Foot Stress Fracture

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What is a foot stress fracture?

Stress fractures are small cracks or fractures in a bone. Hairline fracture is another name for them. They most often occur in weight-bearing bones, frequently affecting people who participate in repetitive activities that put a lot of stress on their feet, such as running and jumping. Foot stress fractures can occur in any bone in the foot, but most often in the second and third metatarsal bones—the long bones that connect your toes to your ankle. Although you have five metatarsal bones, these two bear the most stress when you push off your foot when taking a step or when you jump.

A stress fracture in the foot must be treated as any other fracture to allow it to heal properly and prevent the fracture from becoming more severe.

What are the symptoms of a stress fracture on the foot?

Most people with a foot stress fracture complain of pain, usually in a specific spot in the foot, and the pain intensifies when walking or bearing weight. The pain may ease with rest, but usually returns when you begin walking again. You may also see some swelling. If you press on the area of the fracture, you may feel more pain or tenderness.

While a foot stress fracture isn’t a medical emergency, see a doctor as soon as possible for evaluation of your foot. You may need an X-ray to determine if there is a fracture, where it is, and how severe it is.

What can cause a foot stress fracture?

Stress fractures of the foot are literally caused by stress to the bones in the feet. The stress placed on the bone causes the bone to crack. This stress can be caused by:

  • Overuse, such as frequent or long-distance running

  • Repetitive high-impact movements, such as those in gymnastics or dancing

  • Sudden change in activities or surface, such as running indoors and changing to outdoors

  • Abnormal structure of the foot

What are the risk factors for a foot stress fracture?

Aside from repetitive or high-impact forces on your feet, other risk factors for foot stress fractures include:

  • Being a woman, particularly if you have irregular menstrual periods

  • Having low levels of vitamin D and calcium

  • Having osteoporosis

  • Taking medications such as long-term corticosteroids

  • Having had previous stress fractures in your foot

You can reduce the chances of developing a stress fracture by:

  • Warming up before participating in sports or activities that put pressure or strain on your feet

  • Cross-training, focus on more than one sport or activity rather than a single sport

  • Ensuring you are wearing the right shoes for the right activity

  • Eating a healthy diet. If you have concerns about getting enough vitamin D and calcium in your diet, speak with your doctor or a nutritionist about how you can increase your levels

  • Checking with your doctor regularly if you take medicine known to affect your bone density such as corticosteroids, heparin (a type of blood thinner), and proton pump inhibitors (acid reducers). Ask your doctor or pharmacist if the medicines you take affect bone density. You may need more frequent osteoporosis screening.

It is important to pay attention to your body and signs of a potential problem—like foot pain. If you do experience pain in or both feet, stop the activity and allow your feet to recover or heal. If pain persists, see your doctor or a foot specialist (podiatrist) to evaluate a possible stress fracture.

How is a foot stress fracture treated?

If you suspect a foot stress fracture, see your doctor as soon as possible—particularly if you have diabetes or other condition that might limit blood circulation to your feet. Until you can see your doctor, follow the RICE method to reduce pain and swelling.

  • Rest: Do not walk or bear weight on the foot that is causing pain.

  • Ice: Apply ice packs to the painful or swollen area of the foot for 20 minutes at a time, at least every two hours

  • Compression: Apply a compression bandage or wrap around your foot. You want it snug, but not so tight it affects blood flow to your toes.

  • Elevation: Elevate your foot. If possible, take time off from your everyday activities to rest and elevate your foot as much as possible.

Unless you have been told not to take certain medications, over-the-counter analgesics, such as ibuprofen or naproxen, can help relieve the pain and limit swelling in your foot.

If your doctor diagnoses a stress fracture in your foot, keep in mind it can take up to eight weeks to heal. Foot stress fracture treatment may include:

  • Continuing the RICE protocol

  • Wearing a foot brace or splint

  • Wearing a cast, particularly if the stress fracture is on the fifth metatarsal, the bone closest to the outside of your foot, below your little toe.

Surgery for a foot stress fracture is not common, but it may be necessary if the bone is not healing well. Elite athletes or people who do heavy manual labor that stresses their feet may choose to have surgery to repair the fracture. This type of surgery is done in an operating room in a hospital, where an orthopedic surgeon will insert pins, screws or plates to hold the bone together.

What are the potential complications of a foot stress fracture?

Most foot stress fractures heal with treatment and rest; however, some fractures do not heal properly and this could cause chronic pain. You also could eventually develop arthritis in the area of the injury. Left untreated, a stress fracture in the foot can worsen and become a more serious fracture. This might increase healing time or cause damage to the surrounding tissues.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 21
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Stress Fractures. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/stress-fractures
  2. Stress Fracture. American Orthopaedic Foot & Ankle Society. http://www.aofas.org/footcaremd/conditions/ailments-of-the-midfoot/Pages/Stress-Fractures.aspx
  3. Metatarsal Stress Fractures – Aftercare. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000553.htm
  4. Stress fractures. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stress-fractures/symptoms-causes/syc-20354057
  5. Stress Fractures of the Foot and Ankle. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00379
  6. Panday K, Gona A, and Humphrey M. Medication-induced Osteoporosis: Screening and Treatment Strategies Ther Adv Musculoskelet Dis. 2014;6(5):185–202.
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