The 2nd, 3rd and 4th metatarsals are usually susceptible because of their thin diaphyses. Symptoms, Signs and Diagnosis Patients usually present with forefoot pain, often during a long or intense workout, which disappears within seconds of stopping exercise. On successive exercising, the pain returns earlier than previously, ultimately becoming so severe that it may prohibit exercise and persist even with the patient lying in bed. Palpating the swollen area causes pain at the facture site. An x-ray usually is not sensitive enough to diagnose the fracture until a callus forms 2 to 3 wk after the injury.
Treatment includes stopping all sports that require running.
Women with recurrent stress fractures and oligomenorrhea or amenorrhea may need to be treated with calcium, estrogen and progesterone.