Stress fractures can be a real problem. Often many people think that a stress fracture is not really a fracture. But it is. In general, fractures take four to six weeks to heal. While stress fractures can occur in any bone in the foot, the most common place we see them is in one of the metatarsals in the front of the foot.

How Do You Know You Have A Stress Fracture?

The symptoms that most people experience are really subtle, their pain isn't, but the rest of the findings are really fairly hard to detect. For podiatrists, it's not so hard. The most obvious thing that you can see with a stress fracture, besides having pain, is a slight, puffy swelling on the top of the foot, just at the base of the toes over the metatarsals. The pain is usually localized over one metatarsal. During the first three weeks after the onset of pain, you see virtually nothing on X-ray. This makes it hard for many patients to have confidence in the diagnosis. 

What Causes Stress Fractures?

While stress fractures are most often associated with running and other physical activity, you don't have to be an athlete to develop one.  It's also not necessarily a sign of systemic problems (such as osteoporosis), but it can occur as a result of this and other health issues.

How Are Stress Fractures Treated?

 Here's how it's treated.

  • Avoiding weight bearing exercise including long walks
  • Immobilization in a walking cast.

When stress fractures don't heal in four to six weeks, sometimes we run an MRI. Sometimes that's just to tell both of us that there really is a fracture there and needs to be treated aggressively. So if you've got pain on the top of your foot, sudden onset, localized in one area with just slight puffy swelling or you don't see much of anything, you might want to come in, let us take a look and establish the diagnosis.


Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.