Signs of a stress fracture in the foot Signs of a stress fracture in the Foot Stress fracture Unlike a typical fracture where there is a clear break in the bone, a stress fracture is progressively developed from repetitively exerting the accustomed level of impact on a bone. For a variety of reasons the bone is unable to adapt to the mechanical load, and cannot heal between activities. Historically noted for over 100 years in military recruits caused from marching, it has now become increasingly common in the non-military population. This is believed to coincide with the increase in levels of high impact sport and exercise people participate in. Professional athletes who run or jump are also at an increased risk of these injuries. Development: There are several factors involved in developing a stress fracture: Bone properties: Bone density, geometry and microarchitecture Mechanostat: The sensory system of bone detecting strain and activating an adaptive biological response Functional Stimuli: Mechanical, physiological, and pharmacological Constraints: Genetics, age, sex, nutrition In clinic I see stress fractures that seem to be mainly attributable to levels of activity such as long distance running, problematic gait mechanics and foot structures. Usually these factors are in addition to a sudden increase in levels of activity. It is also common to see them related to poor footwear, and insufficient bone density "“ such as having osteoporosis. Common areas of the foot: Heel: Some people heel strike when running but normally we all heel strike when walking. This is a repetitive function, and insuff