Stress Fractures of the Foot

A stress fracture of the foot is a bone crack that may occur as a result of repetitive low-impact force. Stress fractures are not typically sudden events, and they can begin as tiny cracks in the bone that gradually enlarge with repeated impact over time.

Swelling of the affected area is common, as is pain, particularly when pressure is put on the foot.

This type of foot fracture can usually be identified with a physical examination and/or an imaging test.

Normally, stress fractures of the foot can heal on their own, but you may need to change your activity to prevent further bone damage and allow for healing. In rare instances, a stress fracture in the foot may be severe enough to necessitate surgical intervention.

Symptoms

You may experience pain and tenderness in and around the area of a stress fracture in your foot. The pain is usually worse while you are placing pressure or weight on the fractured bone, such as when you stand or walk. Mild or moderate activity can exacerbate the pain of a stress fracture—you don't need to exert major pressure on your foot to reproduce the discomfort.

Other symptoms of a stress fracture in the foot can include:

• Reduced pain when you rest
• Swelling of the foot
• Bruising around the painful area of the foot

The pain and other symptoms of a stress fracture might not occur immediately when you begin to stand, walk, or run, but can recur after prolonged pressure on the foot.

Causes

A stress fracture is often described as an overuse injury because it tends to develop with repetitive movements, rather than with a sudden twist or fall.

In the foot, the metatarsals (bones leading to the toes) and the navicular bone are prone to stress fractures due to their small size and the heavy force of pressure exerted on them when you step down firmly with your foot.

Risk Factors

Anyone can develop a stress fracture in the foot, but there are risk factors that can predispose you to these injuries, such as:

• Osteoporosis
• Wearing footwear that is not supportive or protective when running or jogging
• Running on a hard surface
• Repetitive pressure on the foot
• An abrupt or marked increase in pressure on the foot

Athletes who participate in activities that cause a low-impact landing on the feet can experience stress fractures. Running or jumping can lead to cracks in the bones of the foot.

Athletes may be prone to stress fractures in certain locations of the foot that correspond to the positioning of feet during sports. For example, soccer players tend to have stress fractures of the fifth metatarsal.

Diagnosis

If you suspect that you may have a stress fracture in your foot or if you have persistent foot pain, see your healthcare provider as soon as possible. Ignoring the pain or taking medication to reduce the discomfort while you continue the activity that caused the fracture can lead to serious consequences.

In fact, without proper medical attention, a bone that already has a small stress fracture might not heal and the bone can break completely.

Your healthcare provider can usually diagnose a stress fracture based on your medical history, your symptoms, and a physical examination.

If you have osteoporosis, your healthcare provider may also check your calcium level with a blood test to determine whether you are low in this mineral.

Treatment

Treatment of a stress fracture usually involves conservative RICE therapy: rest, ice, compression, and elevation. In many cases, taking a break from the harmful activity will help the bone heal. Your healthcare provider may also recommend protective footwear or a cast if your bones need stabilization or protection.

Once your stress fracture is completely healed and you are pain-free, your healthcare provider will reevaluate you and may provide you with instructions about gradually increasing your physical activity.

The vast majority of stress fractures do not require surgery. When a particular stress fracture is prone to slow healing or if the bones are not healing properly, a surgical procedure may be recommended.

Prevention

Stress fractures are not completely preventable, but there are some important steps you can take to reduce your chances of developing one. These strategies are important for anyone who is planning on maintaining a moderate level of physical activity, not just for intense athletes.

• Eat well: Maintain strong, healthy bones by consuming a diet rich in calcium and vitamin D.
• Progress slowly: Be sure to approach exercise and physical activity with a long-term plan to build your strength and endurance, rather than with sudden changes that your body may not be ready for. Increase the intensity of your workouts gradually over time.
• Wear the right shoes: Your shoes should fit properly and provide your feet with support. Make sure to replace shoes as necessary.
• Acknowledge pain: If you experience any pain or swelling in your feet, be sure to stop the pain-inducing activity. If pain persists or recurs, see your healthcare provider.

A Word From Verywell

Stress fractures are not uncommon. If you experience pain, you should have a medical evaluation. These small bone cracks can heal on their own, but ignoring a stress fracture can lead to a more severe break in the bone.