March Stress Fracture
(Stress Fracture, March; Stress Fracture of Metatarsal Bone; Fatigue Fracture)
A march stress fracture is a small break in a metatarsal bone of the foot. There are five metatarsal bones in each foot. They are between the toes and the ankle.
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A march stress fracture is an overuse injury caused by repetitive stress to the foot. It can also be caused by normal stress on weakened bones.
This problem is more common in women. Other things that may raise the risk are:
- Doing sports that put impact on the feet, such as:
- Jumping events in track
- Military training
- Female athlete triad
- Having problems that weaken the bones, such as osteoporosis
A march stress fracture may cause pain in the middle or front of the foot. There may be swelling. The foot will feel better when resting and feel worse with activity.
The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the foot. You will be asked about the activities that you do. A doctor who treats bones may need to examine the foot. A doctor who treats athletes may also be needed.
Images may be taken of the foot. This can be done with:
Stress fractures are treated with rest and nonsteroidal anti-inflammatory drugs (NSAIDs). The foot will need rest for 6 to 8 weeks. Crutches may be needed to avoid putting weight on the foot. A brace or cast may also be needed.
Some people may need surgery to help the bone heal. This can be done with pins, screws, and plates to hold the bones together.
This problem cannot always be prevented. Starting a new sport slowly may help lower the risk of injury.
- Metatarsal stress fracture. Sports injury website. Available at: http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/metatarsal-fracture.
- Stress fracture. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries_poisoning/sports_injury/stress_fractures.html.
- Stress fractures of the foot and ankle. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/stress-fractures-of-the-foot-and-ankle.
- Welck MJ, Hayes T, et al. Stress fractures of the foot and ankle. Injury 2017 Aug;48(8):1722.
- Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: https://acsearch.acr.org/docs/69424/Narrative.
- Laura Lei-Rivera, PT, DPT
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