Stress Fractures

What is a stress fracture?

A stress fracture occurs when a small crack develops in the cortex of the bone. Over time, if left untreated the crack will expand until the fracture line extends through the whole bone. Most stress fractures occur in the weight-bearing bones of the foot such as the metatarsals, most commonly the 2nd and 3rd metatarsals. Stress fractures can also occur in the heel, the navicular of the fibula.

Common Causes

  • Overuse
  • High impact activities like distance running or basketball.
  • Improper shoes or hard surfaces
  • Bone Insufficiency
  • Osteoporosis
  • Vitamin D deficiency


  • Pain that develops gradually, increases with weight-bearing and diminishes with rest
  • Pain that becomes more severe and occurs during normal, daily activities
  • Swelling on top of the foot or the outside of the ankle.
  • Tenderness to touch at the site of the fracture
  • Possible bruising

Physical exam and x-rays will be obtained. While most stress fractures don’t show up on the bone like a trauma induced fracture will, but there will be slight changes at the periosteum (dense layer of vascular connective tissue that envelopes the bones) of the bone where the stress fracture exists. In addition to traditional x-rays that show bones, our diagnostic ultrasound machine reveals soft tissue disorders, so we are well equipped to diagnose any foot or ankle problem.

Rest, use of a custom splint or post op shoe or immobilization via a below the knee pre-fabricated cast such as an AirCast or a fiberglass cast applied by a podiatrist. The site of the stress fracture and degree of pain will determine the treatment. If there is a deficiency in bone density that will need to be addressed as well.

Call Central Carolina Foot and Ankle Associates at 919-477-9333 for an appointment or click the link below.

Central Carolina Foot & Ankle Associates

2609 N. Duke Street, Ste. 301
Durham, NC 27704
(near the corner of N. Duke St. and Stadium Dr.)

5107 Southpark Drive
Suite 202
Durham, NC 27713
(close to RTP and Chapel Hill)