Medial Malleolus Stress Fracture

Medial malleolus ankle

The medial malleolus is the bony bit on the inside of the ankle. A stress fracture of the medial malleolus is rare, causing gradual onset pain on the inside of the ankle.


Medial malleolus stress fracture symptoms

Symptoms of a medial malleolus stress fracture include:

  • Pain on the inside of the ankle.
  • Pain is worse by running and jumping activities.
  • There will be specific point tenderness over the medial malleolus or bony part on the inside of the ankle.
  • You may also have ankle swelling, but not in all cases.
  • If the stress fracture is in the early stages it may not show up on an X-ray but a bone scan, CT scan or MRI can confirm the diagnosis.

Treatment of a malleolus stress fracture

Treatment is basically resting from weight-bearing activities for around 6 weeks. An ankle brace or support may help protect and support the joint. If the injury progresses to a complete fracture then you will most likely need surgery.

After a period of rest then ankle strengthening and proprioception exercises should be done to restore full strength and coordination to the ankle joint preventing future injuries. This should be gradual and take up to 12 weeks2.

It is also important to identify the cause of the stress fracture in the first place. This may be due to overtraining, poor technique, or poor foot biomechanics.

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A podiatrist or sports injury professional may prescribe orthotic insoles to correct any biomechanical problems of the foot. Specialist sports coaches should be consulted if training errors are suspected to have contributed to the injury.

References & further reading

  1. Brukner P, Bennell K, Matheson G. Stress Fractures. Melbourne: Blackwells Scientific Asia, 1999.
  2. Jowett AJ, Birks CL, Blackney MC. Medial malleolar stress fracture secondary to chronic ankle impingement. Foot Ankle Int 2008;29(7):716–21.
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