Stress Fracture of the Talus

Talar bone

The talus bone is the bone at the top of the ankle which the tibia or shin bone sits on. Stress fractures of the talus are sometimes seen in footballers and track and field athletes.

Talar stress fracture symptoms

Symptoms of a stress fracture of the talus develop gradully over time and include:

  • Pain on the outside of the ankle.
  • Symptoms get worse with exercise, particularly running, and ease with rest.
  • There is likely to be tenderness and possibly swelling over the sinus tarsi. This is a small canal where nerves pass into the ankle.
  • Bone scans and CT scans can confirm the diagnosis as a stress fracture is unlikely to show up on an X-ray until healing has begun.

Stress Fracture of the talus explained

The talus is a tarsal bone in the ankle which sits on top of the calcaneus or heel bone and supports the tibia and fibula shin bones. The talus is more susceptible to developing a stress fracture when the ankle is repeatedly overpronated and plantarflexed or rolling in and flattening at the same time as pointing the foot downwards.

This movement is seen in pole vaulters who plant the pole too late making the foot land too far forward at take off.


Treatment of a talar stress fracture

  • Treatment usually involves six weeks immobilization in a plaster cast.
  • Surgery to remove the lateral process of the talus bone is sometimes done, as this can speed up the healing process.
  • Biomechanical correction of any overpronation with orthotic inserts is done if required.
  • Identifying the causes of the stress fracture in the first place is important. This can be training errors, poor technique or simply doing too much too soon.

Returning to normal training

A gradual rehabilitation program to strengthen the ankle should be done. If the ankle has been immobilized in a cast then mobility exercises will be important initially.

Restoring the co-ordination or proprioception of the ankle through balance or wobble board exercises should be done regularly.

This article has been written with reference to the bibliography.