What is it?
Bone continuously remodels in response to load. When load increases faster than bone can adapt, microscopic damage accumulates into a fracture.
What causes it?
- A rapid increase in running or training
- Changing surfaces or footwear
- Low bone density or low vitamin D
- Inadequate nutrition relative to training
- Foot structure that concentrates stress
What does it feel like?
- Pain that begins gradually and worsens with activity
- Pain that eases with rest
- Swelling on the top of the foot
- A very specific tender spot on the bone
How is it diagnosed?
X-rays often look normal for the first two to three weeks. MRI can detect stress injury early. Some locations — such as the navicular and the base of the fifth metatarsal — are higher-risk and need careful management.
When should you see a podiatrist?
- Focal bone pain that worsens with activity
- Swelling on the top of the foot
- Foot pain after increasing training
- A history of prior stress fractures
Nonsurgical treatment
- Protected weight-bearing
- A walking boot or stiff-soled shoe.
- Activity modification
- Cross-training that does not load the injured bone.
- Bone-health evaluation
- Particularly with recurrent fractures.
- Graduated return to activity
- Once the bone is healing.
When is surgery considered?
Surgery is reserved for high-risk locations, displaced fractures, and fractures that do not heal.
Fixation with screws or plates stabilizes the bone and can speed a return to activity for high-risk fractures.
Related procedures
What is recovery like?
Most low-risk stress fractures heal in six to eight weeks. High-risk fractures take longer and require closer follow-up.
Frequently asked questions
Can I walk on a stress fracture?
Often yes in a protective boot, depending on the bone involved. Continuing to run on it risks a complete fracture.