Stress Fracture of the Foot

Stress Fracture of the Foot

Article
Bone, Muscle, & Joint
Podiatry (Lower Leg & Foot)
+1
Contributed byKrish Tangella MD, MBAMay 04, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Foot Stress Fracture
  • March Fracture

What is Stress Fracture of the Foot? (Definition/Background Information)

  • Stress Fractures of the Foot are small microfractures of the bone, associated with repetitive force and overuse of the extremity (feet), caused by activities, such as long distance running or gymnastics
  • A high percentage of such fracture injuries, occur within the foot, ankle, or lower leg. A majority of Stress Fractures of the Foot, heal without any serious complications
  • Individuals who participate in athletic sports, such as tennis, gymnastics, or basketball, have the highest risk for Stress Fractures of the Foot, due to the repetitive nature of physical movement/motion associated with these sports

Who gets Stress Fracture of the Foot? (Age and Sex Distribution)

  • Individuals of all age, race, or ethnic groups, and belonging to any gender, may develop Stress Fracture of the Foot
  • A high percentage of individuals who develop Stress Fractures of the Foot are young athletes, who participate in sports
  • These fractures may also occur in middle-aged or elderly adults, who develop Osteoarthritis

What are the Risk Factors for Stress Fracture of the Foot? (Predisposing Factors)

Some of the risk factors associated with Stress Fracture of the Foot include:

  • Repetitive overuse of the foot, associated with athletics/sports
  • Osteoporosis, a degenerative condition that leads to weak bones, is the most noteworthy and recognized risk factor associated with Stress Fractures of the Feet. Osteoporosis is very common in postmenopausal women or inactive older individuals (having a lack of physical activities or exercise)
  • Structural abnormalities of the foot
  • A previous stress fracture injury
  • Women with irregular or absent, menstrual period
  • Abnormally low bone density (in women, low bone density is usually secondary to poorly circulating estrogen levels)
  • Use of improper footwear
  • Lack of flexibility within the muscles; which could be due to a lack of ‘warming-up’ the body muscles, prior to participating in any sport
  • Muscle weakness
  • Disproportionate muscle strength, which could be the result of  uneven distribution of stress on the body
  • Poor technique, while running or performing other sport activity

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Stress Fracture of the Foot? (Etiology)

The common causes associated with Stress Fracture in the Foot include:

  • Repetitive motion or overuse of the feet, due to participation in athletics, sports, or even dance activities
  • Osteoporosis, a degenerative condition causing weak bones
  • A structural abnormality of the foot
  • Excess body weight associated with obesity, causing abnormally increased pressure on the joints

What are the Signs and Symptoms of Stress Fracture of the Foot?

Signs and symptoms of Stress Fractures in the Foot include:

  • Swelling of the foot (top of the foot)
  • Pain, when performing regular/daily activities
  • Increased pain while exercising
  • Tenderness around the injury site
  • Possible bruising, around the injury site
  • The most common foot bones that are affected are the metatarsal and the heel bone

How is Stress Fracture of the Foot Diagnosed?

Tests a physician may use to diagnose Stress Fractures of the Foot include:

  • Physical examination: A thorough physical examination is usually performed in identifying the correct location of the Foot Stress Fracture. In addition to this, a complete medical history will aid in arriving at the cause of the injury
  • X-ray: In a majority of the cases, Stress Fractures of the Feet are not usually visual on standard x-rays, if taken shortly after an individual begins to notice some sign and symptoms. It may take several weeks to over a month, for some evidence of a Stress Fracture on an X-ray
  • Bone scan: It is a diagnostic test used to locate any bone abnormalities by injecting tiny amounts of radioactive material into the bloodstream. However, this test may not be always helpful in distinguishing between different bone injuries, some of which may be caused by stress, or by other factors
  • Magnetic resonance imaging (MRI): An MRI scan is a more detailed scan, which uses radio waves and a magnetic field to generate thorough images of the bone interior and soft tissues. An MRI can usually help identify Stress Fractures in the Feet, within the first week of the injury

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Stress Fracture of the Foot?

  • Some Stress Fractures of the Foot may not heal properly, which can result in prolonged/chronic pain
  • If the injury is not treated properly or it does not heal well; then, the individuals are at an increased risk of additional fractures

How is Stress Fracture of the Foot Treated?

Nonsurgical treatment measures for Stress Fracture of the Foot include:

  • Any activity that further aggravates the foot condition should be avoided. The physician would normally advise to refrain from all such activities, until the symptoms stop and the bone heals
  • Oral medications, such as Tylenol, can help decrease the foot pain. Certain studies have found that pain medications, such as ibuprofen (Advil, Motrin, etc.) and naproxen (like Aleve), may impede the bone from healing.
  • Specialized assistive devices, such as a cane, walker, or walking boots, may be recommended to help the individual perform some of their regular/daily activities. These can help decrease the weight/pressure on the bone, until it has healed. Occasionally, complete immobilization of the foot with a splint or cast may be required, if the Stress Fracture is severe

Surgical treatment measures to treat Stress Fractures of the Foot are usually rare. However, some injuries may require surgery to ensure complete healing.

  • Open reduction and internal fixation (ORIF): An open reduction is a surgical procedure to realign the fractured bone, to its original position. Internal fixation devices (such as a plate, screw, or rod) are then used to hold the bone together, until it is fully healed

How can Stress Fracture of the Foot be Prevented?

To prevent Stress Fractures of the Foot, one should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play; any probable danger involved should be anticipated and safety measures adopted.

A few ways to further help prevent unwanted injuries or a Stress Fracture of the Foot include:

  • Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a Stress Fracture. For women, the recommended amount of calcium, increases with age and menopause
  • Wearing appropriate footwear (like wearing the proper shoe size), may help prevent accidents
  • Individuals who participate in any high-risk sports, such as football, should wear appropriate safety equipment, to help reduce the possibility of a Foot Stress Fracture
  • Always begin any new physical activity slowly, after a good warm-up. This helps in loosening the muscles
  • Individuals are advised to add low-impact activities to their exercise program, in order to avoid repetitiveness

What is the Prognosis of Stress Fracture of the Foot? (Outcomes/Resolutions)

  • A majority of Stress Fractures of the Foot heal without any serious complications
  • A full recovery and a return to sports or normal daily activities usually require 3-4 weeks, depending on the severity of the injury
  • When properly treated and rehabilitated, a high percentage of individuals regain their full strength and range of motion of the feet

Additional and Relevant Useful Information for Stress Fracture of the Foot:

  • Stress Fracture of the metatarsal bones (certain bones of the feet), is also known as March Fracture (a fracture term linked to marching soldiers). It is the most common ‘bone’ location for Stress Fracture within the Foot
  • Over 50 percent of all Stress Fracture injuries, occur in the lower leg
  • Unlike Stress Fractures that are small microfractures in the bone associated with repetitive force and bone overuse, acute fractures are injuries caused by unexpected and traumatic events
Was this article helpful

On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

0 Comments

Please log in to post a comment.

Related Articles

Test Your Knowledge

Asked by users

Related Centers

Loading

Related Specialties

Loading card

Related Physicians

Related Procedures

Related Resources

Join DoveHubs

and connect with fellow professionals

Related Directories

Who we are

At DoveMed, our utmost priority is your well-being. We are an online medical resource dedicated to providing you with accurate and up-to-date information on a wide range of medical topics. But we're more than just an information hub - we genuinely care about your health journey. That's why we offer a variety of products tailored for both healthcare consumers and professionals, because we believe in empowering everyone involved in the care process.
Our mission is to create a user-friendly healthcare technology portal that helps you make better decisions about your overall health and well-being. We understand that navigating the complexities of healthcare can be overwhelming, so we strive to be a reliable and compassionate companion on your path to wellness.
As an impartial and trusted online resource, we connect healthcare seekers, physicians, and hospitals in a marketplace that promotes a higher quality, easy-to-use healthcare experience. You can trust that our content is unbiased and impartial, as it is trusted by physicians, researchers, and university professors around the globe. Importantly, we are not influenced or owned by any pharmaceutical, medical, or media companies. At DoveMed, we are a group of passionate individuals who deeply care about improving health and wellness for people everywhere. Your well-being is at the heart of everything we do.

© 2023 DoveMed. All rights reserved. It is not the intention of DoveMed to provide specific medical advice. DoveMed urges its users to consult a qualified healthcare professional for diagnosis and answers to their personal medical questions. Always call 911 (or your local emergency number) if you have a medical emergency!