Stress fractures can occur in any bone of the foot, however the most common sites affected are the metatarsals (long bones connecting the toes), navicular (midfoot bone), calcaneus (heel bone). They can also occur at the talus, tibia and fibula which are the bones that form part of the ankle.
Females are more prone to stress fractures due to a number of factors including reduced bone mineral density, reduced muscle mass, and hormonal changes related to menstruation. Those who suffer from a combination of menstrual irregularity, decreased bone mineral density and low energy availability (from nutritional deficiencies or disordered eating), are significantly at risk of developing stress fractures. The interrelationship between these conditions is known as the Female Athlete Triad, and is relatively common in young females participating in sport.
Stress fractures can worsen without treatment, becoming more painful and debilitating. If left untreated, avascular necrosis (bone death) may occur, potentially leading to permanent changes to the bone and it’s joint surface. This can cause chronic pain, and increase the risk of developing arthritis in the area of injury. If sufficient healing fails to occur, surgery may be the only option for treatment.