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March Stress Fracture

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

Definition

A march stress fracture is a small break in a metatarsal bone of the foot that occurs without a major traumatic episode. There are five metatarsal bones in each foot. They are located in the area between your toes and your ankle. They were called march fractures because they were first seen in military recruits from too much marching and still do occur in that group.

March Stress Fracture

Stress fracture foot
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This condition can be treated. Contact your doctor if you think you may have a march stress fracture.

Causes    TOP

A march stress fracture is an overuse injury caused by repetitive stress to the foot.

Risk Factors    TOP

These factors increase your chance of a march stress fracture. Tell your doctor if you have any of these risk factors:

  • Participation in high foot impact sports
    • Running
    • Basketball
    • Dancing
    • Jumping events in track
  • Soldiers
  • Feet with high arches
  • Use of poor or improper footwear
  • Osteoporosis
  • Female runners with amenorrhea (absent menstruation), osteoporosis, or an eating disorder

Symptoms    TOP

If you have any of these symptoms do not assume it is due to a march stress fracture. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Pain in the middle of the foot
  • Swelling of the foot
  • Foot feels better when resting
  • Foot feels worse with activity

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist. An orthopedist focuses on bones. A sports medicine physician works on sport related injuries.

To search for a break in the bone the following tests may be done:

Treatment    TOP

Stress fractures are treated with rest and nonsteroidal anti-inflammatory drugs (NSAIDs). You will need to rest your foot for 3-6 weeks. Your doctor may recommend crutches for a week or two so that you don’t put any weight on your foot. Sometimes a brace or cast is used for a short time to aid healing.

Once you are able to move without pain, your doctor will allow you to return to normal activities. Gradually increase your activity over several weeks.

Prevention    TOP

To help reduce your chance of a stress fracture, take the following steps:

  • Wear shock-absorbing insoles when running or during other high-impact exercise.
  • When starting a new sport or increasing your workout, do so gradually.
  • Choose footwear that takes into account the specific sport and your type of foot.

RESOURCES:

American Academy of Podiatric Sports Medicine
http://www.aapsm.org/
OrthoInfo.org—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

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

References:

Fractures, an overview. American Society of Orthopaedic Surgeons website. Available at:
...(Click grey area to select URL)
Accessed November 17, 2008.
March fracture. DynaMed website. Available at:
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Accessed November 17, 2008.
Metatarsal stress fracture. Merck Manuel website. Available at:
...(Click grey area to select URL)
Accessed November 17, 2008.
Metatarsal stress fractures. Sports injury website. Available at:
...(Click grey area to select URL)
Accessed November 17, 2008.
What is a stress fracture and how should it be treated? American Academy of Podiatric Sports Medicine website. Available at:
...(Click grey area to select URL)
Accessed November 17, 2008.
4/24/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed April 24, 2014.
Last reviewed September 2013 by Michael Woods, MD
Last Updated: 04/24/2014