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 can occur but is very rare. It causes pain on the inside of the ankle which is exacerbated by activity.


Medial malleolus stress fracture symptoms

  • Symptoms of a medial malleolus stress fracture include pain on the inside of the ankle.
  • Pain is made 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 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 has progressed to a complete fracture then surgery will most likely be required.
  • 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. 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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