A stress fracture is a break in a bone caused by repetitive stress. A stress fracture can occur in any bone, but is commonly found in the 2nd and 3rd metatarsal bones of the foot. You can suddenly develop a painful forefoot after some activity, such a walking, running, or squatting onto the ball of the foot. A small crack develops in the cortex (outer shell) of the bone. A stress fracture can progress to a complete or overt fracture of the bone. Metatarsal stress fracture may not become apparent on x-rays until a few weeks after the injury.
Symptoms
- Sharp pain in the forefoot, aggravated by walking
- Tenderness on palpation of the top surface of the metatarsal bone.
- Diffuse swelling of the skin over the forefoot.
- Bruising or redness of forefoot
Causes
- Decreased density of the bones due to osteoporosis
- Unusual stress on a metatarsal due to a compensation of a forefoot deformity such as a bunion
- Abnormal foot structure such as a flatfoot
- Increased levels of activity without sufficient rest period
- Obesity
If you suspect you have stress fracture you should:
- Seek medical treatment as soon as possible
- Keep weight off your foot
- Ice the top surface of your forefoot for about 20 minutes every hour.
- To reduce swelling, wrap your foot in a tensor bandage with moderate compression.
- Wear a shoe with a very stiff sole
The medical treatment for a stress fracture may include:
- X-rays
- Bone scans to establish a diagnosis
- Offloading of stress on the metatarsal with the application of taping and padding
- Splinting and bracing of the foot with a removable below knee Aircast™.
- Non-steroidal anti-inflammatory medication.
- Physical therapy modalities in the later stages of healing.