A stress fracture is a tiny crack in the bone from chronic overuse. Stress fractures in the foot are commonly found in the metatarsals (called a march stress fracture) and navicular fracture (bone of top of the midfoot).
A march stress fracture is an overuse injury caused by repetitive stress to the foot.
A navicular fracture can be caused by a fall, severe twist, or direct trauma to the navicular bone. It can also be caused by repeated stress to the foot, creating a fracture not due to any acute trauma.
These factors increase your chance of a stress fracture. Tell your doctor if you have any of these risk factors:
Participation in high foot impact sports
Jumping events in track
Women with amenorrhea (absent menstruation), osteoporosis, or an eating disorder
Feet with high arches (march)
Use of poor or improper footwear (march)
If you have any of these symptoms, do not assume it is due to a march stress fracture. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
Pain in the middle of the foot
Swelling of the foot
Foot feels better when resting
Foot feels worse with activity
Symptoms of a navicular fracture include:
Vague, aching pain in the top, middle portion of your foot, which may radiate along your arch
Increasing pain with activity
Pain on one foot only
Pain that resolves with rest
Swelling of the foot
Tenderness to touch on the inside aspect of the foot
Your doctor will ask about your symptoms and medical history, and perform a physical exam, which will include a thorough examination of your foot. Other tests may include:
X-ray — to take a picture of possible bone fractures
CT scan — to take a picture of possible bone fractures
MRI scan — to take a picture of possible bone fractures (this is particularly useful with stress fractures)
Rest is the first thing you can do for a stress fracture. This includes avoiding the activity that caused the fracture and any other activities that cause pain. Rest time required is at least 6-8 weeks. Once you are ready to restart activity your physician may prescribe physical therapy.
The following is a common progression for physical therapy treatment:
Begin with non weight–bearing activities, such as swimming, cycling, use of an Alter-G treadmill etc.
Next, weight-bearing, nonimpact exercise may be prescribed.
Gradually, low-impact activity, starting with walking, will be added to your treatment.
Once you can do fast-paced walking with no pain, your physical therapist will give higher impact activities, such as light jogging.
This gradual progression will continue until you have reached your pre-injury activity level and no longer feel tenderness of the bone.
To reduce your chance of a stress fracture and other fractures of the foot:
Wear well-fitting, supportive shoes appropriate for the type of activity you are doing.
Eat a diet rich in calcium and vitamin D.
Do weight-bearing exercises to build strong bones.
Build strong muscles and practice balancing exercises to prevent falls.
When starting a new sport or increasing your workout, do so gradually.
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This content was created using EBSCO’s Health Library