Stress fractures, also called "march fractures" because soldiers get them frequently while on march, occur most often in runners, dancers, basketball players and people suffering from osteoporosis. According to the American Academy of Sports Medicine, stress fractures occur over a length of time and are caused by repeated microtrauma. This results in a small crack forming in one of the bones, commonly one of the metatarsals. Without treatment, stress fractures will worsen over time.
Mild Pain
One of the first signs of a stress fracture is a mild pain in the front of the foot, according to the Merck Manuals for Healthcare Professionals. As the bone goes through periods of repetitive stress, the forces on the bone weaken it, causing bone fatigue. Bone fatigue can lead to a stress fracture. At first, the pain is felt deep inside the foot and usually occurs after a long workout or run and then goes away after the exercise has stopped. There is no obvious injury, just a feeling of mild, nagging pain or discomfort. This pain can be so slight and the onset so gradual that it might not be noticed.
Debilitating Pain
If a stress fracture is left untreated, the pain progresses into a nagging ache. Over time, the pain continues to become stronger with each repeated activity. It occurs earlier and eventually progresses to a point where it is unbearably painful, even when you are off your feet. According to the American Academy of Orthopaedic Surgeons, stress fractures are more likely to occur with an increase in the frequency, duration or intensity of an activity.
Swelling
It is possible to experience some swelling with a stress fracture. The swelling will be more pronounced over the top of the foot, according to MayoClinic.com. As with pain, the swelling may occur after the activity and then disappear. The area of swelling is typically small, about the size of a silver dollar, but can increase with continued use of the affected foot.
Localized Tenderness
According to the American Academy of Orthopaedic Surgeons, there can be an area of localized tenderness directly over the site of the stress fracture. Again, this area can be small. If this area is pressed on, it will be quite painful. An X-ray study will not show the presence of the stress fracture for at least two weeks. What then appears on the X-ray is not the small crack but the callus of bone healing located around the stress fracture.
Bruising
Redness and bruising may or may not appear with a stress fracture, according to MayoClinic.com. The diagnosis of stress fracture can be difficult to make, because it often feels more like a muscle sprain. The treatment consists of complete rest and cessation of the activity. It may be necessary to use crutches to keep weight off the affected foot. With stress fractures, the foot is not usually put into a cast. A wooden-bottomed surgical shoe is often used because it allows for more movement and less atrophy of the calf muscles. Healing takes from six to 12 weeks.
