.
Symptoms typically include localised pain that worsens with activity, mild swelling, tenderness in the affected area, and, in some cases, bruising.
Diagnosis usually involves a medical history review, physical examination, and imaging studies. X-rays may not always show stress fractures initially, so MRI or bone scans may be used for confirmation.
Treatment generally involves rest, ice application, modifying footwear, and gradually returning to activity. Physical therapy may also be recommended to strengthen surrounding muscles.
Recovery time varies depending on the severity of the fracture, but it typically ranges from several weeks to a few months.
Preventive measures include gradually increasing activity levels, wearing appropriate footwear, using proper techniques during sports, and maintaining good bone health through diet and exercise.
Surgery is rarely required for stress fractures. Most can be managed with conservative treatment. However, surgical intervention may be considered in severe cases or when there are complications.
Untreated stress fractures can lead to worsening pain, increased risk of complete fractures, and prolonged recovery time. It’s essential to address symptoms early.
Consult a healthcare professional if you experience persistent pain in the lower limb, swelling, or difficulty walking that does not improve with rest and self-care.

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