- Stress fractures are relatively common in the foot and may affect all bones, classically the metatarsals or navicular. Caused by excessive weight bearing activity or a recent increase in activity / change in training conditions.
- Patients typically complain of poorly localised, worse on activity, relieved by rest.
- Examination may reveal localised swelling with pain on direct palpation.
- MRI is the investigation of choice after a failure of conservative management.
Conservative measures include
- Avoid activities that exacerbate symptoms.
- Patient education.
- Protective boot for up to 6 weeks.
- OTC orthotics if flat footed.
- Excercise to improve strength, balance and core stability.
- Gradual return to activity.
- Diagnostic uncertainty.
- Failure of conservative measures after a minimum of 6 weeks.