Stress fracture
in the foot.Symptoms, recovery time and treatment for a stress fracture in the foot, from the running physios who treat them every week.
Small bones.
Big load.
The foot takes two to three times your body weight with every running stride.
A foot stress fracture is a breakdown in one of its bones that builds over time, when running load outpaces the bone's ability to recover. Most are in the metatarsals, the long bones on top of the foot, but where yours is changes how it's treated and how long it takes.
New to bone stress injuries? Start with our stress fracture guide.
Find your spot.
Know your risk.
Where the pain sits is the best early clue to which bone is involved, and how carefully it needs managing.
Top of the forefoot
2nd to 4th metatarsalsThe most common foot stress fracture in runners. A sore spot on top of the foot, often with mild swelling, after a jump in mileage or speed work.
Outside edge of the midfoot
Base of the 5th metatarsalPain on the outer side of the foot, halfway along. Poor blood supply here means slower healing and a higher chance of needing a boot or surgical opinion.
Top and inside of the midfoot
NavicularVague, hard to pin down pain that can spread into the arch. Easy to miss and slow to heal. See our navicular stress fracture guide.
Heel, when you squeeze the sides
CalcaneusOften mistaken for plantar fasciitis. The giveaway is pain when you squeeze the heel from both sides.
Under the big toe joint
SesamoidsPain under the ball of the foot at the big toe, worse when pushing off. Slow to heal and prone to complications.
Signs of a
foot stress fracture.
Foot stress fractures usually build gradually. These are the signs we look for.
Pain that builds over days or weeks
No single moment you rolled or knocked it. It started as a niggle on runs and kept growing.
One tender spot on the bone
Pressing on the bone hurts in one place. With navicular injuries the pain can be more vague and spread into the arch.
Swelling on top of the foot
Mild puffiness over the sore area, sometimes with warmth. Shoes may feel tight across the top.
Pain walking, hopping or at night
Early on it only hurts when running. Later it aches walking, on stairs or at rest, and hopping on that foot is painful.
Stop running and get assessed this week if the pain is on the top and inside of the midfoot, the outer edge of the midfoot, or under the big toe joint. These can be high risk stress fractures (navicular, base of the 5th metatarsal, sesamoids). Running through them can lead to a complete fracture and a much longer recovery.
Not every sore foot
is a fracture.
Several common running injuries feel similar. A physio can usually tell them apart at the first appointment.
| Where it hurts | What gives it away | |
|---|---|---|
| Metatarsal stress fracture | Top of the forefoot, on one bone | Tender to press on the bone itself, worse with hopping, mild swelling on top |
| Plantar fasciitis | Under the heel, inside edge | Worst with the first steps in the morning, often eases once warmed up |
| Calcaneal stress fracture | The whole heel | Pain when you squeeze the heel from both sides, worse the longer you run |
| Morton's neuroma | Between the 3rd and 4th toes | Burning, tingling or numb toes, like a pebble in your shoe |
| Plantar plate tear | Under the ball of the foot, near the 2nd toe | Pain under the toe joint, and the toe may start to drift or lift |
| Extensor tendon pain | Top of the foot, along a tendon | Often from tight laces, eases with looser lacing, sore along a line rather than one spot |
How long
until I run?
The bone involved matters more than anything else. A 2023 review of 76 studies pooled the average time back to sport, how many athletes got back, and how often treatment ran into complications.
"Back to sport" means back to full training or competition, not your first run. Complications include slow healing, the bone not healing, the injury coming back, or needing surgery. Low grade stress reactions caught early are often quicker than these averages. The review grouped the 1st to 4th metatarsals together.
Source: Hoenig T, et al. Return to sport following low risk and high risk bone stress injuries: a systematic review and meta analysis. Br J Sports Med 2023;57:427 to 432. doi:10.1136/bjsports-2022-106328
Heal it.
Then fix why.
Diagnose the bone and the grade
History, a hands on exam, hop testing and, where needed, a referral for MRI, X ray or CT. Knowing the exact bone and grade sets your timeline.
Offload the foot
Low risk metatarsal injuries often settle with less running and a stiffer shoe. Navicular, 5th metatarsal and sesamoid injuries may need a CAM boot or crutches first, sometimes with a surgical opinion.
Keep you fit and strong
Cycling, swimming or deep water running where it's pain free, plus calf, foot and hip strength so the foot is better protected when you return.
Find the cause
Training load, footwear, running mechanics on our Zebris instrumented treadmill, strength testing, and energy and hormonal health, with referrals to our sports doctors and nutritionists where needed.
Return to running, properly
A structured walk and run program once walking and hopping are pain free, building over weeks to months. Speed work, tempo and hills come back last.
Book your
assessment.
No GP referral needed. We refer for MRI when it's needed. Private health insurance accepted at all Australian clinics.
Questions
answered.
Can you walk on a stress fracture in your foot?
Often, yes, with a low risk metatarsal stress fracture, as long as walking is pain free. Some injuries need a boot or crutches for a period. High risk sites like the navicular, 5th metatarsal or sesamoids should be assessed before you keep walking on them.
What does a stress fracture in the foot feel like?
Usually a sore spot on top of the foot that builds over days or weeks, tender when you press on the bone, sometimes with mild swelling. It hurts more the further you run, and later when walking or at night.
How do I know if it's a stress fracture or a sprain?
A sprain follows a clear moment, like rolling your ankle, and the pain is around the joint. A stress fracture builds gradually with no single injury, and the pain sits on the bone itself.
Do I need a moon boot for a foot stress fracture?
Not always. Many metatarsal stress fractures are managed with less running and a stiffer shoe. A CAM (moon) boot is more likely for navicular, 5th metatarsal and sesamoid injuries, higher grade injuries, or when walking is painful.
Will a foot stress fracture show on an X ray?
Often not in the first two to three weeks. MRI is the gold standard because it shows bone stress before a fracture line appears and lets us grade the injury. We can refer you for imaging.
Can I keep running with a foot stress fracture?
No. Running on it can turn a stress reaction into a full fracture and add weeks or months to your recovery. Cross training keeps your fitness while the bone heals.
Back on your feet.
Back running.
The sooner a foot stress fracture is diagnosed, the sooner you're running again. Book a running physio assessment at your nearest clinic.
This page is general information and isn't a substitute for an individual assessment. If you can't put weight through your foot or have sudden severe pain, seek medical care promptly.