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After The Injury: Signs You Might Have A Hairline Fracture

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If you injure your foot, it is often easy to tell if you have a broken bone-- bruising, intense swelling, misshapen areas and the fact you heard a pop or a snap could all indicate a broken bone. If you have pain but did not hear a sound, you might assume it is a sprain. However, sometimes intense pain can also be caused by a hairline fracture in one of your bones. These fractures, also known as stress fractures, do not show up as visibly on x-rays, but they are actually tiny cracks in the bone and still need to be treated by a podiatrist. Here are some indications that you might have a stress fracture in your foot and what you can do about it.

Signs And Causes Of Stress Fractures

Broken bones occur because of extreme force that the bone is not able to withstand. Stress fractures, on the other hand, are often caused by overuse or repetitive action that is hard on the bone, but not forceful enough to cause a break. Over time, the area is weakened. Then, when you suddenly change activities, the new force can cause cracks. For example, if you ran long-distance every day, but then suddenly decided to play ultimate frisbee with friends three times a week, you could injure your foot when you jump and land after catching the frisbee. Other exercise changes, like suddenly jogging on cement instead of the shock absorbent indoor track, could also cause fractures.

Other signs or indications of stress fractures include:

  • pain that radiates from the the top center of the foot. The most susceptible areas to hairline fractures are the metatarsal bones of your second and third toes. They absorb a lot of impact when running and jumping. 
  • pain in the heel. The next common area for stress injury is the fibula and calcaneus. These bones make up the heel and ankle area of your foot. If you strike the ground with heel first, you will be more likely to have a hairline fracture in one of these bones instead. 
  • injury occurring with back-to-back exercise sessions. Overuse injuries like stress fractures can happen when you don't give your weight-bearing bones enough time to heal between workouts of repetitive motion. 
  • gradual onset of pain, instead of sudden, searing pain that indicate immediate injury. Hairline fractures often develop over time, so gradual, increasing intensity of pain is a sign that you are not dealing with a break or sprain. 
  • tenderness when the fractured area is touched.
  • reduction in the level of pain when the foot is resting, such as when you are sleeping or watching a movie. Conversely, broken bones will hurt even when they are at rest. 
  • increase in pain as you go about your daily activities. Pain might be minimal in the morning and increase over the course of the day. 
  • swelling and bruising that returns with exercise or with increased activity. Most stress fractures occur when you increase your activity level too quickly on a particular exercise. Therefore, foot pain with increased activity is a sign that you should have your foot examined. 


First, resting the injured area is essential to recovery. You should not continue to exercise until the stress fracture is healed. Your doctor will likely want you to wear a split style cast or supportive boot for a stress fracture even though the bones are not broken. The reason for the protective wear is to prevent the cracked bone from breaking. If you have a stress fracture, the bone is much more likely to break from outside or exaggerated force. 

In rare cases, you might need a cast or even surgery to fully recover from a stress fracture.