Competitive Dancers Not Immune to Foot and Ankle Stress Fractures

​Glenn B. Pfeffer, MD
The American Orthopaedic Foot & Ankle Society offers injury prevention advice 
ROSEMONT, IL, April 16, 2012 Stress fractures of the foot and ankle are commonly associated with athletes and runners but according to the American Orthopaedic Foot & Ankle Society (AOFAS), competitive dancers (as seen on ABC's Dancing with the Stars) or anyone who engages in a rapid increase in physical activity are prone to stress fractures. The most common overuse injuries of the foot and ankle, stress fractures result from a series of loading and unloading cycles that cause damage to the bone. If these forces continue and the bone is not able to repair itself fast enough, a fracture may occur.

Glenn B. Pfeffer, MD, an LA orthopaedic surgeon, past president of the AOFAS, and Director of the Foot Center at Cedars-Sinai Hospital, treats many patients with stress fractures including ABC's Dancing with the Stars contestants. "Repetitive stress can lead to fractures in the small bones of the foot. Even a piece of steel will break if it is subject to sufficient repetitive stress – and the bones in the foot are no different," says Dr. Pfeffer. "The stress on the foot can exceed 500,000 pounds during a few minute dance routine. Cushioned soles on practice shoes can help prevent injury. Stay away from hard dance surfaces. If the pain is already present, however, don't ignore it, as the problem can only get worse. Treatment options include rest, immobilization, and the avoidance of prolonged repetitive pressure on the foot. You can't dance for long on a broken foot without making it worse," he adds.

According to the AOFAS, the typical symptom of a stress fracture is pain, which may occur suddenly or may gradually increase over several days.  Swelling in the foot and lower leg is also common. Treatment for a stress fracture of the foot includes activity modification and use of a stiff-soled shoe for approximately 2-4 weeks after injury. Depending on the location of the fracture, immobilization in a cast or use of crutches may be needed. Fractures in the 5th metatarsal, talus and navicular bone heal very slowly or may not heal at all due to poor blood supply. Longer periods of treatment or surgical intervention may be necessary in order to heal these types of fractures. 
The best way to avoid a stress fracture of the foot when starting a dance or exercise program is to take it slow, know your limits and follow a sensible program. 

Red flags to watch for after any workout include:

  • Pain in the foot or lower leg that persists more than 72 hours
  • Swelling of the foot or leg that persists for more than 24 hours
  • Pain which increases with exercise or walking
  • Pain at rest or with elevation of the legs

Preventative measures include:

  • Select the proper footwear for the specific type of exercise
  • Start out slowly when beginning a dance or exercise program following a layoff period
  • Walk and stretch to warm up gradually before dancing or running 
  • Focus on stretching and strengthening the muscles in the calf
  • Increase running or walking distance and speed gradually, in increments no greater than 10% per week
  • Avoid unaccustomed strenuous sprinting
  • Take the time to cool down properly after dance and exercise

These simple measures may prevent stress fractures of the foot and ankle for dancers, athletes or those just starting a workout routine. For more information on stress fractures as well as resources on foot and ankle care go to the AOFAS website The site also features a surgeon referral service that makes it easy for patients to find a local orthopaedic surgeon specializing in foot and ankle care.


Jennifer Hicks
Public Education Manager
Office: 847-430-5079