Stress Fracture

Metatarsal stress fracture first visit (3 weeks old)

What is a Stress Fracture?

Stress fractures are breaks in the bone that happen from overuse.

Overuse injuries occur when tissues (in this case bone) have more stress placed on them than they can fully recover from before being stressed again.

For example, a runner who begins training for an endurance race may develop a stress fracture after a few weeks of training: the amount of pressure on the bone during each training session was more than the bone could recover from before the next training session. After a few days to a few weeks the bone finally had enough and a crack developed in the bone.

What is the difference between a fracture and a break?

Fractures and breaks are two different words that both describe a broken bone. There are different severities of fractures, but all fractures are broken bones and all broken bones are fractures.

Metatarsal stress fracture (7 weeks)

How did I get a Stress Fracture?

Stress fractures are overuse injuries. Overuse injuries can happen in many ways. Most of the time overuse injuries happen after people begin a level of exercise that they are not used to. Sometimes, though, overuse injuries happen without any change in exercise or activity level.

Stress fractures can also be caused by Tumors or Cysts in bone. As the Tumor or Cyst grows, it presses on the bone from the inside and can cause a stress fracture.

Can any bone develop a Stress Fracture?

Yes. In the foot, ankle and leg the most common stress fractures are in the metatarsals. However, we have treated stress fractures in many bones, including the sesamoids (small bones under the great toe joint), cuboid (rearfoot bone), calcaneaus (heel bone), and tibia (large ankle/leg bone).

What are the symptoms of stress fracture?

Metatarsal stress fracture (15 weeks)

Symptoms of stress fractures include:

  • Pain that gets worse throughout the day
  • Swelling around the broken bone that gets worse throughout the day
  • Pain gets worse day by day

How do you diagnose a Stress Fracture?

In addition to a history and physical exam that may show a change to exercise levels, a change in footwear, and pain and swelling at the site of fracture, we perform x-rays. If x-rays are negative an ultrasound may show the fracture.

If both x-ray and ultrasound are negative, an MRI or bone scan will show the fracture.

How do you treat a Stress Fracture?

Most stress fractures are treated with immobilization of the fractured bone in a protective boot or shoe for 4-8 weeks. Some require non-weightbearing and immobilization. X-rays are repeated at check-up visits to monitor the healing of bone.

How can I prevent Stress Fractures?

When starting a new exercise or training program that involves significant walking or running, try these tips:

  • Wear supportive footwear that is sturdy and well padded.
  • Start off doing non-impact exercises such as an elliptical machine or stationary bike.
  • If training for a specific event such as a 10K, half marathon, Ragnar, etc, go on-line and obtain a recommended training schedule for your event. There are different schedules for beginning runners and advanced runners .Follow the schedule for beginning runners. Don't overtrain or do more than the program recommends!
  • Don't increase your walking/running distance until you feel you are easily tolerating the current distance.
  • Always stretch your legs, back, etc after your run/walk. Better flexibility to the calf muscles decreases the strain on the metatarsals which lowers the risk of stress fracture.

Visit our Self-Treatment page for more tips and advice.

If you think you have a Stress Fracture , get into a podiatrist for a complete evaluation including x-rays.