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How to Tell If You Have a Stress Fracture In the Foot by San Francisco Running Podiatrist

Stress fractures in the foot are one of the most common overtraining injuries among marathon runners that I see as a sports medicine podiatrist in San Francisco.  Of all the overuse injuries, a stress fracture in the foot is probably the most likely to force a runner or triathlete to stop training and lose fitness.  The reason for this is that stress fractures typically get worse and may even turn onto a completely broken bone if not treated. 

Most runners are aware that an aching throbbing foot could be a stress fracture that will get worse if you keep running.  But there are simple ways you can tell if you might have a stress fracture yourself.  The first thing is to check to see if you have had any of the main signs and symptoms of metatarsal stress fractures.

Signs of Metatarsal Stress Fractures:

Aching foot pain, throbbing pain in the foot, bruising on the top or side of the foot, or swelling in the foot (one foot that swells by the end of the day) are all hallmarks of a stress fracture that podiatrists look for to diagnose a stress fracture.  If you stopped running, but still have a sore foot while walking, this could be a sign of a stress fracture. Pain in the foot that gets worse when running, or aching or throbbing pain in the foot later in the day after your run also can suggest a stress fracture.  If you notice that you are limping by the end of a run this could also suggest a stress fracture. 

All of these signs could suggest a bunch of different injuries, but with a little self diagnosis you might be able to tell what’s going on.

Self-diagnosis of Stress Fractures in the Foot:

The easiest way to tell if you might have a metatarsal stress fracture in the foot is to simply press on the specific metatarsal bones without pressing on other structures that might be causing the pain such as tendons and ligaments.  This article will help you understand how to check your foot to see if it is probable that you have a stress fracture.

 

When we look at this illustration of the foot, you can see the metatarsal bones are numbered one through five.  You will want to push on the end of the metatarsal bones one at a time right where you see the numbers on the bones. 

If you bend the toes downward (called plantarflexion by foot doctors) the ends of the metatarsal bones will poke up through the skin making them easy to identify.  Now press on each one where it protrudes upward looking like a marble under the skin at the base of each toe. 

In the VIDEO LINK we show you how to press on the first metatarsal, second metatarsal, third metatarsal, fourth metatarsal, and fifth metatarsal.  This is one way you can see if it is likely you developed a stress fracture in your foot from running.   

If you have a stress fracture in your foot and you attempt to “bend” that bone (when you push down on the metatarsal head, it will hurt a lot.  You will likely feel sudden, sharp pain when pushing on the bone that has the stress fracture. 

If most of the pain is on the top of the foot it is more likely that you have a stress fracture of the second, third or fourth metatarsal bones.  Podiatrists refer to these as the “central metatarsals” because they are in the middle of the foot.  The second seems to develop stress fractures more that the third or fourth just because it is longer and often takes more abuse when you run.

If you have pain and bruising on the outside of the foot, you may have a fifth metatarsal stress fracture.  When trying to determine if you have a stress fracture of the fifth metatarsal bone, your sports medicine podiatrist will push on the end of the bone (called the metatarsal head), the shaft of the bone and the base of the metatarsal bone. If you have pain when you press on the hard knot of bone about halfway along the outside of your foot, this could be a sign of a Jones fracture.  That is a particular type of stress fracture that sends a lot of runners to the operating room for surgery.

 

Stress fractures can turn into a completely cracked bone or broken foot if not treated correctly.  It is unlikely that you will set a new marathon PR in cast, so its important to get the right treatment as fast as possible. 

If you think you might have a stress fracture, make sure you see a podiatrist who specializes in running injuries who will treat the problem right away.  If you choose a doctor who actually runs, you will have the best chances of getting the best stress fracture treatment.  

With early treatment from a running injury expert, you may still be able to run your race, just don’t put it off.  See a stress fracture expert today. 

Dr. Christopher Segler is an award winning foot doctor practicing podiatry in San Francisco.  He makes house calls all over the Bay Area to help busy athletes who don't want to waste time going to see a foot doctor.  If you have had a history of stress fractures, he can make custom running orthotics for you that will not only decrease your risk of a stress fracture, but are also guaranteed to make you run faster.   If you have a sore foot and think you might have a stress fracture, you can have San Francisco's sports medicine podiatrist come right to you!  If you just have a question about stress fractures from running, you can call him directly at 415-308-0833