Runners place a great deal of stress or force on the forefoot while running. This force on the feet can be as much as four times the body weight of the runner. A stress fracture is a break in the bone resulting from increased activity, running, or repetitive jumping. Metatarsal stress fractures, also known as hairline or fatigue fractures, are unfortunately a common foot injury affecting runners. Metatarsal stress fractures account for the most common location of stress fractures of the lower extremity, the second metatarsal being the most frequently affected. The typical presentation of a metatarsal stress fracture will be sharp pain upon weight bearing or an ongoing sore/aching pain with swelling. Usually this occurs in runners who start a new workout routine or suddenly increase their running mileage. If you are of post-menopausal age, be aware that you are at increased risk for developing stress fractures due to lower bone density and osteoporosis. If you believe you may have a stress fracture, do not hesitate to see a podiatrist to have an x-ray-an ultrasound is sometimes helpful as well.

Treatment/Prevention:

  • Rest, ice, and elevation

  • Short leg cast or walker boot

  • Usually 4-6 weeks of non-weight bearing

To prevent the onset of a stress fracture, modify your running routine. Gradually increase your road/treadmill mileage over a longer period of time rather than large increments. Another option is to try running on softer terrain such as grass, gravel, or dirt as opposed to hard surfaces such as concrete or asphalt. Remember to retire shoes that have excessive mileage and possibly consider a cushioning shoe if you have a history of stress fractures.  Some metatarsal stress fractures can be prevented if you take the recommended appropriate precautions.