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Foot Stress Fracture—what it is, potential damage to foot, and ways to relieve it

What is a foot stress fracture?

 A stress fracture happens when a weight-bearing bone develops a thin crack, otherwise known as a “hairline” fracture; a foot stress fracture is when this injury hits the weight-bearing bones in the feet, the metatarsals. Foot stress fracture is basically an overuse injury caused by repetitive and unusual stress and it often crops up on the second metatarsal bone of the right foot.

 Muscles and bones both serve as shock absorbers during movement. If one’s muscles are overtaxed during an exercise, the muscles won’t be able to absorb its share of the stress and lobs the work off to the nearest bone. When the bones are stressed to a certain point, they develop small fractures that may worsen if not treated.

 The most common areas where a foot stress fracture can occur is the second and third metatarsals, the heel (calcuneus), and the navicular, the bone on the top of the middle of the foot. Stress fracture often occurs in the outer lower leg bone (fibula) as well.

 Causes of foot stress fracture

 Foot stress fracture is also called “march fracture” as it commonly occurs in soldiers who are required to march over long distances over an extended period. The injury is also common in professional athletes, dancers, hikers, and those whose line of work requires standing for long periods of time. As this type of injury is attributed to repetitive and prolonged stress, foot stress fracture can be triggered by professional athletes who suddenly intensify their training regiments. Sedentary people who suddenly exercise and overexert themselves are also prone to this type of injury.

 Those who don’t exercise can also get the said injury; people with osteoporosis, osteomalacia or any other illness that affects the density of bones are more susceptible to foot stress fracture. Any normal activity can cause the said injury in those people.

 According to the American Academy of Orthopedic Surgeons (AAOS), a foot stress fracture can occur when activities are increased in frequency (how often the activity is done), duration (how long), and intensity (level of exertion). The AAOS further explains that other causes include poor muscle conditioning, alternating running or walking on different surfaces (sand, grass, clay, and concrete, among other surfaces), and using poor equipment and old shoes can increase the risk of getting foot stress fracture. Incorrect technique during exercise and conditions that cause bone insufficiency and poor bone density are also factors that increase the risk.

 Foot stress fracture symptoms and detection

 One can experience pain in the front of the foot after repetitive stress like walking, marching or participating in sports. Also, tenderness and diffuse swelling can also occur in the forefoot.

 Foot stress fracture starts out as a pain in the foot during and after exercise or an activity. At this point, the pain is still intermittent and it will go away when the activity is stopped and the foot is rested. The pain will intensify and recur every time one walks or runs as the foot stress fracture progressively worsens. If the foot stress fracture remains undetected and untreated, the fracture will cause constant pain, in addition to swelling, bruising, and general tenderness in the area.

 Outside military infirmaries, it’s hard to tell when one has a foot stress fracture, especially when the condition is very hard to detect on X-rays. The condition can be detected using a CT (computed tomography) scan and an MRI (magnetic resonance imaging).


 The first aid for foot stress fracture is simple, just stop and rest the injured foot. Continuing the exercise or activity during an injury like this can cause a complete fracture. A cold compress should be applied on the area and make sure that one’s weight doesn’t rest on the injured foot as much possible.

 Long term treatment includes nonsurgical and surgical treatment. Nonsurgical treatments for a foot stress fracture mostly involve rest. A doctor can also recommend staying away from high impact exercises, keeping weight off the injured foot by the use of crutches, wearing protective footwear such as wooden sandals, or having a cast applied. Surgical treatment for foot stress fracture entails having the surgeon insert pins, screws, and plates into the area. Once the foot stress fracture is completely healed, one can gradually return to his normal activities.

 Prevention of foot stress fracture

 To prevent foot stress fracture, one should maintain a healthy diet. Food rich in calcium and vitamin D are especially important since those improve bone strength and density. One should also replace worn running shoes and improper equipment. Strength training and exercising while gradually increasing frequency, duration and intensity should strengthen the bones as well.