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March Stress Fracture

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(Stress Fracture, March; Stress Fracture of Metatarsal Bone; Fatigue Fracture)

Definition

A march stress fracture is a small break in a foot bone which occurs without a major traumatic episode. The metatarsal bones of the foot are commonly afflicted by stress fractures. There are five metatarsal bones in each foot. They are located in the area between your toes and your ankle.
March Stress Fracture
Stress fracture foot
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This condition can be treated. Contact your doctor if you think you may have a march stress fracture.

Causes

A march stress fracture is an overuse injury caused by repetitive stress to the foot. In previous years these were sometimes called march fractures because they were first seen in military recruits and still do occur in that group. They are more common in certain athletic events such as running, basketball, etc.

Risk Factors

These factors increase your chance of a march stress fracture. Tell your doctor if you have any of these risk factors:
  • Participation in high impact sports
    • Running
    • Basketball
    • Dancing
  • Soldiers
  • Feet with high arches
  • Poor footwear
  • Osteoporosis
  • Female runners with amenorrhea (absent menstruation), osteoporosis, or an eating disorder

Symptoms

If you have any of these symptoms do not assume it is due to a march stress fracture. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
  • Pain
  • Swelling
  • Foot feels better when resting
  • Foot feels worse with activity
  • Redness

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist. An orthopedist focuses on bones. A sports medicine physician works on sport related injuries.
To search for a break in the bone the following tests may be done:
  • X-ray —test that uses radiation to take pictures of structures in the body
  • MRI scan —test that uses magnetic waves to form an image of structures in the body
  • CT scan —type of x-ray that uses computer to form an image of structures in the body

Treatment

Stress fractures are treated with rest and nonsteroidal antiinflammatory drugs (NSAIDs). You will need to rest your foot for 3-6 weeks. Your doctor may recommend crutches for a week or two so that you don’t put any weight on your foot. Sometimes a brace or cast is used for a short time to aid healing.
Once you are able to move without pain, your doctor will allow you to return to normal activities. Gradually increase your activity over several weeks.

Prevention

To help reduce your chance of a stress fracture, take the following steps:
  • Wear shock-absorbing insoles when running or during other high-impact exercise.
  • When starting a new sport or increasing your workout, do so gradually.
  • Choose footwear that takes into account the specific sport and your type of foot.

RESOURCES

American Academy of Orthopaedic Surgeons http://www.aaos.org

American Academy of Podiatric Sports Medicine http://www.aapsm.org

American Physical Therapy Association http://www.apta.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org/

Canadian Orthopaedic Foundation http://www.canorth.org/

References

Fractures, an overview. American Society of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00139&return%5Flink=0 . Accessed November 17, 2008.

March fracture. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed November 17, 2008.

Metatarsal stress fracture. Merck Manuel website. Available at: http://www.merck.com/mmpe/sec21/ch324/ch324m.html . Accessed November 17, 2008.

Metatarsal stress fractures. Sports injury website. Available at: http://www.sportsinjuryclinic.net/cybertherapist/front/foot/metatarsal.htm . Accessed November 17, 2008.

What is a stress fracture and how should it be treated? American Academy of Podiatric Sports Medicine website. Available at: http://www.aapsm.org/ct0398.html . Accessed November 17, 2008.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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