San Francisco Podiatry Video


Saturday, March 20, 2010

What Happens If I Keep Running on a Stress Fracture in the Foot - San Francisco Sports Medicine Podiatrist Explains

Stress fractures in the foot are one of the most common injuries in runners. Although runners often endure many different aches and pains while training for a marathon or half marathon, an ache in the foot that is a stress fracture is one pain that shouldn't be ignored. One of the questions I get from runners on a regular basis is "what happens if I keep running and it is stress fracture."

The short answer is that if you continue to run, the stress fracture will likely get worse and lead to a complete break in the bone.

I have seen this happen more than once. One runner was actually a triathlete. He had been rapidly increasing his milage while training for an olympic distance triathlon. He started to notice a vague aching sensation in foot one day during a run. The next day the foot was sore. By the end of that day at work it was throbbing. He took off a couple of days from running and rode his bike instead. He resumed running a couple of days later. Then he noticed the dull ache in his foot with every step during his run. When he took his shoe off he noticed some bruising of the foot as well. He kept running anyway.

When I finally saw him, he had been running on this painful, aching foot for about 5 weeks. The foot was swollen, tender and bruised. As soon as we took an x-ray of the foot, it was obvious that he had fractured the fifth metatarsal bone. He had to have foot surgery to repair the fractured bone and allow it to heal. Obviously, foot surgery is not a good start to any running or triathlon training season.

A stress fracture is a tiny (virtually invisible) crack in the bone. If you continue to apply stress to it (such as running) the tiny crack gets bigger. Continue running and the crack can lead to a complete break in the bone. Once the bone breaks, the ground essentially pushes the bone up out of the way. At that point the stress that was being applied to that bone get transfered to the bone next to it.

That is what has happened in this xray image. The pain from the 5th metatarsal stress fracture was ignored by the patient. Once the stress fracture turned into a completely broken bone, a stress fracture started to develop in the next bone over (the 4th metatarsal bone).

Generally a sore foot while running warrants attention from a sports medicine podiatrist. Particularly if you want to keep running. With early treatment, you can get it to calm down and avoid disaster. Make sure you find a podiatrist in your area who runs and understands runners. That will give you the best chance of making to the starting line and finish line of your next big race.

Dr. Christopher Segler is a Podiatrist in San Francisco. He is also an Ironman triathlete and marathon runner. He authored a chapter in the Handbook on Podiatric Sports Medicine. He has also won multiple awards from the American College of Foot and Ankle Surgeons for his research on diagnosing subtle foot fractures. He offers podiatry house call appointments for busy professionals and athletes who prefer the convenience of a house call at their home or office, instead of waiting half a day to go to the doctor. You can learn more about stress fractures in the foot at and Doc On Th


  1. Thank you for the info. It sounds pretty user friendly. I guess I’ll pick one up for fun. thank u

  2. I have a stress fracture in my foot, but i got it x-rayed and nothing was shown, i have been biking on my exercise bike instead of running at the moment for the last 3 weeks of the injury, i can still feel the injury is there, but first thing in the morning when it is at its best i was wondering if it would be ok if i did my run, shorter than my normal run may i add, only a thrid of what i normally do, would my foot be ok with doing this every other day or something, just till the pain completely goes away, i also wear support when exercising on it all the time now, for both feet just in case for extra support, i only use freeze stray and when siting down i place a bean bag under my foot. Please help! thanks.

  3. Hi,
    Typically, do fractures of the foot, (like in the case of the person above), do they need a paster cast? Did the man you mentioned above need a plaster cast?

    Thanks for the info.

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  5. You can run after fixation as you explained. As with any running program, however, I recommend that you progress slowly to running (or back to running). Listen to your body and allow sufficient time to get running the way you hope.

    metatarsal stress fracture