A stress fracture in the foot usually takes 6 to 8 WEEKS to heal. Getting back to full running takes longer than that, because the return has to be built up gradually over several more weeks.
The most common place is the second or third metatarsal, the long bones in the middle of the foot. The pain builds over days or weeks, gets worse when you walk or run, and eases with rest. Often one spot on the top of the foot is very tender to press, with some swelling.
One exception matters.
A fracture near the base of the fifth metatarsal, on the outside of the foot, called a Jones fracture, heals SLOWLY because the blood supply there is poor. It needs stricter treatment, and sometimes surgery.
What a stress fracture is
A stress fracture is a tiny crack in a bone.
It doesn’t come from one big injury. It builds up when a bone takes repeated load faster than it can repair itself.
- A sudden jump in training: more miles, more days, faster runs or a new sport, all at once. This is the most common cause
- A change of surface or shoes: moving to harder ground, or running in worn-out shoes with little cushioning left
- Not eating enough for the exercise you do: bones need fuel to repair. If you train hard without eating enough to cover it, bone repair slows. In women, periods that become irregular or stop are a sign this may be happening, and it’s worth raising with your doctor
- Bone health: low vitamin D, or thinner bones (osteoporosis), make stress fractures more likely
- Foot shape: a stiff big toe, a bunion or a high arch can shift extra load onto the smaller metatarsals
If the pain under the ball of the foot is an ache without one tender spot on the bone, see metatarsalgia.
If it burns or tingles between the toes, see Morton’s neuroma. If the heel bone broke in a fall or a hard landing, see calcaneus fracture recovery.
Symptoms
- Pain that builds: it starts as an ache near the end of a run, then comes on earlier, then with ordinary walking
- One tender spot: pressing on the bone itself hurts in one place
- Swelling on the top of the foot, sometimes with a little bruising
- Better with rest: and worse again the next time you load it
X-rays often look normal in the first few weeks, because the crack is too fine to see until the bone starts to heal. An MRI can show it earlier. A normal first X-ray doesn’t rule a stress fracture out.
Treatment
- Offload it: a walking boot or a stiff-soled shoe for most metatarsal stress fractures. Crutches for a while if walking in the boot still hurts
- Stop the activity that caused it: running, jumping and long walks are out while the bone heals
- Keep fit without impact: cycling, swimming, pool running and upper-body work are usually fine if they’re pain-free
- Fix the cause: look honestly at the training jump, your shoes, how much you eat and your bone health. If nothing changes, the next stress fracture is waiting
- Pain relief: acetaminophen (paracetamol) is a simple option. Some doctors prefer you avoid regular anti-inflammatory tablets while a bone heals, so ask yours
The crack heals in weeks. Whatever caused it can bring it back in months.
Return to running: a typical timeline
Your doctor or physio may give you a different plan. Use theirs.
- Weeks 0 to 6: boot or stiff shoe, no running, low-impact exercise only
- Weeks 6 to 8: out of the boot once walking is pain-free and the bone is no longer tender to press
- Before your first run: a common test is walking briskly for 30 minutes and hopping about 15 times on the injured foot, both without pain
- The first runs: walk-run sessions on flat, even ground, starting with mostly walking and short bursts of running, such as 30 seconds of running in every 5 minutes
- Over about 4 weeks: the running bursts get longer and the walking shorter, until you can run 30 minutes without stopping
- After that: add no more than a little each week. Pain during a run, or the next day, means drop back to the last level that felt fine
The Jones fracture: a special case
- Where it is: the outside of the foot, near the base of the fifth metatarsal (the long bone that leads to the little toe), just past the bony bump you can feel there
- Why it’s different: this part of the bone has a poor blood supply, so it heals slowly and sometimes doesn’t join at all
- Treatment without surgery: a cast or boot with NO weight on the foot for at least 6 weeks, often longer
- Surgery: athletes, and people whose fracture hasn’t healed, are often offered a screw inside the bone, which tends to heal more reliably
- Return to sport: around 12 weeks at the earliest
- Not the same as an ankle-roll fracture: a small piece pulled off the tip of that bump when you roll your ankle is a different injury that usually heals well in a boot or stiff shoe. See ankle sprain recovery
The American Academy of Orthopaedic Surgeons has a clear overview of stress fractures of the foot and ankle.
Get seen today if
- You can’t put weight on the foot at all
- The pain started suddenly with a crack or snap, rather than building up
- The foot is red, hot and swollen, or you have a fever
- You have diabetes and the foot is suddenly warm, swollen or changing shape, even if it doesn’t hurt much. It can be a rare but serious bone problem called Charcot foot
Get it checked if
- Pain is on the outside of the foot near the base of the little toe bone, especially if you play sport
- This is your second stress fracture, or you’ve had them in different bones. It’s worth checking bone health, vitamin D and whether you’re eating enough for your training
- Your periods have become irregular or stopped while training hard
- Pain is no better after 6 weeks in a boot, or it comes back every time you restart running
- The middle of the foot hurts after a twist, with bruising under the arch. It could be a Lisfranc injury
The bone heals in weeks. A slower build-up is what keeps it healed.