How stress fractures develop and how to avoid them

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It’s not every week a stress fracture will walk through our doors, which is why it was bizarre to treat a few in the one afternoon.

A stress fracture is a tiny crack in a bone, which develops over a period of time from a repetitive activity. Often the pain is distinctive and becomes worse as weight bearing activities continue. Often the patients are still able to weight bear, however it is extremely uncomfortable.

The foot has 26 bones, and the long bones – the metatarsals, are very prone to stress fractures as opposed to the others. Symptoms include pain that subsides during rest, aching, swelling and tenderness at the area.

Stress fractures can often go undiagnosed, and if not treated correctly can often lead to recurrent injuries. The patients that were being treated had very similar foot shapes, all had very active lifestyles and were all devastated to discover what the diagnosis was. So, what are the risk factors of developing a stress fracture?

Have you suddenly increased your physical activity?

City2surf, Oxfam and Blackmores Sydney running have all come and gone. When an individual sets their heart on an event, fitness levels are often priority, and the conditioning of your feet may become neglected. Doing too much too soon is a very common cause for stress fractures, not only in beginners but also experienced athletes.

It is important to work up to a mileage slowly, and listen to your body. Do not push through any discomfort in your feet, as it may be that extra pressure that will lead to a stress fracture.

What is your foot type?

Have you had your foot mechanics assessed? The most common areas in the foot to get a stress fracture are you 2nd and 3rd metatarsal, and your 5th metatarsal. People whose feet over-pronate, or roll in, often have stress fractures associated with the 2nd and 3rd metatarsals.

These bones are longer and thinner than the others, and are under a lot of impact when you propel forward. Also if you have a high arched, rigid foot.

People with a cavoid foot type do not shock absorb through the feet well, which means there is greater ground reaction forces going through the feet, and also high pressure at the lateral border of the foot.

Are you wearing poor footwear?

If you’re notching up the training, it’s important to invest in a pair of comfortable shoes with good shock absorption. Shoes will lose their ability over time to do this, so if your feet are starting to ache after training or you find them uncomfortable during the session, it’s time to buy a new pair.


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