Foot

What It Is

Stress fractures are small cracks in the bone. They often happen through overuse, when a movement is repeated so often, for example in basketball or distance running, that the bone does not have enough time to recover between sessions (AAOS, n.d.). Most of these fractures occur in the weight-bearing bones of the lower leg and the foot, and in the foot the metatarsals are the most common site (AAOS, n.d.). Studies indicate that athletes taking part in track and field, tennis, dance, gymnastics and basketball are at increased risk of these fractures; ballet dancers are at particularly high risk of metatarsal stress fractures (AAOS, n.d.). In these sports, the repeated stress of the foot hitting the ground can cause problems.

Rest from the activity that caused it is a key part of recovering from one of these fractures.

These fractures often occur when you suddenly increase high-impact activity in terms of intensity, frequency or duration, either in training or by doing "too much, too soon" (AAOS, n.d.; Cambridge University Hospitals NHS Foundation Trust, 2024). People who don't exercise can still get these fractures. If osteoporosis or another condition has weakened the bones, normal everyday activities can cause a stress fracture; this is known as bone insufficiency (AAOS, n.d.).

The second and third metatarsals are the most prone to stress fractures. Fractures of the fourth and fifth metatarsals are less common, but the base of the fifth metatarsal has a poor blood supply, so fractures there can take longer to heal (AAOS, n.d.).

Metatarsal Stress Fracture Anatomy

In each foot, you have five metatarsal bones running from the toe joints to the arch. The second and third metatarsals are thinner (and often longer) than the first metatarsal, and they sit in the area of greatest impact when you push off to walk or run (AAOS, n.d.). Stress fractures of these bones typically cause pain through the middle of the foot, while fractures of the fourth and fifth metatarsals cause pain on the outside of the foot (AAOS, n.d.).

Bone is constantly being broken down and renewed. With too much activity, the breakdown of older bone can happen faster than the body can repair and replace it, so the bone weakens and becomes vulnerable to stress fractures (AAOS, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Metatarsal Stress Fracture

Once your medical team allows, I can help you work out what overloaded the bone and rebuild the strength in your foot and leg for a gradual return to activity. See the My Approach tab for how I work.

1. Rest

Taking a break from the activities that caused the fracture is crucial. It usually takes 6 to 8 weeks for a stress fracture to heal, and more serious ones can take longer (AAOS, n.d.). During this time, switch to activities that put less stress on your foot and leg; swimming and cycling are good options. However, don't restart any physical activity that involves the injured foot or ankle, even low-impact activity, until your doctor has agreed (AAOS, n.d.).

2. Therapy

The key thing is to work out the underlying problem. Is it simply too much load on the bone, or is there a problem with the way the foot works as well? A physiotherapist can look at this, and so can I. If there is a problem with how your foot works, I can give you exercises for the foot and ankle (see the My Approach tab), help you work out whether different footwear or orthotics would help and how to get them, and point you to a chiropodist or podiatrist if you need custom orthotics.

3. Sports Technique

Errors in technique can contribute to stress fractures (AAOS, n.d.), so speaking to a sports coach can be very useful. Changing or improving technique, especially running technique, can be very important.

Treatments you may want to discuss with your family doctor, nurse practitioner or fracture clinic

Options outside my scope

Walking boot or protective footwear: many stress fractures are managed in a supportive boot or a stiff-soled shoe, and your clinic will tell you how much weight to put through the foot (Cambridge University Hospitals NHS Foundation Trust, 2024; AAOS, n.d.).
Crutches: may be used, especially early on, to take weight off the foot (Cambridge University Hospitals NHS Foundation Trust, 2024; AAOS, n.d.).
Cast: some stress fractures, including many at the base of the fifth metatarsal, need extra protection in a cast or boot and a period without putting weight on the foot (AAOS, n.d.).
Tests: if a stress fracture happened with only light activity, your doctor may suggest a bone density scan, or blood tests to check for problems such as low vitamin D (AAOS, n.d.).

How I can help (see the My Approach tab)

Easing the other leg, hips and back while you're off the foot
Help with crutches, and gait training as you go back to full weight
Foot and leg strength once your team allows
A gradual return to running and sport

Tips

Doing too much too soon is a common cause of these fractures. When you return to training, start slowly and build up gradually, by no more than about 10% a week (Cambridge University Hospitals NHS Foundation Trust, 2024; AAOS, n.d.).
Improper sporting equipment can contribute to stress fractures. Worn-out or flimsy shoes that have lost their shock-absorbing ability may be a factor (AAOS, n.d.).
Errors in technique or training are another contributing factor to these fractures (AAOS, n.d.).
Insufficiency stress fractures occur when the bone is too weak. Good nutrition, including enough calcium and vitamin D, is important for bone health (AAOS, n.d.).
Female athletes are more prone to stress fractures than male athletes, partly because of low bone density linked to relative energy deficiency in sport (REDs), where the body does not get enough energy from food for the amount of training (AAOS, n.d.). Female athletes who have irregular or absent periods might have decreased bone density.
Do not drive while wearing a walking boot (Cambridge University Hospitals NHS Foundation Trust, 2024).

Treatment

My Approach

A stress fracture needs time away from the load that caused it, and building back up too fast can bring it back. Your doctor or fracture clinic decides whether you need a boot, crutches or a cast, how much weight the foot can take, and when activity can restart. I work inside those limits, and if the fracture stops you doing your normal daily activities, I need your team's okay before any hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I also look at why the bone was overloaded: your training, footwear, how you walk and run, and your strength. If low bone density may be part of it, I keep pressure and loading gentle.

While It's Healing

Easing the calf, other leg, hips and back, and your shoulders if you're on crutches, keeping clear of the sore bone, with gentle lymphatic drainage if the foot is swollen
Help with crutches, and keeping fit with swimming or cycling once your doctor agrees

Once Your Team Allows More

Hands-on work for the calf, shin and foot, with warm or cool applications in the clinic
Gait training, then foot and ankle strength, calf raises and balance work, building to gym-based leg strength
Footwear advice, and working out whether orthotics would help, with a chiropodist or podiatrist for custom ones
A graded return to running and sport, building up by no more than about 10% a week

If the pain in the bone comes back as you build up, ease off and check in with your doctor.

What to Expect

Typical Course

Typical course: While the bone is healing, visits are usually about weekly; once your doctor agrees you can build up, most people come once or twice a week, then less often. Most stress fractures take about 6 to 8 weeks to heal, and more serious ones, such as at the base of the fifth metatarsal, can take longer, so your return to running follows your doctor's plan.

What I Focus On

Working Within Your Team's Limits

Compensation Relief

Training & Footwear Review

Foot & Leg Strength

Graded Return to Running

Please read

When to See a Doctor First

When to Get Help

If you think you might have a stress fracture, see a doctor so it can be properly diagnosed. Stress fractures can be hard to see on an X-ray at first (AAOS, n.d.). Until you are seen, AAOS (n.d.) advises:

Rest: avoid activities that put weight on your foot, and if you must stand, wear a very supportive shoe.
Ice: use a cold pack for 20 minutes at a time, several times a day. Do not apply ice directly to the skin; wrap it in a tea towel (AAOS, n.d.; Cambridge University Hospitals NHS Foundation Trust, 2024).
Compression: lightly wrap the area in a soft bandage.
Elevation: as often as possible, rest with your foot raised higher than your heart.

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Stress fractures of the foot and ankle. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/stress-fractures-of-the-foot-and-ankle/ (Accessed: 7 October 2026).
Cambridge University Hospitals NHS Foundation Trust (2024) Metatarsal fractures and stress fractures. Available at: https://cuh.nhs.uk/patient-information/metatarsal-fractures-and-stress-fractures (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooMetatarsal Stress Fracture

What It Is

Metatarsal Stress Fracture Anatomy

Self-Care & Treatment

How to Treat a Metatarsal Stress Fracture

1. Rest

2. Therapy

3. Sports Technique

Treatments you may want to discuss with your family doctor, nurse practitioner or fracture clinic

Tips

My Approach

While It's Healing

Once Your Team Allows More

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooMetatarsal Stress Fracture

What It Is

Metatarsal Stress Fracture Anatomy

Self-Care & Treatment

How to Treat a Metatarsal Stress Fracture

1. Rest

2. Therapy

3. Sports Technique

Treatments you may want to discuss with your family doctor, nurse practitioner or fracture clinic

Tips

My Approach

While It's Healing

Once Your Team Allows More

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Club Foot

Complex Regional Pain Syndrome

Diabetic (Charcot) Foot

Extensor Tendon Rupture (Foot)

Book a session