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Stress Fractures of the Foot: Causes, Symptoms, & Treatment

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By Janik Sundstrom
Romi Hector
Edited by Romi Hector

Updated January 26, 2024.

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A stress fracture is characterized by very small cracks in the weight-bearing bones of the feet and lower legs. Stress fractures occur through repetitive force applied to a bone repeatedly over a period of time.

The forces repeatedly applied to create a stress fracture are usually minimal to moderate, while a higher force is required to cause a more significant and traumatic fracture. The bones of the foot and ankle are susceptible to stress fractures or injury due to relatively small bones having to absorb large amounts of force as you land on your ankle.

Not allowing enough time for rest between high-impact activities can lead to sudden ankle pain and stress fractures over time. 

Symptoms of a Stress Fracture in Your Foot 

The primary reported symptom of a stress fracture is localized pain arising in the area. Depending on where the stress fracture has occurred in the foot and lower leg, you might be able to feel around for the affected area and determine where the potential fracture could be. 

Symptoms of pain are often made worse by activity due to repetitive forces applied to the foot and lower leg. For example, you might experience more severe heel pain after running. Symptoms will usually improve with rest and limiting high-impact activities.

Causes of a Stress Fracture in Your Foot 

The majority of stress fractures seen in healthy bones of the feet and lower leg are caused by repetitive force applied to the area over time. This can be commonly seen in people who are runners, basketball players, cheerleaders, athletes, or anyone doing repetitive movements during high-impact activities.

Increasing the duration and frequency of these activities can result in the development of stress fractures. In fact, most of these activities are linked to pain at the back of the heel, which is likely due to a stress fracture of the heel bone.

Stress fractures also occur more frequently in people with bone conditions like osteoporosis. Osteoporosis leads to weak bones and an increased chance of a bone fracture.

This condition usually occurs slowly with age or could be due to the use of medications that have been linked to osteoporosis. Other conditions such as flat feet and past injuries can also increase the chances of developing a stress fracture while participating in high-impact activities. 

Risk factors for developing a stress fracture include:

  • High-impact sports such as basketball, athletics, and gymnastics 
  • Foot problems such as flat feet, high arches, or bunions
  • Osteoporosis 
  • Improper footwear 
  • Increase in frequency and duration of activity 
  • Change in activity surface 
  • Medications leading to weakened bones

Treating a Stress Fracture in Your Foot 

For the bone to heal, there needs to be considerable activity modification that allows time for the stress fracture to heal. Applying ice to the area can help reduce pain and inflammation caused by the stress fracture. This may also help with healing in the long term.

Depending on the X-rays or MRIs that have been used to diagnose the severity of the stress fracture, the doctor may suggest a supportive moonboot or cast with crutches to reduce pressure on that foot or leg for optimal healing.

Medication can be used to control pain in the area during the healing process. After enough time has passed and once the pain has disappeared, activity can gradually be resumed under the instruction of your medical doctor.

It is essential to follow the doctor's instructions regarding healing times, as you could put yourself at risk of worsening the fracture or completely fracturing the bone. In cases where the bones fail to heal correctly, surgery may be required to attach the ends of the bone for proper healing to take place.

If you cannot bear weight or walk without experiencing moderate to high pain levels, please seek medical advice. Make sure you follow the doctor's instructions so that you don't aggravate your stress fracture further, which could potentially lead to a complete fracture. This is crucial in managing this condition. 

How Can You Prevent Stress Fractures?

Orthotics or footwear that provide shock absorption and arch support for running and walking will help reduce the shock placed on the bones of the feet and lower legs. This can reduce your risk of developing a stress fracture. Sufficient rest between high-impact activities will allow the bones to heal and reduce your chances of developing a stress fracture. 

You can try to avoid running on hard surfaces. This can aggravate your symptoms by increasing the pressure placed on the lower leg bones. You can try running on grass as the softer surface won't exacerbate stress fractures.