Causes and Risk Factors of Foot Stress Fractures

While anyone can sustain a foot stress fracture, there are certain activities and risk factors that increase the likelihood of the injury occurring.

Causes of Foot Stress Fractures

As the name suggests, foot stress fractures can occur from any activity that puts too much stress on a bone, such as a new workout routine. Other causes of foot stress fractures include:

• Sudden increase in activity. This increase can be in frequency, duration, or intensity of an activity. For example, an athlete training for a marathon may increase mileage too quickly, which can be hard on the feet.
• Change in surface. Going from a soft surface, such as an indoor running track or turf, to a hard surface, such as a sidewalk, can cause stress to the bones of the feet.
• Improper technique. Other foot conditions, such as blisters or bunions, may impact technique (the way the foot strikes the ground) when running or walking. People may avoid putting weight on a certain area of the foot and unintentionally cause undue stress to a particular bone.
• Improper footwear. Shoes that are ill-fitting, too flimsy, stiff, or worn can contribute to a stress fracture.

While sports are the most common cause of this injury, non-athletes may also experience them. For example, walking excessively on an uneven surface during a vacation may result in stress to the foot bones.

Risks Factors of Foot Stress Fractures

Certain factors increase the likelihood of developing a foot stress fracture.

• Participation in certain sports. Participation in high-impact sports, such as running, soccer, basketball, and dance increase the likelihood of sustaining a stress fracture in the foot.
• Bone insufficiency. Osteoporosis and low levels of vitamin D can decrease bone density and strength, which may result in the increased chance of experiencing a foot stress fracture.
• Female sex. Female athletes are at an increased risk of developing foot stress fractures.¹Chen YT, Tenforde AS, Fredericson M. Update on stress fractures in female athletes: epidemiology, treatment, and prevention. Curr Rev Musculoskelet Med. 2013;6(2):173–181. doi:10.1007/s12178-013-9167-x This may be due to a number of factors including, female biomechanics, nutrition, and hormone levels.²Astur DC, Zanatta F, Arliani GG, Moraes ER, Pochini Ade C, Ejnisman B. Stress fractures: definition, diagnosis and treatment. Rev Bras Ortop. 2015;51(1):3–10. Published 2015 Dec 30. doi:10.1016/j.rboe.2015.12.008 Additionally, female athletes with absent or irregular menstrual periods may be at an even higher risk of experiencing a foot stress fracture.
• Previous stress fracture. Having a previous foot stress fracture increases the chances of developing another in the same foot.

Read more about Stress Fracture Causes and Stress Fracture Risk Factors

Having one of these risk factors does not automatically result in a foot stress fracture. Athletes who fall into these categories should be aware of the risks and take proper precautions.