Fatigue Fracture

Overview

Definition

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.

March Stress Fracture
Stress fracture foot
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Causes

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.

Risk Factors

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:
    • Running
    • Basketball
    • Dancing
    • Jumping events in track
  • Military training
  • Female athlete triad
  • Having problems that weaken the bones, such as osteoporosis

SymptomsandDiagnosis

Symptoms

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.

Diagnosis

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:

  • X-ray
  • MRI scan
  • CT scan

Treatments

Treatment

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.

Prevention

This problem cannot always be prevented. Starting a new sport slowly may help lower the risk of injury.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Stress Fracture, March; Stress Fracture of Metatarsal Bone; Fatigue Fracture)

RESOURCES

American Academy of Podiatric Sports Medicine http://www.aapsm.org 

Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org 

When it Hurts to Move—Canadian Orthopaedic Foundation http://whenithurtstomove.org 

References

Metatarsal stress fracture. Sports injury website. Available at: http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/metatarsal-fracture. Published November 17, 2016. Accessed December 4, 2019.

Stress fracture. Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/sports%5Finjury/stress%5Ffractures.html. Updated March 2018. Accessed December 4, 2019.

Stress fractures of the foot and ankle. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/stress-fractures-of-the-foot-and-ankle . Updated March 20, 2018. Accessed December 4, 2019.

Welck MJ, Hayes T, et al. Stress fractures of the foot and ankle. Injury 2017 Aug;48(8):1722.

4/24/2014 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114482/Decision-rules-for-imaging-of-ankle-and-foot-injuries  : 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. Updated 2013. Accessed December 4, 2019.