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).

• Participation in high foot impact sports
  • Running
  • Basketball
  • Dancing/gymnastics
  • Jumping events in track
• Soldiers/military recruits
• Osteoporosis
• Women with amenorrhea (absent menstruation), osteoporosis, or an eating disorder
• Feet with high arches (march)
• Use of poor or improper footwear (march)
• Trauma (Navicular)

• Pain in the middle of the foot
• Swelling of the foot
• Foot feels better when resting
• Foot feels worse with activity

• 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
• Altered gait
• Pain that resolves with rest
• Swelling of the foot
• Tenderness to touch on the inside aspect of the foot

• 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)

• 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.

• 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.

• American Academy of Podiatric Sports Medicine

http://www.aapsm.org

• OrthoInfo.org—American Academy of Orthopaedic Surgeons

http://orthoinfo.org

• American Academy of Orthopaedic Surgeons

http://www.aaos.org

• American Orthopaedic Foot & Ankle Society

http://www.aofas.org

• Canadian Orthopaedic Association

http://www.coa-aco.org

• Canadian Orthopaedic Foundation

http://www.canorth.org

• Fractures, an overview. American Society of Orthopaedic Surgeons website. Available at:  http://orthoinfo.aaos.org/topic.cfm?topic=A00139&return_link=0 Accessed November 17, 2008.
• March fracture. DynaMed website. Available at:  http://www.ebscohost.com/dynamed/what.php
• Metatarsal stress fracture. Merck Manuel website. Available at:  http://www.merck.com/mmpe/sec21/ch324/ch324m.html Accessed November 17, 2008.
• Metatarsal stress fractures. Sports injury website. Available at:  http://www.sportsinjuryclinic.net/cybertherapist/front/foot/metatarsal.htm Accessed November 17, 2008.
• What is a stress fracture and how should it be treated? American Academy of Podiatric Sports Medicine website. Available at:  http://www.aapsm.org/ct0398.html Accessed November 17, 2008.
• 4/24/2014 DynaMed's Systematic Literature Surveillance  http://www.ebscohost.com/dynamed: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed April 24, 2014.
• Coris EE, Lombardo JA. Tarsal navicular stress fractures. American Family Physician website. Available at: http://www.aafp.org/afp/20030101/85.pdf . Accessed June 26, 2007.
• Stress fractures of the foot and ankle. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00379 . Accessed June 26, 2007.