How Do I Know if I Have a Stress Fracture?

A stress fracture is a repetitive motion or overuse injury in the weight-bearing bones of your body that produces a hairline crack. Left untreated, such an injury can weaken your feet and ankles and put you at risk for a more serious fracture.

At Chicagoland Foot and Ankle, our team of board-certified foot and ankle specialists offers advanced diagnostic tools and effective treatments for stress fractures and many other foot and ankle conditions. 

Because you may not know if you’ve developed a stress fracture, we’ve put together this guide so you can learn what to look for.

Which bones do stress fractures affect?

Overuse injuries are responsible for almost 50% of all sports injuries, and a stress fracture is an overuse injury often seen in long-distance runners due to their feet pounding the pavement.

Stress fractures can occur anywhere in your body, but they’re most often found in the legs, ankles, and feet as a result of repetitive impact and weight-bearing activities. The most common bone affected is the tibia, or shin bone, which accounts for 20%-75% of all stress fractures.

You can also find stress fractures in your feet, which are made up of several bones. The five in each foot that run to the toes are called metatarsals. Stress fractures most commonly happen in the second and third metatarsals.

What causes stress fractures?

Stress fractures occur from both intrinsic (inside the body) and extrinsic (environmental) factors. 

Intrinsic factors

You have less control over intrinsic factors than extrinsic ones. Intrinsic factors include:

Age

Athletes who are older are more prone to bone density problems like osteoporosis. The weakened bone develops fractures sooner than healthy bone.

Weight

Being underweight or overweight can lead to stress fractures. Underweight people may also have bone density issues, leading to fractures with less stress than for someone of a normal weight. 

Overweight people put a greater load on their weight-bearing muscles and bones with each step, leading to stress-induced fractures.

Anatomy

Foot problems such as high or low arches, bunions, blisters, and tendinitis can affect the way your foot strikes the ground. So can muscle weakness, an unbalanced gait, or lack of flexibility. Putting repeated stress on the wrong part of your foot can lead to a stress fracture.

Gender

Women are more at risk if they have irregular menstrual periods or no periods, since low estrogen can weaken bone structure.

Extrinsic factors

Extrinsic, or environmental, factors include:

• Changing your activity level without gradually adapting
• Incorrectly practicing a sport technique
• Running on a hard surface like gravel or concrete
• Running on a track that slopes
• Using improper footwear (e.g., old shoes, no arch support)
• Playing high-impact sports such as basketball, tennis, gymnastics, or dance
• Having a poor diet to support your exercise
• Having a low vitamin D level
• Playing one sport year-round without taking a break

All these are within your control to change so you can minimize the risk of a fracture occurring.

How do I know if I have a stress fracture?

Stress fractures produce symptoms that include:

• Pain, swelling, and/or aching at the fracture site
• Tenderness when you touch the bone
• Pain that starts when you begin an activity, then continues or resolves with rest
• Pain when at rest or with normal walking
• Inability to shift weight to the affected leg or foot because of pain

If you experience any of these symptoms, you need to come in and see us at Chicagoland Foot and Ankle. If you don’t treat a stress reaction — an early stage where you have pain but the fracture hasn’t yet formed — the pain can become severe. 

You also risk the fracture becoming displaced (out of normal alignment). Certain stress fractures, such as those in the hip, are considered high risk because if you don’t identify them early, you may not be able to treat them simply with ice, rest, and immobilization. They may require surgical intervention.

If you experience any of the symptoms of a stress fracture, especially if you’re active in sports or have recently taken up an activity, don’t wait. Contact us to make an appointment for an accurate diagnosis and effective treatment. We have two Chicago locations and offices in Orland Park and New Lenox, Illinois.