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July 2011: Stress Fractures in the Foot

30 Jun 2011

Dr. Charles Caplis is a podiatrist affiliated with Weiss Memorial Hospital. His areas of expertise include foot and ankle surgery, diabetic wound care/limb salvage and sports injuries. Visit to learn more.

Charles A. Caplis, D.P.M.
Weiss Memorial Hospital
(312) 701-0770

About the foot
The foot is comprised of 26 bones with a complex arrangement of ligaments and tendons. Stress fractures may occur when forces within the foot overpower the strength of the bone. The most common area for foot stress fractures is in the long bones known as the metatarsals.  There are five metatarsals that vary in length.

Stress fractures
Stress fractures are caused by repetitive trauma in many ways, such as starting a new exercise program, biomechanical abnormalities (excessive pronation—“rolling in"/fallen arches or very high arches with no shock absorption and lack of proper arch support), or extra-long metatarsal and/or the metatarsal is in a fixed abnormal position.

Metatarsal stress fractures usually have a gradual onset of pain which worsens with activity. It is also common to have pain at rest following activity. There may be localized pain and swelling on the top of the foot located around the neck region of the metatarsal bone. The second, third and fourth metatarsals are the most common of all metatarsals to become injured.

Evaluating and treating stress fractures
It is important to make an appointment with your podiatrist for proper evaluation and treatment if you experience symptoms of stress fracture. The visit would most certainly include a set of X-rays. However, stress fractures may not show any visible sign of bone changes until ten days or longer following the onset of pain. Therefore, it may be necessary to take another set of X-rays two to three weeks later to confirm the diagnosis.

If you think you may be suffering from metatarsal stress fractures, you can alleviate discomfort on your own with rest or non-impact exercise. Additionally, icing the foot with an ice pack or bag of frozen vegetables wrapped in a towel for skin barrier will help with the associated pain and swelling. When icing the affected area, alternate the ice pack on and off for 10-15 minutes, for a period of 30-45 minutes after increased activity. You should also use compression on the foot by using an Ace bandage wrap or other over-the-counter compression sleeve. Wearing a lace-up stiff-soled shoe will also help by preventing motion at the injury site. If symptoms fail to improve after treatment, a trip to your doctor’s office should not be delayed. Neglected stress fractures can progress to more serious fractures which may require surgical intervention.

For more information
If you would like more information about stress fractures or other foot disorders, or would like an appointment, please call Dr. Caplis’ office at (312) 701-0770.