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Stress Fractures of the Foot Bones

Metatarsal stress fractures are tiny cracks in the long bones of the foot caused by repetitive impact from running, jumping, or marching - the second metatarsal is most commonly affected (called 'marching fracture' from military recruits), while fifth metatarsal base fractures (Jones fractures) are high-risk due to poor blood supply - most stress fractures heal with 6-8 weeks in a walking boot and activity modification (95%+ success), but Jones fractures often require surgery with screw fixation to prevent nonunion, especially in athletes.

📅Last reviewed: January 2026đŸĨBones & Joints

📖What is Stress Fractures of the Foot Bones?

Metatarsal stress fractures are tiny cracks in the long bones of the foot caused by repetitive impact from running, jumping, or marching - the second metatarsal is most commonly affected (called 'marching fracture' from military recruits), while fifth metatarsal base fractures (Jones fractures) are high-risk due to poor blood supply - most stress fractures heal with 6-8 weeks in a walking boot and activity modification (95%+ success), but Jones fractures often require surgery with screw fixation to prevent nonunion, especially in athletes.

đŸ”ŦWhat Causes It?

  • Repetitive impact loading from running, marching, or jumping causing bone microdamage faster than repair
  • Sudden increase in training volume or intensity (too much too soon)
  • Change in running surface (concrete vs grass) or footwear increasing stress
  • Poor bone density or inadequate calcium/vitamin D intake weakening bone
  • Biomechanical factors: high arches (cavus foot), tight calf muscles, poor running form

âš ī¸Risk Factors

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You may be at higher risk if:

  • Long-distance runners, military recruits, dancers, basketball players
  • Female athletes with menstrual irregularities (Female Athlete Triad - low energy, amenorrhea, osteoporosis)
  • Previous stress fractures (50% recurrence risk if underlying factors not addressed)
  • Sudden training increase (more than 10% weekly mileage increase)
  • Inadequate footwear or worn-out running shoes (less than 400-500km lifespan)
  • Low bone density or osteoporosis

đŸ›Ąī¸Prevention

  • ✓Gradual training progression (increase weekly mileage by no more than 10%)
  • ✓Replace running shoes every 400-500km (worn shoes lose shock absorption)
  • ✓Cross-training (mix running with swimming, cycling to reduce repetitive impact)
  • ✓Adequate calcium (1000-1300mg daily) and vitamin D (800-1000 IU daily)
  • ✓Female athletes: address menstrual irregularities (Female Athlete Triad increases stress fracture risk)
  • ✓Proper running form and biomechanical assessment if recurrent injuries