How a Stress Fracture in the Foot Feels

Healing takes several weeks

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A stress fracture in the foot can be painful, especially when the foot bears weight. Stress fractures happen when muscles become fatigued and are unable to absorb shock, such as when your foot hits the pavement while running. Instead, this shock is transferred to the bone, eventually causing tiny cracks called stress fractures.

In this article, learn about foot stress fracture treatment and recovery.

Close up of a foot, wrapped in a bandage, while a healthcare provider with stethoscope holds the heel.

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Foot Stress Fracture Causes

People with healthy bones may get a stress fracture from repetitive or high-impact activities, increasing physical activity too quickly, or not resting enough between workouts.

Sports with a high risk of stress fractures include:

  • Gymnastics
  • Running
  • Track and field
  • Tennis
  • Basketball

It's also possible to get a stress fracture from the impact of normal daily activities if you have preexisting bone conditions (such as osteoporosis) that make your bones more fragile and susceptible to fracture.

Symptoms: Do I Have a Stress Fracture in My Foot?

The most common symptom of a stress fracture in the foot is pain in the foot or ankle, which comes on slowly and gets worse during weight-bearing activities like walking, running, or jumping.

Foot stress fracture symptoms include:

  • Pain that worsens during weight-bearing activities
  • Pain that gets better during rest
  • Swelling along the top of the foot and/or ankle
  • Tenderness at a specific spot
  • Bruising

You can get stress fractures in any bone, but more than half of stress fractures occur in the lower leg, including the feet.

Stress Fracture

Stress Fracture Official Diagnosis

If you have stress fracture symptoms, see a healthcare provider to discuss your health history and get imaging. The gold standard for stress fracture diagnosis is magnetic resonance imaging (MRI). However, some healthcare providers may also use radiographs, ultrasound, computed tomography (CT), and bone scans.

How Long Does a Foot Stress Fracture Take to Heal?

According to the American Academy of Orthopaedic Surgeons, it takes most stress fractures about six to eight weeks to heal.

However, healing time differs based on individual factors like:

  • Location of your stress fracture
  • Activity level
  • Adherence to activity modifications
  • Sex
  • Age
  • Bone density

A healthcare provider should be able to offer you a personalized healing timeline based on your imaging and other variables.

Starting Stress Fracture Treatment for Foot Symptoms 

If you've been diagnosed with a stress fracture in your foot, you will be given treatment based on your fracture's risk level and location.

Low-Risk Foot Stress Fractures

Sometimes, healthcare providers start with conservative treatment, allowing stress fractures to heal independently without surgery. Conservative treatment may include:

  • Rest, ice, compression, elevation (RICE) method during acute stages
  • Nonsteroidal anti-inflammatory (NSAID) medications., such as Advil or Motrin (ibuprofen) and Aleve (naproxen sodium)
  • Short-term non-weight-bearing with crutches or a knee scooter until the initial pain subsides
  • Activity modification for six to eight weeks to reduce stress on the foot
  • Protective footwear, such as stiff-soled shoes, wooden-soled sandals, brace, or boots
  • Physical therapy for a physical rehabilitation plan, reconditioning and return to regular activity, and healing modalities
  • Occupational therapy for training in assistive devices and ways to modify your environment, mobility, and activities of daily living within your new restrictions

High-Risk Foot Stress Fractures

High-risk foot stress fractures are treated with more proactive measures, sometimes including surgery. High-risk stress fractures include those that don't respond to conservative treatment or progress to complete fracture.

Specific locations in the foot and ankle that have high load and low blood flow are also considered high risk:

  • Medial malleolus: The bony bump on the inner side of the ankle.
  • Talus: An ankle bone located at the top and back of your foot. This is where the two lower leg bones (tibia and fibula) connect to the foot.
  • Tarsal navicular: A small bone in the midfoot that has an important role in maintaining the arch of the foot.
  • Proximal fifth metatarsal: One of the five long, thin bones that connect from the base of the ankle toward the base of the toes. The fifth metatarsal, in particular, is prone to injury due to its location on the outer edge of the foot.
  • Great toe sesamoids: Two small, circular bones located on the underside of the big toe joint.

High-risk stress fracture treatment is more likely to progress to surgery because these breaks may not heal independently. Treatment typically includes:

  • Non-weight-bearing immobilization with a boot or knee scooter
  • An extended period away from sports
  • Methodical and cautious reintroduction to athletic activity
  • Possible surgery

Mobility Support With a Stress Fracture in Foot

Most of the time, you can walk on a stress fracture in your foot; you will just be advised to limit high-stress weight-bearing activity, like running, and take analgesics.

Depending on the severity, fracture location, and other factors, your healthcare provider may advise you to wear a boot.

Sometimes, a healthcare provider will recommend a pneumatic boot with a chamber of compressed air, offering cushioning to your foot and reducing the impact of walking. You can walk around with the boot but shouldn't try running or jumping.

When to Resume Normal Physical Activity 

Resume regular physical activity when your healthcare provider advises you to. For most people, this is approximately six to eight weeks from diagnosis. However, it could be as soon as four weeks or as long as 12 weeks out.

You can do some things to prevent future stress fractures when you resume regular physical activity. These include:

  • Increase physical activity/workouts gradually and progressively.
  • Rest between physical activity and workouts.
  • Include cross-training in your workout plans.
  • Use shock-absorbing inserts in your shoes.
  • Consider calcium and vitamin D supplementation.
  • Stop the activity if you experience pain or swelling, and wait for it to go away before resuming.

Consult with a healthcare provider before taking any vitamins or supplements and discuss other ways to prevent future stress fractures.

Summary

Stress fractures in the foot can be painful, tender, swollen, sore, and sometimes bruised. The pain from a foot stress fracture typically gets worse during weight-bearing activity. Conservative treatment for foot stress fractures typically lasts six to eight weeks and includes pain relief and activity modification. High-risk foot stress fractures may require a pneumatic boot or even surgery in some cases, although this is less common.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Sarah Bence, OTR/L
Bence is an occupational therapist with a range of work experience in mental healthcare settings. She is living with celiac disease and endometriosis.